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Hu CY, Alcala CS, Lamadrid-Figueroa H, Tamayo-Ortiz M, Mercado-Garcia A, Rivera Rivera N, Just AC, Gennings C, Téllez-Rojo MM, Wright RO, Wright RJ, Carroll KN, Rosa MJ. Associations of prenatal exposure to phthalates and their mixture with lung function in Mexican children. JOURNAL OF HAZARDOUS MATERIALS 2024; 475:134863. [PMID: 38885590 PMCID: PMC11250751 DOI: 10.1016/j.jhazmat.2024.134863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
Early life phthalates exposure has been associated with adverse respiratory outcomes. However, evidence linking prenatal phthalates exposure and childhood lung function has been inconclusive. Additionally, few studies have examined phthalates exposure as a mixture and explored sexually dimorphic associations. We aimed to investigate sex-specific associations of prenatal phthalates mixtures with childhood lung function using the PROGRESS cohort in Mexico (N = 476). Prenatal phthalate concentrations were measured in maternal urine collected during the 2nd and 3rd trimesters. Children's lung function was evaluated at ages 8-13 years. Individual associations were assessed using multivariable linear regression, and mixture associations were modeled using repeated holdout WQS regression and hierarchical BKMR; data was stratified by sex to explore sex-specific associations. We identified significant interactions between 2nd trimester phthalates mixture and sex on FEV1 and FVC z-scores. Higher 2nd trimester phthalate concentrations were associated with higher FEV1 (β = 0.054, 95 %CI: 0.005, 0.104) and FVC z-scores (β = 0.074, 95 % CI: 0.024, 0.124) in females and with lower measures in males (FEV1, β = -0.017, 95 %CI: -0.066, 0.026; FVC, β = -0.014, 95 %CI: -0.065, 0.030). This study indicates that prenatal exposure to phthalates is related to childhood lung function in a sex-specific manner.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Cecilia S Alcala
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Hector Lamadrid-Figueroa
- Department of Perinatal Health, Center for Population Health Research, National Institute of Public Health (INSP), Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Marcela Tamayo-Ortiz
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Adriana Mercado-Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Nadya Rivera Rivera
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Allan C Just
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, USA
| | - Chris Gennings
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Martha María Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA
| | - Maria José Rosa
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
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Xiang Y, Wang Y, Deng Y, Wang T, Chen J, He M. Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02085-9. [PMID: 38969801 DOI: 10.1007/s00420-024-02085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods. METHODS A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted. RESULTS The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (β=-3.19, 95%CI: -6.07, -0.30) and adolescents (β=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (β=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (β=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses. CONCLUSIONS Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.
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Affiliation(s)
- Yuting Xiang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Yuting Wang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Ye Deng
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Tianyun Wang
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Jiamei Chen
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Miao He
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention, Ministry of Education, China Medical University, Shenyang, 110122, China.
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Sun BZ, Gaffin JM. Recent Insights into the Environmental Determinants of Childhood Asthma. Curr Allergy Asthma Rep 2024; 24:253-260. [PMID: 38498229 DOI: 10.1007/s11882-024-01140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE OF REVIEW Ubiquitous environmental exposures, including ambient air pollutants, are linked to the development and severity of childhood asthma. Advances in our understanding of these links have increasingly led to clinical interventions to reduce asthma morbidity. RECENT FINDINGS We review recent work untangling the complex relationship between air pollutants, including particulate matter, nitrogen dioxide, and ozone and asthma, such as vulnerable windows of pediatric exposure and their interaction with other factors influencing asthma development and severity. These have led to interventions to reduce air pollutant levels in children's homes and schools. We also highlight emerging environmental exposures increasingly associated with childhood asthma. Growing evidence supports the present threat of climate change to children with asthma. Environmental factors play a large role in the pathogenesis and persistence of pediatric asthma; in turn, this poses an opportunity to intervene to change the course of disease early in life.
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Affiliation(s)
- Bob Z Sun
- Division of Pulmonary Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, BCH 3121, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, BCH 3121, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
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Amiri S, Li YC, Buchwald D, Pandey G. Machine learning-driven identification of air toxic combinations associated with asthma symptoms among elementary school children in Spokane, Washington, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 921:171102. [PMID: 38387571 PMCID: PMC10939716 DOI: 10.1016/j.scitotenv.2024.171102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Air toxics are atmospheric pollutants with hazardous effects on health and the environment. Although methodological constraints have limited the number of air toxics assessed for associations with health and disease, advances in machine learning (ML) enable the assessment of a much larger set of environmental exposures. We used ML methods to conduct a retrospective study to identify combinations of 109 air toxics associated with asthma symptoms among 269 elementary school students in Spokane, Washington. Data on the frequency of asthma symptoms for these children were obtained from Spokane Public Schools. Their exposure to air toxics was estimated by using the Environmental Protection Agency's Air Toxics Screening Assessment and National Air Toxics Assessment. We defined three exposure periods: the most recent year (2019), the last three years (2017-2019), and the last five years (2014-2019). We analyzed the data using the ML-based Data-driven ExposurE Profile (DEEP) extraction method. DEEP identified 25 air toxic combinations associated with asthma symptoms in at least one exposure period. Three combinations (1,1,1-trichloroethane, 2-nitropropane, and 2,4,6-trichlorophenol) were significantly associated with asthma symptoms in all three exposure periods. Four air toxics (1,1,1-trichloroethane, 1,1,2,2-tetrachloroethane, BIS (2-ethylhexyl) phthalate (DEHP), and 2,4-dinitrophenol) were associated only in combination with other toxics, and would not have been identified by traditional statistical methods. The application of DEEP also identified a vulnerable subpopulation of children who were exposed to 13 of the 25 significant combinations in at least one exposure period. On average, these children experienced the largest number of asthma symptoms in our sample. By providing evidence on air toxic combinations associated with childhood asthma, our findings may contribute to the regulation of these toxics to improve children's respiratory health.
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Affiliation(s)
- Solmaz Amiri
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA.
| | - Yan-Chak Li
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA
| | - Gaurav Pandey
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Yu Y, Wang JQ. Phthalate exposure and lung disease: the epidemiological evidences, plausible mechanism and advocacy of interventions. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:37-45. [PMID: 36151703 DOI: 10.1515/reveh-2022-0077] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Phthalates are a kind of synthetic plasticizers, which extensively used as plastic productions to improve their plasticity and flexibility. However, exposure to phthalates has been proved an increased risk of respiratory disease, because by they affect the development and functions of the lung and immune system. Here, we attempt to review respiratory health of phthalate exposure. Firstly, we describe the relationship between phthalates and lung function and airway inflammation. Then, the role of phthalates in asthma, lung cancer, rhinitis, and respiratory tract infections and the possible mechanisms of action are discussed. Finally, possible effective measures to reduce exposure to phthalates are proposed, and health care workers are called upon to provide educational resources and advocate for informed public health policies. Overall, the evidence for association between phthalate exposure and respiratory disease is weak and inconsistent. Therefore, thorough implementation in large populations is needed to produce more consistent and robust results and to enhance the overall understanding of the potential respiratory health risks of phthalate in long-term exposure.
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Affiliation(s)
- Yun Yu
- The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Jian Qing Wang
- The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- School of Pharmacy, Anhui Medical University, Hefei, Anhui, China
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6
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Day DB, LeWinn KZ, Karr CJ, Loftus CT, Carroll KN, Bush NR, Zhao Q, Barrett ES, Swan SH, Nguyen RHN, Trasande L, Moore PE, Adams Ako A, Ji N, Liu C, Szpiro AA, Sathyanarayana S. Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium. ENVIRONMENT INTERNATIONAL 2024; 185:108486. [PMID: 38367551 PMCID: PMC10961192 DOI: 10.1016/j.envint.2024.108486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
A multimorbidity-focused approach may reflect common etiologic mechanisms and lead to better targeting of etiologic agents for broadly impactful public health interventions. Our aim was to identify clusters of chronic obesity-related, neurodevelopmental, and respiratory outcomes in children, and to examine associations between cluster membership and widely prevalent chemical exposures to demonstrate our epidemiologic approach. Early to middle childhood outcome data collected 2011-2022 for 1092 children were harmonized across the ECHO-PATHWAYS consortium of 3 prospective pregnancy cohorts in six U.S. cities. 15 outcomes included age 4-9 BMI, cognitive and behavioral assessment scores, speech problems, and learning disabilities, asthma, wheeze, and rhinitis. To form generalizable clusters across study sites, we performed k-means clustering on scaled residuals of each variable regressed on study site. Outcomes and demographic variables were summarized between resulting clusters. Logistic weighted quantile sum regressions with permutation test p-values associated odds of cluster membership with a mixture of 15 prenatal urinary phthalate metabolites in full-sample and sex-stratified models. Three clusters emerged, including a healthier Cluster 1 (n = 734) with low morbidity across outcomes; Cluster 2 (n = 192) with low IQ and higher levels of all outcomes, especially 0.4-1.8-standard deviation higher mean neurobehavioral outcomes; and Cluster 3 (n = 179) with the highest asthma (92 %), wheeze (53 %), and rhinitis (57 %) frequencies. We observed a significant positive, male-specific stratified association (odds ratio = 1.6; p = 0.01) between a phthalate mixture with high weights for MEP and MHPP and odds of membership in Cluster 3 versus Cluster 1. These results identified subpopulations of children with co-occurring elevated levels of BMI, neurodevelopmental, and respiratory outcomes that may reflect shared etiologic pathways. The observed association between phthalates and respiratory outcome cluster membership could inform policy efforts towards children with respiratory disease. Similar cluster-based epidemiology may identify environmental factors that impact multi-outcome prevalence and efficiently direct public policy efforts.
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Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA.
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- Department of Preventive Medicine, Division of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | - Ako Adams Ako
- Department of Pediatrics, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA
| | - Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Chang Liu
- Department of Psychology, Washington State University, Johnson Tower, Pullman, WA 99164, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Seattle, WA 98195, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA; Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
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7
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Baker BH, Melough MM, Paquette AG, Barrett ES, Day DB, Kannan K, Hn Nguyen R, Bush NR, LeWinn KZ, Carroll KN, Swan SH, Zhao Q, Sathyanarayana S. Ultra-processed and fast food consumption, exposure to phthalates during pregnancy, and socioeconomic disparities in phthalate exposures. ENVIRONMENT INTERNATIONAL 2024; 183:108427. [PMID: 38194756 PMCID: PMC10834835 DOI: 10.1016/j.envint.2024.108427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Consuming ultra-processed foods may increase exposure to phthalates, a group of endocrine disruptors prevalent in food contact materials. OBJECTIVES Investigate associations between ultra-processed food intake and urinary phthalates during pregnancy, and evaluate whether ultra-processed foods mediate socioeconomic disparities in phthalate exposures. METHODS In a socioeconomically diverse sample of 1031 pregnant women from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study in the urban South, the Block Food Frequency Questionnaire was administered and urinary phthalate metabolites were measured in the second trimester. Linear regressions modeled associations between phthalates and overall ultra-processed food consumption, individual ultra-processed foods, and exploratory factor analysis dietary patterns. Causal mediation analyses examined whether ultra-processed food intake mediates relationships between socioeconomic disparities and phthalate exposures. RESULTS Ultra-processed foods constituted 9.8-59.0 % (mean = 38.6 %) of participants' diets. 10 % higher dietary proportion of ultra-processed foods was associated with 13.1 % (95 %CI: 3.4 %-22.9 %) higher molar sum concentrations of di(2-ethylhexyl) phthalate metabolites (ΣDEHP). 10 % higher consumption of minimally-processed foods was associated with lower ΣDEHP (10.8 %: 3.4 %-22.9 %). Ultra- and minimally-processed food consumption were not associated with non-DEHP metabolites. Standard deviation higher consumptions of hamburger/cheeseburger, French fries, soda, and cake were associated with 10.5 % (4.2 %-17.1 %), 9.2 % (2.6 %-16.2 %), 7.4 % (1.4 %-13.6 %), and 6.0 % (0.0 %-12.4 %), respectively, higher ΣDEHP. Exploratory factor analysis corroborated positive associations of processed food with ΣDEHP, and uncovered a healthy dietary pattern associated with lower urinary ΣDEHP, mono(2-ethyl-5-hydroxyhexyl) (MEHHP), mono(2-ethyl-5-carboxypentyl) (MECPP), mono(2-carboxymethylhexyl) (MCMHP), and mono-isononyl (MINP) phthalates. Significant indirect effects indicated that lower income and education levels were associated with 1.9 % (0.2 %-4.2 %) and 1.4 % (0.1 %-3.3 %) higher ΣDEHP, respectively, mediated via increased ultra-processed food consumption. CONCLUSIONS Consumption of ultra-processed foods may increase exposure to phthalates. Policies to reduce dietary phthalate exposures from food packaging and processing are needed, as socioeconomic barriers can preclude dietary recommendations as a sole means to reduce phthalate exposures.
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Affiliation(s)
- Brennan H Baker
- University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA.
| | | | - Alison G Paquette
- University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
| | | | - Drew B Day
- University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
| | | | | | - Nicole R Bush
- University of California San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- University of California San Francisco, San Francisco, CA, USA
| | | | - Shanna H Swan
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
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8
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Barrett ES, Day DB, Szpiro A, Peng J, Loftus CT, Ziausyte U, Kannan K, Trasande L, Zhao Q, Nguyen RHN, Swan S, Karr CJ, LeWinn KZ, Sathyanarayana S, Bush NR. Prenatal exposures to phthalates and life events stressors in relation to child behavior at age 4-6: A combined cohort analysis. ENVIRONMENT INTERNATIONAL 2024; 183:108425. [PMID: 38199129 PMCID: PMC10863744 DOI: 10.1016/j.envint.2024.108425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
Prenatal exposures to chemical and psychosocial stressors can impact the developing brain, but few studies have examined their joint effects. We examined associations between prenatal phthalate exposures and child behavior, hypothesizing that prenatal stressful life events (PSLEs) may exacerbate risks. To do so, we harmonized data from three U.S. pregnancy cohorts comprising the ECHO-PATHWAYS consortium. Phthalate metabolites were measured in single mid-pregnancy urine samples. When children were ages 4-6 years, mothers completed the Child Behavior Checklist (CBCL), from which a Total Problems score was calculated. Mothers additionally provided recall on their exposure to 14 PSLEs during pregnancy. Primary models examined problem behaviors in relation to: (1) phthalate mixtures calculated through weighted quantile sums regression with permutation test-derived p-values; and (2) joint exposure to phthalate mixtures and PSLEs (counts) using interaction terms. We subsequently refitted models stratified by child sex. Secondarily, we fit linear and logistic regression models examining individual phthalate metabolites. In our main, fully adjusted models (n = 1536 mother-child dyads), we observed some evidence of weak main effects of phthalate mixtures on problem behaviors in the full cohort and stratified by child sex. Interaction models revealed unexpected relationships whereby greater gestational exposure to PSLEs predicted reduced associations between some phthalates (e.g., the metabolites of di-2-ethylhexyl phthalate, di-n-octyl phthalate, di-iso-nonyl phthalate) and problem behaviors, particularly in males. Few associations were observed in females. Additional research is needed to replicate results and examine potential mechanisms.
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Affiliation(s)
- Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA.
| | - Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - James Peng
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Christine T Loftus
- Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA
| | - Ugne Ziausyte
- Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | | | - Leonardo Trasande
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Shanna Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Catherine J Karr
- Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA; Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
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9
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Goyal SP, Saravanan C. An insight into the critical role of gut microbiota in triggering the phthalate-induced toxicity and its mitigation using probiotics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166889. [PMID: 37683852 DOI: 10.1016/j.scitotenv.2023.166889] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Exposure to phthalates, a major food safety concern, has been implicated in various chronic human disorders. As dietary exposure serves as a primary exposure route for phthalate exposure, understanding the detrimental impact on the gastrointestinal tract and resident gut microbiota is indispensable for better managing public health risks. Various reports have explored the intricate interplay between phthalate exposure, gut microbiota dysbiosis and host pathophysiology. For instance, oral exposure of dibutyl phthalate (DBP) or di-(2-ethylhexyl) phthalate (DEHP) affected the Firmicutes/Bacteroidetes ratio and abundance of Akkermansia and Prevotella, ensuing impaired lipid metabolism and reproductive toxicity. In some cases, DEHP exposure altered the levels of gut microbial metabolites, namely short-chain fatty acids, branched-chain amino acids or p-cresol, resulting in cholesterol imbalance or neurodevelopmental disorders. Conversely, supplementation of gut-modulating probiotics like Lactococcus or Lactobacillus sp. averted the phthalate-induced hepatic or testicular toxicity through host gene regulation, gut microbial modulation or elimination of DEHP or DBP in faeces. Overall, the current review revealed the critical role of the gut microbiota in initiating or exacerbating phthalate-induced toxicity, which could be averted or mitigated by probiotics supplementation. Future studies should focus on identifying high-efficiency probiotic strains that could help reduce the exposure of phthalates in animals and humans.
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Affiliation(s)
- Shivani Popli Goyal
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Sonipat, Haryana 131028, India
| | - Chakkaravarthi Saravanan
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Sonipat, Haryana 131028, India.
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10
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Jackson-Browne MS, Patti MA, Henderson NB, Hauptman M, Phipatanakul W. Asthma and Environmental Exposures to Phenols, Polycyclic Aromatic Hydrocarbons, and Phthalates in Children. Curr Environ Health Rep 2023; 10:469-477. [PMID: 37973722 PMCID: PMC10877704 DOI: 10.1007/s40572-023-00417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Medina S Jackson-Browne
- Division of General Pediatrics, Boston Children's Hospital, Member of the Faculty, Harvard Medical School, 300 Longwood Avenue, LM 7605.1, Boston, MA, 02115, USA.
- Harvard Medical School, Harvard University, Boston, MA, USA.
| | - Marisa A Patti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Noelle B Henderson
- Department of Environmental Health, Boston University School of Public Health, Boston University, Boston, MA, USA
| | - Marissa Hauptman
- Division of General Pediatrics, Boston Children's Hospital, Member of the Faculty, Harvard Medical School, 300 Longwood Avenue, LM 7605.1, Boston, MA, 02115, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- New England Pediatric Environmental Health Specialty Unit, Boston, MA, USA
| | - Wanda Phipatanakul
- Harvard Medical School, Harvard University, Boston, MA, USA
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
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11
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Lei F, Wu Y, Li C, Yan B, Chen S, Peng Q, Yang X, Ma P. Mediation of endoplasmic reticulum stress and NF-κB signaling pathway in DINP-exacerbated allergic asthma: A toxicological study with Balb/c mice. JOURNAL OF HAZARDOUS MATERIALS 2023; 460:132392. [PMID: 37657325 DOI: 10.1016/j.jhazmat.2023.132392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023]
Abstract
Epidemiological evidence indicates a significant relationship between exposure to diisononyl phthalate and allergic asthma. Despite this, the mechanism underlying this association remains unclear. Previous toxicological researches have suggested that the development of allergic asthma may involve the activation of endoplasmic reticulum stress (ERS) and the nuclear factor κ-B (NF-κB) pathways. Nevertheless, it is currently unknown whether these specific signaling pathways are implicated in diisononyl phthalate (DINP)-induced allergic asthma. The objective of this research was to understand how DINP exacerbates allergic asthma in Balb/c mice through ERS and NF-κB pathways. To systematically examine the aggravated effects of DINP in Balb/c mice, we measured airway hyperresponsiveness (AHR), lung tissue pathology, cytokines, and ERS and NF-κB pathway biomarkers. Additionally, we applied the ERS antagonist phenylbutyric acid (4-PBA) or the NF-κB antagonist pyrrolidine dithiocarbamate (PDTC) to verify the mediating effects of ERS and NF-κB on DINP-exacerbated allergic asthma. The results of our experiment show that oral DINP exposure may exacerbate airway hyperresponsiveness and airway remodeling. This deterioration is accompanied by an imbalance in immunoglobulin levels, Th17/Treg cells, ERS, and NF-κB biomarkers, leading to the activation of pro-inflammatory pathways. Furthermore, our study found that the blocking effect of 4-PBA or PDTC can inhibit the Th17/Treg imbalance and effectively alleviate symptoms resembling allergic asthma. In conclusion, ERS and NF-κB signaling pathways play an important role in regulating DINP-induced allergic asthma exacerbations.
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Affiliation(s)
- Fan Lei
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China; Department of Pharmacy, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Yang Wu
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Chongyao Li
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Biao Yan
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Shaohui Chen
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Qi Peng
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Xu Yang
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China
| | - Ping Ma
- Key Laboratory of Environmental Related Diseases and One Health, Xianning Medical College, Hubei University of Science and Technology, Xianning 437100, China; Hubei Industrial Technology Research Institute of Intelligent Health, Xianning 437100, China.
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12
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Duh TH, Yang CJ, Lee CH, Ko YC. A Study of the Relationship between Phthalate Exposure and the Occurrence of Adult Asthma in Taiwan. Molecules 2023; 28:5230. [PMID: 37446892 DOI: 10.3390/molecules28135230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Although phthalate esters contribute to airway remodeling by increasing bronchial cells' migration and proliferation, the relationship between human exposure to phthalates and asthma is not understood. We measured phthalate exposure in the human body and evaluated its effect on asthma. Asthma (n = 123) and asthma-free (n = 139) participants were, respectively, recruited from an asthma clinic and the community in Taiwan. The urine levels of six phthalate metabolites were determined by liquid chromatography tandem mass spectrometry. Compared with the controls, male asthma patients had higher means of mono-(2-ethylhexyl) phthalate (MEHP) (116.3 nmol/g), monobutyl phthalate (MBP) (850.3 nmol/g) and monoethyl phthalate (MEP) (965.8 nmol/g), and female patients had greater MBP (2902.4 nmol/g). Each 10-fold increase in the level of these phthalate metabolites was correspondingly associated with a 5.0-, 5.8-, 4.2- and 5.3-fold risk of contracting asthma. Male asthma patients were identified to have a higher proportion of MEHP exposure (32.5%) than the controls (25.3%). In asthma patients, an increase in urine MEHP levels and the total phthalate metabolite concentration were notably linked to increased risks of emergency room visits and being hospitalized. For the occurrence and acute clinical events of adult asthma, phthalate exposures and MEHP retention may contribute to higher risks of contracting this respiratory disorder.
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Affiliation(s)
- Tsai-Hui Duh
- Department of Medicinal and Applied Chemistry, College of Life Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Jen Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chien-Hung Lee
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ying-Chin Ko
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
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13
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Dearborn LC, Hazlehurst MF, Loftus CT, Szpiro AA, Carroll KN, Moore PE, Adgent MA, Barrett ES, Nguyen RHN, Sathyanarayana S, LeWinn KZ, Bush NR, Kaufman JD, Karr CJ. Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy. Epidemiology 2023; 34:554-564. [PMID: 37042935 PMCID: PMC10563986 DOI: 10.1097/ede.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/12/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Infants experiencing bronchiolitis are at increased risk for asthma, but few studies have identified modifiable risk factors. We assessed whether early life air pollution influenced child asthma and wheeze at age 4-6 years among children with a history of bronchiolitis in the first postnatal year. METHODS Children with caregiver-reported physician-diagnosed bronchiolitis were drawn from ECHO-PATHWAYS, a pooled longitudinal cohort from six US cities. We estimated their air pollution exposure from age 1 to 3 years from validated spatiotemporal models of fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ). Caregivers reported children's current wheeze and asthma at age 4-6 years. We used modified Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for child, maternal, and home environmental factors. We assessed effect modification by child sex and maternal history of asthma with interaction models. RESULTS A total of 224 children had caregiver-reported bronchiolitis. Median (interquartile range) 2-year pollutant concentrations were 9.3 (7.8-9.9) µg/m 3 PM 2.5 , 8.5 (6.4-9.9) ppb NO 2 , and 26.6 (25.6-27.7) ppb O 3 . RRs (CI) for current wheeze per 2-ppb higher O 3 were 1.3 (1.0-1.7) and 1.4 (1.1-1.8) for asthma. NO 2 was inversely associated with wheeze and asthma whereas associations with PM 2.5 were null. We observed interactions between NO 2 and PM 2.5 and maternal history of asthma, with lower risks observed among children with a maternal history of asthma. CONCLUSION Our results are consistent with the hypothesis that exposure to modest postnatal O 3 concentrations increases the risk of asthma and wheeze among the vulnerable subpopulation of infants experiencing bronchiolitis.
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Affiliation(s)
- Logan C Dearborn
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Marnie F Hazlehurst
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Christine T Loftus
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - Kecia N Carroll
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ruby HN Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Sheela Sathyanarayana
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Nicole R Bush
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Joel D Kaufman
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
- Department of Medicine, School of Medicine, University of Washington; Seattle, WA
| | - Catherine J Karr
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
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14
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Coiffier O, Lyon-Caen S, Boudier A, Quentin J, Gioria Y, Pin I, Bayat S, Thomsen C, Sakhi AK, Sabaredzovic A, Slama R, Philippat C, Siroux V. Prenatal exposure to synthetic phenols and phthalates and child respiratory health from 2 to 36 months of life. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 330:121794. [PMID: 37178953 DOI: 10.1016/j.envpol.2023.121794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/21/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
Exposure to phthalates and synthetic phenols is ubiquitous. Some of them are suspected to impact child respiratory health, although evidence still remains insufficient. This study investigated the associations between prenatal exposure to phthalates and phenols, individually and as a mixture, and child respiratory health assessed by objective lung function measures since 2 months of age. Among 479 mother-child pairs from the SEPAGES cohort, 12 phenols, 13 phthalate and 2 non-phthalate plasticizer metabolites were measured in 2 pools including each 21 urine samples collected at the 2nd and 3rd pregnancy trimesters. Lung function was measured at 2 months using tidal breathing flow-volume loops and nitrogen multiple-breath washout, and at 3 years using oscillometry. Asthma, wheezing, bronchitis and bronchiolitis were assessed by repeated questionnaires. A cluster-based analysis was applied to identify exposure patterns to phenols and phthalates. Adjusted associations between clusters as well as each individual exposure biomarker and child respiratory health were estimated by regression models. We identified four prenatal exposure patterns: 1) low concentrations of all biomarkers (reference, n = 106), 2) low phenols-moderate phthalates (n = 162), 3) high concentrations of all biomarkers except bisphenol S (n = 109), 4) high parabens-moderate other phenols-low phthalates (n = 102). At 2 months, cluster 2 infants had lower functional residual capacity and tidal volume and higher ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) and cluster 3 had lower lung clearance index and higher tPTEF/tE. Clusters were not associated with respiratory health at 3 years but in the single-pollutant models, parabens were associated with increased area of the reactance curve, bronchitis (methyl, ethyl parabens) and bronchiolitis (propyl paraben). Our results suggested that prenatal exposure to mixtures of phthalates reduced lung volume in early life. Single exposure analyses suggested associations of parabens with impaired lung function and increased risk of respiratory diseases.
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Affiliation(s)
- Ophélie Coiffier
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
| | - Anne Boudier
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France; Pediatric Department, Grenoble University Hospital, 38700, La Tronche, France
| | - Joane Quentin
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
| | - Yoann Gioria
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
| | - Isabelle Pin
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France; Pediatric Department, Grenoble University Hospital, 38700, La Tronche, France
| | - Sam Bayat
- Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
| | | | | | | | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France.
| | - Valérie Siroux
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), 38000, Grenoble, France
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15
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Wang JQ, Liang CM, Hu YB, Xia X, Li ZJ, Gao H, Sheng J, Huang K, Wang SF, Zhu P, Hao JH, Tao FB. The effect of phthalates exposure during pregnancy on asthma in infants aged 0 to 36 months: a birth cohort study. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:1951-1974. [PMID: 35751763 DOI: 10.1007/s10653-022-01320-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
This cohort study sought to investigate the effects of phthalates exposure during pregnancy on offspring asthma and its association with placental stress and inflammatory factor mRNA expression levels. A total of 3474 pregnant women from the China Ma'anshan birth cohort participated in this study. Seven phthalate metabolites were detected in urine samples during pregnancy by solid phase extraction-high-performance liquid chromatography tandem mass spectrometry. Placenta stress and inflammation mRNA expression were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). Early pregnancy may be the critical period when phthalates exposure increases the risk of asthma in infants and young children, and there is a certain gender difference in the risk of asthma in infants and young children. Moreover, through the placenta stress and inflammatory factor associated with infant asthma found anti-inflammatory factor of interleukin-10 (IL-10) mRNA expression will reduce the risk of 36-month-old male infant asthma. The expression of interleukin-4(IL-4) and macrophage (M2) biomarker cluster of differentiation 206(CD206) mRNA reduced the risk of asthma in 18-month-old female infants. Placental stress and inflammatory response were analyzed using mediating effects. Tumor necrosis factor-α (TNFα) showed a complete mediating effect between mono-benzyl phthalate (MBzP) exposure in early pregnancy and asthma in 12-month-old males, and IL-10 also showed a complete mediating effect between mono-n-butyl phthalate (MBP) exposure in early and late pregnancy and asthma in 36-month-old males. In summary, exposure to phthalates during pregnancy may contribute to the development of asthma in infants, which may be associated with placental stress and inflammation.
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Affiliation(s)
- Jian-Qing Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Chun-Mei Liang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ya-Bin Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xun Xia
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Pediatrics, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Zhi-Juan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hui Gao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Pediatrics, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jie Sheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Su-Fang Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jia-Hu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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16
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Herrin MA, Sherris AR, Dearborn LC, Loftus CT, Szpiro AA, Moore PE, Adgent MA, Barrett ES, Nguyen RHN, Carroll KN, Karr CJ. Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1166174. [PMID: 38045485 PMCID: PMC10691794 DOI: 10.3389/fepid.2023.1166174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Asthma is a leading cause of childhood morbidity in the U.S. and a significant public health concern. The prenatal period is a critical window during which environmental influences, including maternal occupational exposures, can shape child respiratory health. Cleaning chemicals are commonly encountered in occupational settings, yet few studies have examined the potential link between prenatal occupational exposures to cleaning chemicals and risk of childhood wheeze and asthma. Methods We evaluated the potential influence of maternal occupational exposure to cleaning chemicals during pregnancy on pediatric asthma and wheeze at child age 4-6 years in 453 mother-child pairs from two longitudinal pregnancy cohorts, TIDES and GAPPS, part of the ECHO prenatal and early childhood pathways to health (ECHO-PATHWAYS) consortium. Maternal occupational exposure to cleaning chemicals was defined based on reported occupation and frequency of occupational use of chemicals during pregnancy. Child current wheeze and asthma outcomes were defined by parental responses to a widely-used, standardized respiratory outcomes questionnaire administered at child age 4-6 years. Multivariable Poisson regression with robust standard errors was used to estimate relative risk (RR) of asthma in models adjusted for confounding. Effect modification by child sex was assessed using product interaction terms. Results Overall, 116 mothers (25.6%) reported occupational exposure to cleaning chemicals during pregnancy, 11.7% of children had current wheeze, and 10.2% had current asthma. We did not identify associations between prenatal exposure to cleaning chemicals and current wheeze [RRadjusted 1.03, 95% confidence interval (CI): 0.56, 1.90] or current asthma (RRadjusted 0.89, CI: 0.46, 1.74) in the overall sample. Analyses of effect modification suggested an adverse association among females for current wheeze (RR 1.82, CI: 0.76, 4.37), compared to males (RR 0.68, CI: 0.29, 1.58), though the interaction p-value was >0.05. Conclusion We did not observe evidence of associations between maternal prenatal occupational exposure to cleaning chemicals and childhood wheeze or asthma in the multi-site ECHO-PATHWAYS consortium. We leveraged longitudinal U.S. pregnancy cohorts with rich data characterization to expand on limited and mixed literature. Ongoing research is needed to more precisely characterize maternal occupational chemical exposures and impacts on child health in larger studies.
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Affiliation(s)
- Melissa A Herrin
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| | - Paul E Moore
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
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17
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Liang HW, Snyder N, Wang J, Xun X, Yin Q, LeWinn K, Carroll KN, Bush NR, Kannan K, Barrett ES, Mitchell RT, Tylavsky F, Adibi JJ. A study on the association of placental and maternal urinary phthalate metabolites. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:264-272. [PMID: 36114292 PMCID: PMC10101560 DOI: 10.1038/s41370-022-00478-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Phthalate exposure in pregnancy is typically estimated using maternal urinary phthalate metabolite levels. Our aim was to evaluate the association of urinary and placental tissue phthalates, and to explore the role of maternal and pregnancy characteristics that may bias estimates. METHODS Fifty pregnancies were selected from the CANDLE Study, recruited from 2006 to 2011 in Tennessee. Linear models were used to estimate associations of urinary phthalates (2nd, 3rd trimesters) and placental tissue phthalates (birth). Potential confounders and modifiers were evaluated in categories: temporality (time between urine and placenta sample), fetal sex, demographics, social advantage, reproductive history, medication use, nutrition and adiposity. Molar and quantile normalized phthalates were calculated to facilitate comparison of placental and urinary levels. RESULTS Metabolites detectable in >80% of both urine and placental samples were MEP, MnBP, MBzP, MECPP, MEOHP, MEHHP, and MEHP. MEP was most abundant in urine (geometric mean [GM] 7.00 ×102 nmol/l) and in placental tissue (GM 2.56 ×104 nmol/l). MEHP was the least abundant in urine (GM 5.32 ×101 nmol/l) and second most abundant in placental tissue (2.04 ×104 nmol/l). In aggregate, MEHP differed the most between urine and placenta (2.21 log units), and MEHHP differed the least (0.07 log units). MECPP was positively associated between urine and placenta (regression coefficient: 0.31 95% CI 0.09, 0.53). Other urine-placenta metabolite associations were modified by measures of social advantage, reproductive history, medication use, and adiposity. CONCLUSION Phthalates were ubiquitous in 50 full-term placental samples, as has already been shown in maternal urine. MEP and MEHP were the most abundant. Measurement and comparison of urinary and placental phthalates can advance knowledge on phthalate toxicity in pregnancy and provide insight into the validity and accuracy of relying on maternal urinary concentrations to estimate placental exposures. IMPACT STATEMENT This is the first report of correlations/associations of urinary and placental tissue phthalates in human pregnancy. Epidemiologists have relied exclusively on maternal urinary phthalate metabolite concentrations to assess exposures in pregnant women and risk to their fetuses. Even though it has not yet been confirmed empirically, it is widely assumed that urinary concentrations are strongly and positively correlated with placental and fetal levels. Our data suggest that may not be the case, and these associations may vary by phthalate metabolite and associations may be modified by measures of social advantage, reproductive history, medication use, and adiposity.
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Affiliation(s)
- Hai-Wei Liang
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Nathaniel Snyder
- Center for Metabolic Disease Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Jiebiao Wang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Xiaoshuang Xun
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Qing Yin
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Kaja LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Kecia N Carroll
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Kurunthachalam Kannan
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, Scotland, UK
| | - Fran Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jennifer J Adibi
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
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18
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Wright RJ. Advancing Exposomic Research in Prenatal Respiratory Disease Programming. Immunol Allergy Clin North Am 2023; 43:43-52. [PMID: 36411007 DOI: 10.1016/j.iac.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Disease programming reflects interactions between genes and the environment. Unlike the genome, environmental exposures and our response to exposures change over time. Starting in utero, the respiratory system and related processes develop sequentially in a carefully timed cascade, thus effects depend on both exposure dose and timing. A multitude of environmental and microbial exposures influence respiratory disease programming. Effects result from toxin-induced shifts in a host of molecular, cellular, and physiologic states and their interacting systems. Moreover, pregnant women and the developing child are not exposed to a single toxin, but to complex mixtures.
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Affiliation(s)
- Rosalind J Wright
- Department of Environmental Medicine and Public Health, New York, NY, USA; Institute for Exposomic Research, New York, NY, USA.
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19
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Loftus CT, Szpiro AA, Workman T, Wallace ER, Hazlehurst MF, Day DB, Ni Y, Carroll KN, Adgent MA, Moore PE, Barrett ES, Nguyen RHN, Kannan K, Robinson M, Masterson EE, Tylavsky FA, Bush NR, LeWinn KZ, Sathyanarayana S, Karr CJ. Maternal exposure to urinary polycyclic aromatic hydrocarbons (PAH) in pregnancy and childhood asthma in a pooled multi-cohort study. ENVIRONMENT INTERNATIONAL 2022; 170:107494. [PMID: 36279735 PMCID: PMC9810359 DOI: 10.1016/j.envint.2022.107494] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Prenatal exposure to polycyclic aromatic hydrocarbons (PAH) may increase risk of pediatric asthma, but existing human studies are limited. OBJECTIVES We estimated associations between gestational PAHs and pediatric asthma in a diverse US sample and evaluated effect modification by child sex, maternal asthma, and prenatal vitamin D status. METHODS We pooled two prospective pregnancy cohorts in the ECHO PATHWAYS Consortium, CANDLE and TIDES, for an analytic sample of N = 1296 mother-child dyads. Mono-hydroxylated PAH metabolites (OH-PAHs) were measured in mid-pregnancy urine. Mothers completed the International Study on Allergies and Asthma in Childhood survey at child age 4-6 years. Poisson regression with robust standard errors was used to estimate relative risk of current wheeze, current asthma, ever asthma, and strict asthma associated with each metabolite, adjusted for potential confounders. We used interaction models to assess effect modification. We explored associations between OH-PAH mixtures and outcomes using logistic weighted quantile sum regression augmented by a permutation test to control Type 1 errors. RESULTS The sociodemographically diverse sample spanned five cities. Mean (SD) child age at assessment was 4.4 (0.4) years. While there was little evidence that either individual OH-PAHs or mixtures were associated with outcomes, we observed effect modification by child sex for most pairs of OH-PAHs and outcomes, with adverse associations specific to females. For example, a 2-fold increase in 2-hydroxy-phenanthrene was associated with current asthma in females but not males (RRfemale = 1.29 [95 % CI: 1.09, 1.52], RRmale = 0.95 [95 % CI: 0.79, 1.13]; pinteraction = 0.004). There was no consistent evidence of modification by vitamin D status or maternal asthma. DISCUSSION This analysis, the largest cohort study of gestational PAH exposure and childhood asthma to date, suggests adverse associations for females only. These preliminary findings are consistent with hypothesized endocrine disruption properties of PAHs, which may lead to sexually dimorphic effects.
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Affiliation(s)
- Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Adam A Szpiro
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kecia N Carroll
- Department of Pediatrics, Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret A Adgent
- Department of Pediatrics, College of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily S Barrett
- Department of Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, Department of Environmental Medicine, New York University School of Medicine, New York City, NY, USA
| | - Morgan Robinson
- Department of Pediatrics, Department of Environmental Medicine, New York University School of Medicine, New York City, NY, USA
| | - Erin E Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nicole R Bush
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Pediatrics, School of Medicine, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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20
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LeWinn KZ, Karr CJ, Hazlehurst M, Carroll K, Loftus C, Nguyen R, Barrett E, Swan SH, Szpiro AA, Paquette A, Moore P, Spalt E, Younglove L, Sullivan A, Colburn T, Byington N, Sims Taylor L, Moe S, Wang S, Cordeiro A, Mattias A, Powell J, Johnson T, Norona-Zhou A, Mason A, Bush NR, Sathyanarayana S. Cohort profile: the ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS). BMJ Open 2022; 12:e064288. [PMID: 36270755 PMCID: PMC9594508 DOI: 10.1136/bmjopen-2022-064288] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Exposures early in life, beginning in utero, have long-term impacts on mental and physical health. The ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS) was established to examine the independent and combined impact of pregnancy and childhood chemical exposures and psychosocial stressors on child neurodevelopment and airway health, as well as the placental mechanisms underlying these associations. PARTICIPANTS The ECHO-PATHWAYS consortium harmonises extant data from 2684 mother-child dyads in three pregnancy cohort studies (CANDLE [Conditions Affecting Neurocognitive Development and Learning in Early Childhood], TIDES [The Infant Development and Environment Study] and GAPPS [Global Alliance to Prevent Prematurity and Stillbirth]) and collects prospective data under a unified protocol. Study participants are socioeconomically diverse and include a large proportion of Black families (38% Black and 51% White), often under-represented in research. Children are currently 5-15 years old. New data collection includes multimodal assessments of primary outcomes (airway health and neurodevelopment) and exposures (air pollution, phthalates and psychosocial stress) as well as rich covariate characterisation. ECHO-PATHWAYS is compiling extant and new biospecimens in a central biorepository and generating the largest placental transcriptomics data set to date (N=1083). FINDINGS TO DATE Early analyses demonstrate adverse associations of prenatal exposure to air pollution, phthalates and maternal stress with early childhood airway outcomes and neurodevelopment. Placental transcriptomics work suggests that phthalate exposure alters placental gene expression, pointing to mechanistic pathways for the developmental toxicity of phthalates. We also observe associations between prenatal maternal stress and placental corticotropin releasing hormone, a marker of hormonal activation during pregnancy relevant for child health. Other publications describe novel methods for examining exposure mixtures and the development of a national spatiotemporal model of ambient outdoor air pollution. FUTURE PLANS The first wave of data from the unified protocol (child age 8-9) is nearly complete. Future work will leverage these data to examine the combined impact of early life social and chemical exposures on middle childhood health outcomes and underlying placental mechanisms.
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Affiliation(s)
- Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences and Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Marnie Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kecia Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christine Loftus
- Department of Environmental Health and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Ruby Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alison Paquette
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Paul Moore
- Division of Allergy, Immunology, and Pulmonology and the Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Spalt
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Lisa Younglove
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alexis Sullivan
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Trina Colburn
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Nora Byington
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Lauren Sims Taylor
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Stacey Moe
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
| | - Sarah Wang
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Alana Cordeiro
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Aria Mattias
- Department of Envrionmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Powell
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Tye Johnson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Amanda Norona-Zhou
- Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Alex Mason
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences and the Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health; Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
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21
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Wilson K, Gebretsadik T, Adgent MA, Loftus C, Karr C, Moore PE, Sathyanarayana S, Byington N, Barrett E, Bush N, Nguyen R, Hartman TJ, LeWinn KZ, Calvert A, Mason WA, Carroll KN. The association between duration of breastfeeding and childhood asthma outcomes. Ann Allergy Asthma Immunol 2022; 129:205-211. [PMID: 35552008 PMCID: PMC9442497 DOI: 10.1016/j.anai.2022.04.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Postnatal exposures, including breastfeeding, may influence asthma development. OBJECTIVE To investigate the association between breastfeeding duration and child asthma. METHODS We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma. RESULTS Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (Pinteractions 0.12-0.40). CONCLUSION Longer duration of exclusive breastfeeding had a protective association with child asthma.
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Affiliation(s)
- Keadrea Wilson
- Division of Neonatology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christine Loftus
- Departments of Environmental and Occupational Health Sciences and Pediatrics, University of Washington, Seattle, Washington
| | - Catherine Karr
- Seattle Children's Research Institute, Seattle, Washington
| | - Paul E Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sheela Sathyanarayana
- Departments of Environmental and Occupational Health Sciences and Pediatrics, University of Washington, Seattle, Washington
| | - Nora Byington
- Seattle Children's Research Institute, Seattle, Washington
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Rutgers University, Piscataway, New Jersey
| | - Nicole Bush
- Department of Pediatrics, University of California San Francisco, San Francisco, California; Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Ruby Nguyen
- Department of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Terry J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kaja Z LeWinn
- Weill Institute for Neurosciences, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Alexis Calvert
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
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22
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Liao J, Fang D, Liu Y, Xiong S, Wang X, Tian Y, Zhang H, An S, He C, Chen W, Liu X, Wu N, Tian K, Wang L, Zhang Y, Yuan H, Zhang L, Li Q, Shen X, Zhou Y. Exposure characteristics of phthalate metabolites among the Zunyi cohort of pregnant women in Southwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:58869-58880. [PMID: 35377124 DOI: 10.1007/s11356-022-19990-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/26/2022] [Indexed: 06/14/2023]
Abstract
Reported evidence has increasingly indicated that exposure to phthalates can cause adverse pregnancy outcomes. However, phthalate exposure levels among pregnant women remains unclear. We aimed to evaluate the concentrations and predictors of phthalate metabolites in urine samples of the ongoing Zunyi cohort of pregnant women from Southwest China. The urine samples were collected from 1003 pregnant women during their third trimester of pregnancy. The concentrations of nine phthalate metabolites in urine samples were then determined. Data on socio-demographic profiles of the participants, lifestyle during pregnancy, parity, and sampling season were collected using questionnaires. The detectable rate of phthalate metabolites ranged from 76 to 100%. On average, mono-butyl phthalate exhibited the highest median concentration (62.45 μg/L), while mono-benzyl phthalate exhibited the lowest median concentration (0.04 μg/L). Urine concentrations of phthalate metabolites were significantly higher in older, multiparous, higher body mass index, higher income, and passive smoking during pregnancy participants. The levels of low-molecular-weight phthalate metabolites were highest during the summer. The findings indicate the health of pregnant women and fetuses in Zunyi may be generally harmed by the high exposure of phthalate metabolites, especially by mono-n-butyl phthalate. In addition, phthalate metabolites present a demographic and seasonal differential distribution among the study population. Targeted measures to reduce phthalate exposure for high-risk pregnant women and during high-exposure seasons may have potential benefits for maternal and fetal health protection.
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Affiliation(s)
- Juan Liao
- Soochow University Medical College, Suzhou, 215000, Jiangsu, China
- Department of Obstetrics and Gynecology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Derong Fang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Yijun Liu
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Shimin Xiong
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Xia Wang
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Yingkuan Tian
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Haonan Zhang
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Songlin An
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Caidie He
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Wei Chen
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Xiang Liu
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Nian Wu
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Kunming Tian
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Linglu Wang
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Ya Zhang
- Xishui County People's Hospital, Zunyi, 564600, Guizhou, China
| | - Hongyu Yuan
- Xishui County People's Hospital, Zunyi, 564600, Guizhou, China
| | - Li Zhang
- Meitan County People's Hospital, Zunyi, 564100, Guizhou, China
| | - Quan Li
- Department of Obstetrics and Gynecology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Xubo Shen
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China.
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23
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Wang L, Hu X, Xiang C. Does the timing of antibiotic exposure in pregnancy impact the risk of development of pediatric asthma?: A systematic review and meta-analysis. J Asthma 2022; 60:856-867. [PMID: 35849144 DOI: 10.1080/02770903.2022.2103709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Maternal exposure to antibiotics has been linked to the development of pediatric asthma. However, the impact of the timing of exposure is unclear. We aimed to explore if the risk of pediatric asthma varies with trimester-specific exposure to antibiotics through a systematic review and meta-analysis. METHODS PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched for studies reporting an association between trimester-specific maternal exposure to antibiotics and risk of asthma in the offspring. RESULTS Eleven studies were included. The total sample size of the included studies was 2,160,216. Meta-analysis revealed a statistically significant increased risk of asthma with first (RR: 1.13 95% CI: 1.10, 1.17 I2 = 59% p < 0.00001), second (RR: 1.14 95% CI: 1.07, 1.21 I2 = 92% p < 0.0001), and third (RR: 1.14 95% CI: 1.08, 1.20 I2=86% p < 0.00001) trimester exposure of antibiotics. The results were stable on sensitivity analysis. On subgroup analysis, we noted that the association for the first and second trimester was significant for studies on children >5 years but not for those on children <5 years of age. The certainty of evidence based on GRADE was low. CONCLUSION Our results indicate that antibiotics administered during any trimester of pregnancy lead to an increased risk of childhood asthma. The overall risk is small and could be due to confounding. Further studies rigorously adjusting for important confounding variables are needed for stronger evidence.
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Affiliation(s)
- Liping Wang
- Department of Pediatrics, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang, China
| | - Xiaomei Hu
- Department of Pediatrics, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang, China
| | - Caixia Xiang
- Department of Pediatrics, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang, China
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24
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Kuiper JR, O’Brien KM, Welch BM, Barrett ES, Nguyen RH, Sathyanarayana S, Milne GL, Swan SH, Ferguson KK, Buckley JP. Combining Urinary Biomarker Data From Studies With Different Measures of Urinary Dilution. Epidemiology 2022; 33:533-540. [PMID: 35473917 PMCID: PMC9585883 DOI: 10.1097/ede.0000000000001496] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Guidance is lacking for how to combine urinary biomarker data across studies that use different measures of urinary dilution, that is, creatinine or specific gravity. METHODS Among 741 pregnant participants from four sites of The Infant Development and Environment Study (TIDES) cohort, we assessed the relation of maternal urinary di-2-ethylhexyl phthalate (DEHP) concentrations with preterm birth. We compared scenarios in which all sites measured either urinary creatinine or specific gravity, or where measure of dilution differed by site. In addition to a scenario with no dilution adjustment, we applied and compared three dilution-adjustment approaches: a standard regression-based approach for creatinine, a standard approach for specific gravity (Boeniger method), and a more recently developed approach that has been applied to both (covariate-adjusted standardization method). For each scenario and dilution-adjustment method, we estimated the association between a doubling in the molar sum of DEHP (∑DEHP) and odds of preterm birth using logistic regression. RESULTS All dilution-adjustment approaches yielded comparable associations (odds ratio [OR]) that were larger in magnitude than when we did not perform dilution adjustment. A doubling of ∑DEHP was associated with 9% greater odds of preterm birth (OR = 1.09, 95% confidence interval [CI] = 0.91, 1.30) when applying no dilution-adjustment method, whereas dilution-adjusted point estimates were higher, and similar across all scenarios and methods: 1.13-1.20 (regression-based), 1.15-1.18 (Boeniger), and 1.14-1.21 (covariate-adjusted standardization). CONCLUSIONS In our applied example, we demonstrate that it is possible and straightforward to combine urinary biomarker data across studies when measures of dilution differ.
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Affiliation(s)
- Jordan R. Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Katie M. O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Barrett M. Welch
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, NJ
| | - Ruby H.N. Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, WA
| | - Ginger L. Milne
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN
| | - Shanna H. Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Effect Evaluation of Electronic Health PDCA Nursing in Treatment of Childhood Asthma with Artificial Intelligence. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:2005196. [PMID: 35388323 PMCID: PMC8979696 DOI: 10.1155/2022/2005196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 01/18/2023]
Abstract
Asthma in children has a long duration and is prone to recurring attacks. Children will feel chest tightness, shortness of breath, cough, and difficulty breathing when they are onset, which has a serious impact on their health. Clinical nursing is of great significance in the treatment of childhood asthma. At present, the electronic health PDCA nursing model is widely used in clinical nursing as a common and effective nursing method. Therefore, it is very important to evaluate the efficacy of the PDCA nursing model in the treatment of childhood asthma. With the development of artificial intelligence, artificial intelligence can be used to evaluate the effect of the PDCA nursing model in the treatment of childhood asthma. The BP network can effectively perform data training and discrimination, but its training efficiency is low, and it is easily affected by initial weights and thresholds. Aiming at this defect, this work uses the genetic simulated annealing (GSA) algorithm to improve it. In view of the problems that the genetic algorithm falls into local minimum and simulated annealing algorithm has a slow convergence speed, the improved genetic simulated annealing algorithm is used to optimize the BP neural network, and an improved genetic simulated annealing BP network (IGSA-BP) is proposed. The algorithm not only reduces the problem that the BP network has an influence on initial weight and threshold on the algorithm but also improves the population diversity and avoids falling into local optimum by improving the crossover and mutation probability formula and improving Metropolis criterion. The proposed method has more efficient performance.
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Preece AS, Knutz M, Lindh CH, Bornehag CG, Shu H. Prenatal phthalate exposure and early childhood wheeze in the SELMA study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:303-311. [PMID: 34475495 DOI: 10.1038/s41370-021-00382-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prenatal maternal phthalate exposure has been associated with wheeze and asthma in children, but results are inconclusive. Previous studies typically assessed exposure in late pregnancy, included only a small number of old phthalates, and assessed outcomes in children aged 5 years or older. OBJECTIVE We explored associations between 1st trimester prenatal maternal exposure to a wider range of phthalates and wheeze in early childhood. METHODS First trimester concentrations of 14 metabolites from 8 phthalates and one alternative plasticizer were quantified in first-morning void urine from 1148 mothers in the Swedish SELMA study. Associations between log-transformed metabolite concentrations and parental reported ever wheeze among 24-month-old children were investigated with logistic regression models adjusted for parental asthma/rhinitis, sex of child, maternal education, smoking, and creatinine. RESULTS Metabolites of replacement phthalates di-iso-decyl phthalate (DiDP) and di-2-propylheptyl phthalate (DPHP) were associated with increased risk for wheeze (aOR 1.47, 95% CI 1.08-2.01 and aOR 1.49, 95% CI 1.04-2.15, respectively). The associations with DiDP and DPHP were stronger among children whose parents did not have asthma or rhinitis. In this group, wheeze was also associated with metabolites of butyl-benzyl phthalate (BBzP) and di-iso-nonyl phthalate (DiNP). SIGNIFICANCE Maternal phthalate exposure during early pregnancy may be a risk factor for wheeze in early childhood, especially among children whose parents do not have asthma or rhinitis symptoms.
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Affiliation(s)
- Anna-Sofia Preece
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Malin Knutz
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Huan Shu
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.
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27
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Ketema RM, Ait Bamai Y, Miyashita C, Saito T, Kishi R, Ikeda-Araki A. Phthalates mixture on allergies and oxidative stress biomarkers among children: The Hokkaido study. ENVIRONMENT INTERNATIONAL 2022; 160:107083. [PMID: 35051840 DOI: 10.1016/j.envint.2022.107083] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exposure to individual phthalates and the mediation effect of oxidative stress in association with asthma and allergic symptoms have been studied previously. Little is known about the mixture effect of phthalates on health outcomes. Thus, we investigated the effect of a mixture of ten phthalate metabolites in association with wheeze, rhino-conjunctivitis, and eczema. The mediating effect of three oxidative stress biomarkers was also assessed. METHODS Levels of 10 phthalate metabolites and 3 oxidative stress biomarkers were measured in 386 urine samples from 7-year-old children. Parents reported demographic and allergic symptoms using ISAAC questionnaires. Logistic regression for individual metabolites and mixture analysis weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) were fitted to examine the association between phthalate metabolite exposure and health outcomes. Baron and Kenny's regression approach was used for mediation analysis. RESULTS In logistic regression model showed mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) (OR = 1.41, 95% CI 1.02-1.97) and mono carboxy-isononyl phthalate (cx-MINP) (OR = 1.40, 95% CI 1.07-1.86) were associated with wheeze. The WQS index had a significant association (OR = 1.46, 95% CI 1.09-1.96) with wheeze and (OR = 1.40, 95% CI 1.07-1.82) with eczema. Mono-isononyl phthalate (MINP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) were the most highly weighted metabolites. In the BKMR model, diisononyl phthalate (DINP) metabolites showed the highest group posterior inclusion probability (PIP). Among DINP metabolites, MINP in wheeze, cx-MINP in rhino-conjunctivitis and OH-MINP in eczema showed the highest conditional PIPs. The overall metabolites mixture effect was associated with eczema. We did not find any mediation of oxidative stress in the association between phthalates and symptoms. No significant association between phthalate metabolites and oxidative stress was observed in this study. CONCLUSION Mixture of phthalate metabolites were associated with wheeze and eczema. The main contributors to the association were DEHP and DINP metabolites. No mediation of oxidative stress was observed.
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Affiliation(s)
- Rahel Mesfin Ketema
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan; Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takeshi Saito
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Atsuko Ikeda-Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan; Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
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28
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Su Y, Santucci-Pereira J, Dang NM, Kanefsky J, Rahulkannan V, Hillegass M, Joshi S, Gurdogan H, Chen Z, Bessonneau V, Rudel R, Ser-Dolansky J, Schneider SS, Russo J. Effects of Pubertal Exposure to Butyl Benzyl Phthalate, Perfluorooctanoic Acid, and Zeranol on Mammary Gland Development and Tumorigenesis in Rats. Int J Mol Sci 2022; 23:ijms23031398. [PMID: 35163327 PMCID: PMC8835802 DOI: 10.3390/ijms23031398] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/18/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Endocrine-disrupting chemicals (EDCs)—including butyl benzyl phthalate (BBP), perfluorooctanoic acid (PFOA), and zeranol (α-ZAL, referred to as ZAL hereafter)—can interfere with the endocrine system and produce adverse effects. It remains unclear whether pubertal exposure to low doses of BBP, PFOA, and ZAL has an impact on breast development and tumorigenesis. We exposed female Sprague Dawley rats to BBP, PFOA, or ZAL through gavage for 21 days, starting on day 21, and analyzed their endocrine organs, serum hormones, mammary glands, and transcriptomic profiles of the mammary glands at days 50 and 100. We also conducted a tumorigenesis study for rats treated with PFOA and ZAL using a 7,12-dimethylbenz[a]anthracene (DMBA) model. Our results demonstrated that pubertal exposure to BBP, PFOA, and ZAL affected endocrine organs and serum hormones, and induced phenotypic and transcriptomic changes. The exposure to PFOA + ZAL induced the most phenotypic and transcriptomic changes in the mammary gland. PFOA + ZAL downregulated the expression of genes related to development at day 50, whereas it upregulated genes associated with tumorigenesis at day 100. PFOA + ZAL exposure also decreased rat mammary tumor latency, reduced the overall survival of rats after DMBA challenge, and affected the histopathology of mammary tumors. Therefore, our study suggests that exposure to low doses of EDCs during the pubertal period could induce changes in the endocrine system and mammary gland development in rats. The inhibition of mammary gland development by PFOA + ZAL might increase the risk of developing mammary tumors through activation of signaling pathways associated with tumorigenesis.
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Affiliation(s)
- Yanrong Su
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
- Correspondence:
| | - Julia Santucci-Pereira
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Nhi M. Dang
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Joice Kanefsky
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Vishnuprabha Rahulkannan
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Meardey Hillegass
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Shalina Joshi
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Hafsa Gurdogan
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Zhen Chen
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
| | - Vincent Bessonneau
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA 02460, USA; (V.B.); (R.R.)
| | - Ruthann Rudel
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA 02460, USA; (V.B.); (R.R.)
| | - Jennifer Ser-Dolansky
- Pioneer Valley Life Sciences Institute, UMASS Chan Medical School-Baystate, Springfield, MA 01199, USA; (J.S.-D.); (S.S.S.)
| | - Sallie S. Schneider
- Pioneer Valley Life Sciences Institute, UMASS Chan Medical School-Baystate, Springfield, MA 01199, USA; (J.S.-D.); (S.S.S.)
| | - Jose Russo
- The Irma H Russo, MD-Breast Cancer Research Laboratory, Fox Chase Cancer Center-Temple Health, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (J.S.-P.); (N.M.D.); (J.K.); (V.R.); (M.H.); (S.J.); (H.G.); (Z.C.); (J.R.)
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29
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Liu M, Zhao L, Liu L, Guo W, Yang H, Chen S, Yu J, Li M, Fang Q, Lai X, Yang L, Zhu R, Zhang X. Urinary phthalate metabolites mixture, serum cytokines and renal function in children: A panel study. JOURNAL OF HAZARDOUS MATERIALS 2022; 422:126963. [PMID: 34449333 DOI: 10.1016/j.jhazmat.2021.126963] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 05/26/2023]
Abstract
Epidemiological evidence regarded the relations of phthalates with children's renal function and its underlying mechanism were largely unknown. We conducted a panel study using 287 paired urine-blood samples by repeated measurements of 103 children (4-13 years) across 3 seasons to explore effects of urinary phthalate metabolites on estimated glomerular filtration rate (eGFR) and the potential role of multiple cytokines. We found that mono-ethyl phthalate (MEP), monobutyl phthalate (MBP), mono-benzyl phthalate (MBzP) and mono-n-octyl phthalate (MOP) were significantly associated with eGFR reduction. Compared with the lowest quartile, MBP, MBzP and MEP in the third and fourth quartiles exhibited a graded decrease in eGFR. Meanwhile, weighted quantile sum regression analyses showed an inverse association of metabolites mixture with eGFR, to which MEP, MBzP, MOP were the major contributors. MEP also remained robust in multiple-phthalate model. Age and weight status might modify such relationships with significant interactions. Furthermore, eGFR related phthalate metabolites were associated with increased multiple cytokines, and CCL27, CXCL1 might be potential mediators between MEP and eGFR with mild mediated proportions. Accordingly, urinary phthalate metabolites were related to eGFR reduction in dose-response manner and multiple cytokines elevation, of which CCL27 and CXCL1 might partly mediate phthalate-associated decreased renal function among children.
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Affiliation(s)
- Miao Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Zhao
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Linlin Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenting Guo
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huihua Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuang Chen
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Yu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meng Li
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Fang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of medical affairs, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rui Zhu
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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30
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Geng M, Tang Y, Liu K, Huang K, Yan S, Ding P, Zhang J, Wang B, Wang S, Li S, Wu X, Cao Y, Tao F. Prenatal low-dose antibiotic exposure and children allergic diseases at 4 years of age: A prospective birth cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 225:112736. [PMID: 34481356 DOI: 10.1016/j.ecoenv.2021.112736] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Based on a medical record or questionnaire survey approach, previous epidemiological studies have investigated associations between maternal antibiotic exposure during pregnancy and childhood allergic diseases. However, biomonitoring studies on the prenatal low-dose antibiotic exposure, mainly from the environment and contaminated food, and in relation to children allergic diseases, are missing. OBJECTIVES This research aimed to examine the associations between prenatal low-dose antibiotic exposure measured at multiple time points and children current allergic diseases at 4 years of age. METHODS The current study including 2453 mother-child pairs was based on the Ma'anshan Birth Cohort study. Selected 41 antibiotics and their two metabolites, which including human antibiotics (HAs), preferred as human antibiotics (PHAs), veterinary antibiotics (VAs) and preferred as veterinary antibiotics (PVAs), in urine samples from 2453 pregnant women were biomonitored through liquid chromatography-triple quadrupole tandem mass spectrometry. Information on children current allergic diseases were collected via validated questionnaires. Generalized estimating equation were used to explore the associations between the repeated measurements of maternal urinary antibiotic over three trimesters and current allergic diseases in children. RESULTS The detection rates of nine individual antibiotics in the three trimester during pregnancy are greater than 10%, and the 90th percentile concentration of the detected antibiotics ranges from 0.07 to 22.34 µg/g, and the 95th percentile concentration ranges from 0.17 to 59.57 µg/g. Among the participants, each one-unit concentration increment of sulfamethazine (adjusted OR=1.28, 95% CI: 1.10, 1.49, P-FDR=0.014) in the first trimester and ciprofloxacin (adjusted OR=1.17, 95% CI: 1.07, 1.28, P-FDR=0.008) in the second trimester were associated with an increased risk of current eczema in children. In the third trimester, each one-unit concentration increment of oxytetracycline (adjusted OR=1.90, 95% CI: 1.30, 2.78, P-FDR=0.014) was associated with an increased risk of current asthma in children. Gender-stratified analyses demonstrated that no gender differences were observed in the associations between prenatal antibiotic exposure and current allergic diseases in children. CONCLUSIONS Maternal exposure to certain specific VAs or PVAs (sulfamethazine, ciprofloxacin and oxytetracycline) in different trimesters was associated with an increased risk of current asthma and current eczema in 4-year-old children. No gender differences were found in these associations. Further studies are warranted to confirm our findings and explore the potential mechanisms.
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Affiliation(s)
- Menglong Geng
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ying Tang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuangqin Yan
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Ma'anshan Maternal and Child Healthcare (MCH) Center, Ma'anshan 243011, China
| | - Peng Ding
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jingjing Zhang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Baolin Wang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Sheng Wang
- The Center for Scientific Research of Anhui Medical University, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shulong Li
- The Center for Scientific Research of Anhui Medical University, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yunxia Cao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei 230032, Anhui, China; Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China.
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China.
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Li YC, Hsu HHL, Chun Y, Chiu PH, Arditi Z, Claudio L, Pandey G, Bunyavanich S. Machine learning-driven identification of early-life air toxic combinations associated with childhood asthma outcomes. J Clin Invest 2021; 131:152088. [PMID: 34609967 DOI: 10.1172/jci152088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/23/2021] [Indexed: 01/19/2023] Open
Abstract
Air pollution is a well-known contributor to asthma. Air toxics are hazardous air pollutants that cause or may cause serious health effects. Although individual air toxics have been associated with asthma, only a limited number of studies have specifically examined combinations of air toxics associated with the disease. We geocoded air toxic levels from the US National Air Toxics Assessment (NATA) to residential locations for participants of our AiRway in Asthma (ARIA) study. We then applied Data-driven ExposurE Profile extraction (DEEP), a machine learning-based method, to discover combinations of early-life air toxics associated with current use of daily asthma controller medication, lifetime emergency department visit for asthma, and lifetime overnight hospitalization for asthma. We discovered 20 multi-air toxic combinations and 18 single air toxics associated with at least 1 outcome. The multi-air toxic combinations included those containing acrylic acid, ethylidene dichloride, and hydroquinone, and they were significantly associated with asthma outcomes. Several air toxic members of the combinations would not have been identified by single air toxic analyses, supporting the use of machine learning-based methods designed to detect combinatorial effects. Our findings provide knowledge about air toxic combinations associated with childhood asthma.
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Affiliation(s)
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health.,Institute for Exposomic Research, and
| | | | | | - Zoe Arditi
- Department of Genetics and Genomic Sciences.,Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Luz Claudio
- Department of Environmental Medicine and Public Health.,Institute for Exposomic Research, and
| | - Gaurav Pandey
- Department of Genetics and Genomic Sciences.,Institute for Exposomic Research, and
| | - Supinda Bunyavanich
- Department of Genetics and Genomic Sciences.,Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Paquette AG, MacDonald J, Lapehn S, Bammler T, Kruger L, Day DB, Price ND, Loftus C, Kannan K, Marsit C, Mason WA, Bush NR, LeWinn KZ, Enquobahrie DA, Prasad B, Karr CJ, Sathyanarayana S. A Comprehensive Assessment of Associations between Prenatal Phthalate Exposure and the Placental Transcriptomic Landscape. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:97003. [PMID: 34478338 PMCID: PMC8415559 DOI: 10.1289/ehp8973] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Phthalates are commonly used endocrine-disrupting chemicals that are ubiquitous in the general population. Prenatal phthalate exposure may alter placental physiology and fetal development, leading to adverse perinatal and childhood health outcomes. OBJECTIVE We examined associations between prenatal phthalate exposure in the second and third trimesters and the placental transcriptome at birth, including genes and long noncoding RNAs (lncRNAs), to gain insight into potential mechanisms of action during fetal development. METHODS The ECHO PATHWAYs consortium quantified 21 urinary phthalate metabolites from 760 women enrolled in the CANDLE study (Shelby County, TN) using high-performance liquid chromatography-tandem mass spectrometry. Placental transcriptomic data were obtained using paired-end RNA sequencing. Linear models were fitted to estimate separate associations between maternal urinary phthalate metabolite concentration during the second and third trimester and placental gene expression at birth, adjusted for confounding variables. Genes were considered differentially expressed at a Benjamini-Hochberg false discovery rate (FDR) p<0.05. Associations between phthalate metabolites and biological pathways were identified using self-contained gene set testing and considered significantly altered with an FDR-adjusted p<0.2. RESULTS We observed significant associations between second-trimester phthalate metabolites mono (carboxyisooctyl) phthalate (MCIOP), mono-2-ethyl-5-carboxypentyl phthalate, and mono-2-ethyl-5-oxohexyl phthalate and 18 genes in total, including four lncRNAs. Specifically, placental expression of NEAT1 was associated with multiple phthalate metabolites. Third-trimester MCIOP and mono-isobutyl phthalate concentrations were significantly associated with placental expression of 18 genes and two genes, respectively. Expression of genes within 27 biological pathways was associated with mono-methyl phthalate, MCIOP, and monoethyl phthalate concentrations. DISCUSSION To our knowledge, this is the first genome-wide assessment of the relationship between the placental transcriptome at birth and prenatal phthalate exposure in a large and diverse birth cohort. We identified numerous genes and lncRNAs associated with prenatal phthalate exposure. These associations mirror findings from other epidemiological and in vitro analyses and may provide insight into biological pathways affected in utero by phthalate exposure. https://doi.org/10.1289/EHP8973.
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Affiliation(s)
- Alison G. Paquette
- Seattle Children’s Research Institute, Seattle, Washington, USA
- University of Washington, Seattle, Washington, USA
| | | | - Samantha Lapehn
- Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Theo Bammler
- University of Washington, Seattle, Washington, USA
| | - Laken Kruger
- Washington State University, Spokane, Washington, USA
| | - Drew B. Day
- Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Nathan D. Price
- Institute For Systems Biology, Seattle, Washington, USA
- Onegevity Health, New York City, New York, USA
| | | | | | | | - W. Alex Mason
- University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
| | - Nicole R. Bush
- University of California San Francisco, San Francisco California, USA
| | - Kaja Z. LeWinn
- University of California San Francisco, San Francisco California, USA
| | | | | | | | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, Washington, USA
- University of Washington, Seattle, Washington, USA
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Hazlehurst MF, Carroll KN, Loftus CT, Szpiro AA, Moore PE, Kaufman JD, Kirwa K, LeWinn KZ, Bush NR, Sathyanarayana S, Tylavsky FA, Barrett ES, Nguyen RHN, Karr CJ. Maternal exposure to PM 2.5 during pregnancy and asthma risk in early childhood: consideration of phases of fetal lung development. Environ Epidemiol 2021; 5:e130. [PMID: 33709049 PMCID: PMC7943175 DOI: 10.1097/ee9.0000000000000130] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Increasingly studies suggest prenatal exposure to air pollution may increase risk of childhood asthma. Few studies have investigated exposure during specific fetal pulmonary developmental windows. OBJECTIVE To assess associations between prenatal fine particulate matter exposure and asthma at age 4. METHODS This study included mother-child dyads from two pregnancy cohorts-CANDLE and TIDES-within the ECHO-PATHWAYS consortium (births in 2007-2013). Three child asthma outcomes were parent-reported: ever asthma, current asthma, and current wheeze. Fine particulate matter (PM2.5) exposures during the pseudoglandular (5-16 weeks gestation), canalicular (16-24 weeks gestation), saccular (24-36 weeks gestation), and alveolar (36+ weeks gestation) phases of fetal lung development were estimated using a national spatiotemporal model. We estimated associations with Poisson regression with robust standard errors, and adjusted for child, maternal, and neighborhood factors. RESULTS Children (n=1469) were on average 4.3 (standard deviation 0.5) years old, 49% were male, and 11.7% had ever asthma; 46% of women identified as black and 53% had at least a college/technical school degree. A 2 μg/m3 higher PM2.5 exposure during the saccular phase was associated with 1.29 times higher risk of ever asthma (95% CI: 1.06-1.58). A similar association was observed with current asthma (RR 1.27, 95% CI: 1.04-1.54), but not current wheeze (RR 1.11, 95% CI: 0.92-1.33). Effect estimates for associations during other developmental windows had confidence intervals that included the null. CONCLUSIONS Later phases of prenatal lung development may be particularly sensitive to the developmental toxicity of PM2.5.
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Affiliation(s)
| | - Kecia N. Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christine T. Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Paul E. Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Joel D. Kaufman
- Department of Epidemiology, University of Washington, Seattle, Washington
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | - Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, California
| | - Nicole R. Bush
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, California
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
- Seattle Children’s Research Institute, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, New Jersey
| | - Ruby H. N. Nguyen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Catherine J. Karr
- Department of Epidemiology, University of Washington, Seattle, Washington
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
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34
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Adibi JJ, Xun X, Zhao Y, Yin Q, LeWinn K, Bush NR, Panigrahy A, Peddada S, Alfthan H, Stenman UH, Tylavsky F, Koistinen H. Second-Trimester Placental and Thyroid Hormones Are Associated With Cognitive Development From Ages 1 to 3 Years. J Endocr Soc 2021; 5:bvab027. [PMID: 33928202 PMCID: PMC8064052 DOI: 10.1210/jendso/bvab027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 12/25/2022] Open
Abstract
Adequate maternal thyroid hormone (TH) is necessary for fetal brain development. The role of placental human chorionic gonadotropin (hCG) in ensuring the production of TH is less well understood. The objective of the study was to evaluate 1) associations of placental hCG and its subunits, and maternal TH in the second trimester, and 2) the single and joint effects of TH and placental hormones on cognitive development and communication at ages 1 and 3 years. Fifty individuals (5%) were selected from the CANDLE (Conditions Affecting Neurocognitive Development and Early Learning) pregnancy cohort in Memphis, Tennessee, with recruitment from 2006 to 2011, to equally represent male and female fetuses. Participants were 68% Black and 32% White. Hormones measured were maternal thyroid (thyrotropin [TSH] and free thyroxine [FT4]) and placental hormones (hCG, its hyperglycosylated form [hCG-h], and free - [hCG] and -subunits [hCG]) in maternal serum (17-28 weeks). The primary outcome measurement was the Bayley Scales of Infant and Toddler Development. All forms of hCG were negatively associated with FT4 and not associated with TSH. hCG was associated with cognitive development at age 1 year and jointly interacted with TSH to predict cognitive development at age 3 years. This pilot study added insight into the thyrotropic actions of hCG in the second trimester, and into the significance of this mechanism for brain development. More research is warranted to elucidate differences between hCG, hCG, and hCG-h in relation to TH regulation and child brain function.
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Affiliation(s)
- Jennifer J Adibi
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Xiaoshuang Xun
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Yaqi Zhao
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Qing Yin
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Kaja LeWinn
- University of California San Francisco, San Francisco, California 94143, USA
| | - Nicole R Bush
- University of California San Francisco, San Francisco, California 94143, USA
| | - Ashok Panigrahy
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15224, USA
| | - Shyamal Peddada
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Henrik Alfthan
- HUSLAB, Helsinki University Hospital, 00290 Helsinki, Finland
| | - Ulf-Håkan Stenman
- University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | | | - Hannu Koistinen
- University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
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