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Day MW, Daley C, Wu Y, Pathmaraj M, Verner MA, Caron-Beaudoin É. Altered oxidative stress and antioxidant biomarkers concentrations in pregnant individuals exposed to oil and gas sites in Northeastern British Columbia. Toxicol Sci 2024; 201:73-84. [PMID: 38897649 PMCID: PMC11347777 DOI: 10.1093/toxsci/kfae080] [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: 06/21/2024] Open
Abstract
Northeastern British Columbia is a region of prolific unconventional oil and gas (UOG) activity. UOG activity can release volatile organic compounds (VOCs) which can elevate oxidative stress and disrupt antioxidant activity in exposed pregnant individuals, potentially increasing the risk of adverse pregnancy outcomes. This study measured biomarkers of oxidative stress and antioxidant activity in pooled urine samples of 85 pregnant individuals living in Northeastern British Columbia, to analyze associations between indoor air VOCs, oil and gas well density and proximity metrics, and biomarker concentrations. Concentrations of catalase, superoxide dismutase (SOD), glutathione S-transferase, total antioxidant capacity, 6-hydroxymelatonin sulfate (aMT6s), malondialdehyde (MDA), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and 8-isoprostane were measured using assay kits. Associations between exposure metrics and biomarker concentrations were determined using multiple linear regression models adjusted for biomarker-specific covariables. UOG proximity was associated with decreased SOD and 8-OHdG. Decreased 8-OHdG was associated with increased proximity to all wells. Decreased aMT6s were observed with increased indoor air hexanal concentrations. MDA was negatively associated with indoor air 1,4-dioxane concentrations. No statistically significant associations were found between other biomarkers and exposure metrics. Although some associations linked oil and gas activity to altered oxidative stress and antioxidant activity, the possibility of chance findings due to the large number of tests cannot be discounted. This study shows that living near UOG wells may alter oxidative stress and antioxidant activity in pregnant individuals. More research is needed to elucidate underlying mechanisms and to what degree UOG activity affects oxidative stress and antioxidant activity.
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Affiliation(s)
- Matthew W Day
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Coreen Daley
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Yifan Wu
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Maduomethaa Pathmaraj
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Marc-André Verner
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC H3C 3J7, Canada
- Centre de Recherche en santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3C 3J7, Canada
| | - Élyse Caron-Beaudoin
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5G 2C8, Canada
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Caron-Beaudoin É, Akpo H, Doyle-Waters MM, Ronald LA, Friesen M, Takaro T, Leven K, Meyer U, McGregor MJ. The human health effects of unconventional oil and gas (UOG) chemical exposures: a scoping review of the toxicological literature. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 0:reveh-2024-0076. [PMID: 38985132 DOI: 10.1515/reveh-2024-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/18/2024] [Indexed: 07/11/2024]
Abstract
Many chemicals associated with unconventional oil and natural gas (UOG) are known toxicants, leading to health concerns about the effects of UOG. Our objective was to conduct a scoping review of the toxicological literature to assess the effects of UOG chemical exposures in models relevant to human health. We searched databases for primary research studies published in English or French between January 2000 and June 2023 on UOG-related toxicology studies. Two reviewers independently screened abstracts and full texts to determine inclusion. Seventeen studies met our study inclusion criteria. Nine studies used solely in vitro models, while six conducted their investigation solely in animal models. Two studies incorporated both types of models. Most studies used real water samples impacted by UOG or lab-made mixtures of UOG chemicals to expose their models. Most in vitro models used human cells in monocultures, while all animal studies were conducted in rodents. All studies detected significant deleterious effects associated with exposure to UOG chemicals or samples, including endocrine disruption, carcinogenicity, behavioral changes and metabolic alterations. Given the plausibility of causal relationships between UOG chemicals and adverse health outcomes highlighted in this review, future risk assessment studies should focus on measuring exposure to UOG chemicals in human populations.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Department of Health and Society, 33530 University of Toronto Scarborough , Ontario, Canada
- Department of Physical and Environmental Sciences, 33530 University of Toronto Scarborough , Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Ontario, Canada
| | - Hélène Akpo
- Department of Occupational and Environmental Health, Université de Montréal, Quebec, Canada
| | - Mary M Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Lisa A Ronald
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | - Michael Friesen
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | - Tim Takaro
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | | | - Ulrike Meyer
- Department of Family Practice, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Margaret J McGregor
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, British Columbia, Canada
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Okui T, Nakashima N. Effects of ambient air pollution on the risk of small- and large-for-gestational-age births: an analysis using national birth data in Japan. Int Arch Occup Environ Health 2024; 97:545-555. [PMID: 38602525 DOI: 10.1007/s00420-024-02063-1] [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: 12/27/2023] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) births are major adverse birth outcomes related to newborn health. In contrast, the association between ambient air pollution levels and SGA or LGA births has not been investigated in Japan; hence, the purpose of our study is to investigate this association. METHODS We used birth data from Vital Statistics in Japan from 2017 to 2021 and municipality-level data on air pollutants, including nitrogen dioxide (NO2), sulfur dioxide (SO2), photochemical oxidants, and particulate matter 2.5 (PM2.5). Ambient air pollution levels throughout the first, second, and third trimesters, as well as the whole pregnancy, were calculated for each birth. The association between SGA/LGA and ambient levels of the air pollutants was investigated using crude and adjusted log-binomial regression models. In addition, a regression model with spline functions was also used to detect the non-linear association. RESULTS We analyzed data from 2,434,217 births. Adjusted regression analyses revealed statistically significant and positive associations between SGA birth and SO2 level, regardless of the exposure period. Specifically, the risk ratio for average SO2 values throughout the whole pregnancy was 1.014 (95% confidence interval [CI] 1.009, 1.019) per 1 ppb increase. In addition, regression analysis with spline functions indicated that an increase in risk ratio for SGA birth depending on SO2 level was linear. Furthermore, statistically significant and negative associations were observed between LGA birth and SO2 except for the third trimester. CONCLUSIONS It was suggested that ambient level of SO2 during the pregnancy term is a risk factor for SGA birth in Japan.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan.
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan
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Grabowski B, Feduniw S, Orzel A, Drab M, Modzelewski J, Pruc M, Gaca Z, Szarpak L, Rabijewski M, Baran A, Scholz A. Does Exposure to Ambient Air Pollution Affect Gestational Age and Newborn Weight?-A Systematic Review. Healthcare (Basel) 2024; 12:1176. [PMID: 38921290 PMCID: PMC11203000 DOI: 10.3390/healthcare12121176] [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: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Current evidence suggests that airborne pollutants have a detrimental effect on fetal growth through the emergence of small for gestational age (SGA) or term low birth weight (TLBW). The study's objective was to critically evaluate the available literature on the association between environmental pollution and the incidence of SGA or TLBW occurrence. A comprehensive literature search was conducted across Pubmed/MEDLINE, Web of Science, Cochrane Library, EMBASE, and Google Scholar using predefined inclusion and exclusion criteria. The methodology adhered to the PRISMA guidelines. The systematic review protocol was registered in PROSPERO with ID number: CRD42022329624. As a result, 69 selected papers described the influence of environmental pollutants on SGA and TLBW occurrence with an Odds Ratios (ORs) of 1.138 for particulate matter ≤ 10 μm (PM10), 1.338 for particulate matter ≤ 2.5 μm (PM2.5), 1.173 for ozone (O3), 1.287 for sulfur dioxide (SO2), and 1.226 for carbon monoxide (CO). All eight studies analyzed validated that exposure to volatile organic compounds (VOCs) is a risk factor for SGA or TLBW. Pregnant women in the high-risk group of SGA occurrence, i.e., those living in urban areas or close to sources of pollution, are at an increased risk of complications. Understanding the exact exposure time of pregnant women could help improve prenatal care and timely intervention for fetuses with SGA. Nevertheless, the pervasive air pollution underscored in our findings suggests a pressing need for adaptive measures in everyday life to mitigate worldwide environmental pollution.
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Affiliation(s)
- Bartlomiej Grabowski
- Department of Urology, Military Institute of Medicine, Szaserow 128, 04-349 Warsaw, Poland;
| | - Stepan Feduniw
- Department of Gynecology, University Hospital Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland
| | - Anna Orzel
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Marcin Drab
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Jan Modzelewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
| | - Zuzanna Gaca
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
| | - Lukasz Szarpak
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michal Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Arkadiusz Baran
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Anna Scholz
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
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Zhang X, Zhu S, Zhang F, Zhao G, Zhang X, Zhu W, Li D. Utilizing daily excessive concentration hours to estimate small for gestational age infants attributable to fine particulate matter in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-12. [PMID: 38576314 DOI: 10.1080/09603123.2024.2337835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
Limited studies in China have explored the association between gravidae exposure to PM2.5 and small for gestational age infants (SGA), yielding inconsistent results. This study in Wuhan utilized daily excessive concentration hours (DECH) as a novel measure to assess PM2.5's impact on SGA. Data on air pollutants and pregnant women were collected from the Wuhan Municipal Ecology and Environmental Bureau and Wuhan Children's Hospital, respectively. Logistic regression models were employed to evaluate the contribution of PM2.5-DECH and PM2.5-mean to SGA. Significant correlations were observed between PM2.5-mean and SGA during the second trimester [OR = 1.23 (95% CI: 1.14-1.32)] and the entire pregnancy [OR = 1.15 (95% CI: 1.07-1.24)]. Similar correlations were found between PM2.5-DECH and SGA. These findings suggest that increased PM2.5 exposure is associated with a higher risk of SGA, and DECH may be used as a prospective substitute indicator for daily average concentration in similar studies.
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Affiliation(s)
- Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
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Fu J, Lin Q, Ai B, Li M, Luo W, Huang S, Yu H, Yang Y, Lin H, Wei J, Su X, Zhang Z. Associations between maternal exposure to air pollution during pregnancy and trajectories of infant growth: A birth cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115792. [PMID: 38064789 DOI: 10.1016/j.ecoenv.2023.115792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE We examined the relationships between infants' growth trajectories and prenatal exposure to air pollution, which is still under-investigated. METHODS A birth cohort study was constructed using medical records of pregnant women and infants born between 2015 and 2019 in Foshan, China. Using satellite-based spatial-temporal models, prenatal exposure to air pollutants including particulate matter with an aerodynamic dimension of < 2.5 µm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) was assessed at each woman's residence. Latent class growth modeling was used to identify trajectories of physical (body length and weight) growth and neurodevelopment, which were repeatedly measured within 1 year after birth. Logistic regression models were used to investigate the associations between prenatal exposure to air pollution and the risks of growth disorders, adjusting for an array of potential confounders. RESULTS We identified two growth trajectories for body length [normal: 3829 (93%); retardation: 288 (7%)], three for weight [normal: 2475 (59.6%); retardation: 390 (9.4%); overgrowth: 1287 (31%)], and two for neurodevelopment [normal: 956 (66.1%); retardation: 491 (33.9%)]. For exposure over whole pregnancy, SO2 was associated with an increased risk of body length retardation (OR for per 1 µg/m3 increment: 1.09, 95%CI: 1.01-1.17); PM2.5 (OR: 1.05, 95%CI: 1.03-1.07), SO2 (OR: 1.15, 95%CI: 1.08-1.22), and NO2 (OR: 1.05, 95%CI: 1.03-1.07) were positively associated with neurodevelopmental retardation. Such associations appeared stronger for exposures over the first and second trimesters. No significant associations were detected for weight growth. CONCLUSIONS Maternal exposure to air pollution during pregnancy was associated with higher risks of impairments in both physical growth, particularly body length, and neurodevelopment.
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Affiliation(s)
- Jiaying Fu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Baozhuo Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meijun Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weidong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Saijun Huang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Hong Yu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Xi Su
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Li Z, Lu J, Ruan X, Wu Y, Zhao J, Jiao X, Sun J, Sun K. Exposure to volatile organic compounds induces cardiovascular toxicity that may involve DNA methylation. Toxicology 2024; 501:153705. [PMID: 38070821 DOI: 10.1016/j.tox.2023.153705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
Volatile organic compounds (VOCs) are common air pollutants and water contaminants. We previously found maternal exposure to VOCs was associated with offspring congenital heart disease (CHD). However, little information is available about the effects of VOCs on cardiovascular development at embryonic stage and the underlying mechanism remains unclear. In this study, we aimed to investigate the effects of a mixture of six VOCs on cardiovascular development in zebrafish embryos. Embryos were exposed to different concentrations of VOCs mixture (32 mg/L, 64 mg/L and 128 mg/L) for 96 h, cardiovascular abnormalities including elongated heart shape, increased distance between sinus venosus and bulbus arteriosus, slowed circulation and altered heart rate were observed in a dose- and time-dependent manner. Meanwhile, VOCs exposure increased global DNA methylation levels in embryos. Analysis identified hundreds of differentially methylated sites and the enrichment of differentially methylated sites on cardiovascular development. Two differentially methylated-associated genes involved in MAPK pathway, hgfa and ntrk1, were identified to be the potential genes mediating the effects of VOCs. By enzyme-linked immunosorbent assay, altered human serum hgf and ntrk1 levels were detected in abnormal pregnancies exposed to higher VOCs levels with fetal CHD. For the first time, our study revealed exposure to VOCs induced severe cardiovascular abnormalities in zebrafish embryos. The toxicity might result from alterations in DNA methylation and corresponding expression levels of genes involved in MAPK pathway. Our study provides important information for the risk of VOCs exposure on embryonic cardiovascular development.
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Affiliation(s)
- Zhuoyan Li
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieru Lu
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Children's Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xuehua Ruan
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yurong Wu
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyuan Zhao
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xianting Jiao
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jing Sun
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Kun Sun
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Jones SI, Pruszynski JE, Spong CY, Nelson DB. Traffic-related air pollution is associated with spontaneous extremely preterm birth and other adverse perinatal outcomes. Am J Obstet Gynecol 2023; 229:455.e1-455.e7. [PMID: 37516397 DOI: 10.1016/j.ajog.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Although there is growing awareness of the relationship between air pollution and preterm birth, limited data exist regarding the relationship with spontaneous preterm birth and severe neonatal outcomes. OBJECTIVE This study aimed to examine the association between traffic-associated air pollution exposure in pregnancy and adverse perinatal outcomes including extremes of preterm birth, neonatal intensive care unit admissions, low birthweight, neonatal respiratory diagnosis, neonatal respiratory support, and neonatal sepsis evaluation. STUDY DESIGN This was a retrospective cohort study of singleton pregnancies of patients residing in a metropolitan area in the southern United States. Using monitors strategically located across the region, average nitrogen dioxide concentrations were obtained from the Environmental Protection Agency Air Quality System database. For patients living within 10 miles of a monitoring station, average exposure to nitrogen dioxide was estimated for individual patients' pregnancy by trimester. Logistic regression models were used to assess the effect of pollutant exposure on gestational age at birth, indicated vs spontaneous delivery, and neonatal outcomes while adjusting for maternal age, self-reported race, parity, season of conception, diabetes mellitus, body mass index, registered Health Equity Index, and nitrogen dioxide monitor region. Adjusted odds ratios and 95% confidence intervals were calculated for an interquartile increase in average nitrogen dioxide exposure. RESULTS Between January 1, 2013 and December 31, 2021, 93,164 patients delivered a singleton infant. Of these, 62,189 had measured nitrogen dioxide exposure during the pregnancy from a nearby monitoring station. Higher average nitrogen dioxide exposure throughout pregnancy was significantly associated with preterm birth (adjusted odds ratio, 1.94; 95% confidence interval, 1.77-2.12) and an increase in neonatal intensive care unit admissions, low birthweight infants, neonatal respiratory diagnosis, neonatal respiratory support, and neonatal sepsis evaluation. This relationship persisted for nulliparous patients and spontaneous preterm birth, and had a greater association with earlier preterm birth. CONCLUSION In a metropolitan area, increased exposure to the air pollutant nitrogen dioxide in pregnancy was associated with spontaneous preterm birth and had a greater association with extremely preterm birth. A greater association with neonatal intensive care unit admissions, low-birthweight infants, neonatal respiratory diagnosis, neonatal respiratory support, and neonatal sepsis evaluation was found even in term infants.
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Affiliation(s)
- Sara I Jones
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Jessica E Pruszynski
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Catherine Y Spong
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - David B Nelson
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
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9
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Delcroix MH, Delcroix-Gomez C, Marquet P, Gauthier T, Thomas D, Aubard Y. Active or passive maternal smoking increases the risk of low birth weight or preterm delivery: Benefits of cessation and tobacco control policies. Tob Induc Dis 2023; 21:72. [PMID: 37256119 PMCID: PMC10226447 DOI: 10.18332/tid/156854] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023] Open
Abstract
In France, maternal smoking, active or passive, remains one of the highest in Europe. At the same time, there is an increase in the number of low birth weight (<2500 g) and premature (<37 weeks of amenorrhea) newborns. The objective of this narrative review is to examine the impact of active or passive maternal smoking on birth weight or prematurity rates, and to consider the benefits of policies to stop or control smoking. This is a narrative review that analyzes and discusses the major articles published over the past 20 years regarding the role of active or passive maternal smoking on the risk of low birth weight or preterm delivery. Articles were selected using the following keywords: maternal smoking, low birth weight, preterm birth, smoking cessation, passive smoking, exhaled carbon monoxide, tobacco control policies. Active smoking is associated, in a dose-response relationship, with increased risks of low birth weight and preterm delivery. Passive smoking, mainly related to the presence of a smoking spouse, increases the risk of low birth weight and preterm birth. Our review confirmed also the benefits of smoking cessation, even in the third trimester, in reducing the risk of small for gestation age or fetal growth restriction and preterm birth. Several studies of tobacco control policies have been shown to be effective in significantly reducing maternal smoking. There is sufficient evidence to infer a causal link between active or passive maternal smoking and low birth weight or preterm delivery. This causal link is compelling and sufficient to justify intensifying efforts to promote rapid progress in tobacco control policies, with the vision of a tobacco-free generation, and smoking cessation with best practices during preconception or pregnancy.
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Affiliation(s)
- Michel-Henri Delcroix
- Établissement Public de Santé Mentale, Association Périnatalité Recherche Information - Maternité Sans Tabac, Bailleul, France
| | - Conchita Delcroix-Gomez
- Service de Gynécologie-Obstétrique, Pôle Femme-Enfant, Centre Hospitalier d’Arras, Arras, France
| | - Pierre Marquet
- Service de Pharmacologie, Toxicologie et de Pharmacovigilance, Centre Hospitalier Universitaire, Limoges, France
| | - Tristan Gauthier
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
| | - Daniel Thomas
- Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Yves Aubard
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
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Zhang F, Zhang X, Zhong Y, Zhu S, Zhao G, Zhang X, Li T, Zhang Y, Zhu W. Joint Exposure to Ambient Air Pollutants Might Elevate the Risk of Small for Gestational Age (SGA) Infants in Wuhan: Evidence From a Cross-Sectional Study. Int J Public Health 2023; 67:1605391. [PMID: 36686387 PMCID: PMC9849243 DOI: 10.3389/ijph.2022.1605391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: To investigate the effect of exposure to multiple ambient air pollutants during pregnancy on the risk of children being born small for gestational age (SGA). Methods: An Air Pollution Score (APS) was constructed to assess the effects of being exposed to six air pollutants simultaneously, PM2.5, PM10, SO2, NO2, CO, and O3 (referred to as joint exposure). A logistic regression model was applied to estimate the associations of APS and SGA. Results: The adjusted odds ratios (ORs) of SGA per 10 ug/m3 increased in APS during the first and second trimesters and the entire pregnancy were 1.003 [95% confidence intervals (CIs): 1.000, 1.007], 1.018 (1.012, 1.025), and 1.020 (1.009, 1.031), respectively. The ORs of SGA for each 10 μg/m3 elevated in APS during the whole pregnancy were 1.025 (1.005, 1.046) for mothers aged over 35 years old vs. 1.018 (1.005, 1.031) for mothers aged under 35 years old. Women who were pregnant for the first time were more vulnerable to joint ambient air pollution. Conclusion: In summary, the results of the present study suggested that joint exposure to ambient air pollutants was associated with the increment in the risks of SGA.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yuanyuan Zhong
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Yan Zhang, ; Wei Zhu,
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Yan Zhang, ; Wei Zhu,
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11
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Nunes IDS, Schnorr C, Perondi D, Godinho M, Diel JC, Machado LMM, Dalla Nora FB, Silva LFO, Dotto GL. Valorization of Different Fractions from Butiá Pomace by Pyrolysis: H 2 Generation and Use of the Biochars for CO 2 Capture. Molecules 2022; 27:7515. [PMID: 36364342 PMCID: PMC9658530 DOI: 10.3390/molecules27217515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/12/2023] Open
Abstract
This work valorizes butiá pomace (Butia capitata) using pyrolysis to prepare CO2 adsorbents. Different fractions of the pomace, like fibers, endocarps, almonds, and deoiled almonds, were characterized and later pyrolyzed at 700 °C. Gas, bio-oil, and biochar fractions were collected and characterized. The results revealed that biochar, bio-oil, and gas yields depended on the type of pomace fraction (fibers, endocarps, almonds, and deoiled almonds). The higher biochar yield was obtained by endocarps (31.9%wt.). Furthermore, the gas fraction generated at 700 °C presented an H2 content higher than 80%vol regardless of the butiá fraction used as raw material. The biochars presented specific surface areas reaching 220.4 m2 g-1. Additionally, the endocarp-derived biochar presented a CO2 adsorption capacity of 66.43 mg g-1 at 25 °C and 1 bar, showing that this material could be an effective adsorbent to capture this greenhouse gas. Moreover, this capacity was maintained for 5 cycles. Biochars produced from butiá precursors without activation resulted in a higher surface area and better performance than some activated carbons reported in the literature. The results highlighted that pyrolysis could provide a green solution for butiá agro-industrial wastes, generating H2 and an adsorbent for CO2.
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Affiliation(s)
- Isaac dos S. Nunes
- Research Group on Adsorptive and Catalytic Process Engineering (ENGEPAC), Federal University of Santa Maria, Roraima Avenue, 1000-7, Santa Maria 97105–900, Brazil
| | - Carlos Schnorr
- Department of Natural and Exact Sciences, Universidad de la Costa, CUC, Calle 58 # 55–66, Barranquilla 080002, Colombia
| | - Daniele Perondi
- Postgraduate Program in Engineering Processes and Technology, University of Caxias do Sul—UCS, Caxias do Sul 95070-560, Brazil
| | - Marcelo Godinho
- Postgraduate Program in Engineering Processes and Technology, University of Caxias do Sul—UCS, Caxias do Sul 95070-560, Brazil
| | - Julia C. Diel
- Research Group on Adsorptive and Catalytic Process Engineering (ENGEPAC), Federal University of Santa Maria, Roraima Avenue, 1000-7, Santa Maria 97105–900, Brazil
| | - Lauren M. M. Machado
- Research Group on Adsorptive and Catalytic Process Engineering (ENGEPAC), Federal University of Santa Maria, Roraima Avenue, 1000-7, Santa Maria 97105–900, Brazil
| | - Fabíola B. Dalla Nora
- Research Group on Adsorptive and Catalytic Process Engineering (ENGEPAC), Federal University of Santa Maria, Roraima Avenue, 1000-7, Santa Maria 97105–900, Brazil
| | - Luis F. O. Silva
- Department of Natural and Exact Sciences, Universidad de la Costa, CUC, Calle 58 # 55–66, Barranquilla 080002, Colombia
| | - Guilherme L. Dotto
- Research Group on Adsorptive and Catalytic Process Engineering (ENGEPAC), Federal University of Santa Maria, Roraima Avenue, 1000-7, Santa Maria 97105–900, Brazil
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Dahal U, Veber T, Åström DO, Tamm T, Albreht L, Teinemaa E, Orru K, Orru H. Perinatal Health Inequalities in the Industrial Region of Estonia: A Birth Registry-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11559. [PMID: 36141830 PMCID: PMC9516979 DOI: 10.3390/ijerph191811559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Despite the increasing number of studies on industrially contaminated sites (ICS) and their health effects, there are very few studies on perinatal health outcomes in ICSs. In the present study, we examined the perinatal health inequalities by comparing adverse birth outcomes (ABOs) in the oil shale industry region of Ida-Viru County in Estonia with national-level figures and investigated the effects of maternal environmental and sociodemographic factors. Based on the 208,313 birth records from 2004-2018, Ida-Viru ICS has a birth weight 124.5 g lower than the average of 3544 g in Estonia. A higher prevalence of preterm birth (4.3%) and low birth weight (4.8%) in Ida-Viru ICS is found compared to 3.3% on both indicators at the national level. Multiple logistic regression analysis shows the statistically significant association of ABOs with fine particle (PM2.5) air pollution, mother's ethnicity, and education throughout Estonia. However, in Ida-Viru ICS, the ABOs odds are remarkably higher in these characteristics except for the mother's ethnicity. Furthermore, the ABOs are associated with the residential proximity to ICS. Thus, the Ida-Viru ICS has unequally higher odds of adverse perinatal health across the environmental and sociodemographic factors. In addition to reducing the air pollutants, policy actions on social disparities are vital to address the country's unjustly higher perinatal health inequalities, especially in the Ida-Viru ICS.
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Affiliation(s)
- Usha Dahal
- Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
- Institute of Social Science, University of Tartu, 51003 Tartu, Estonia
| | - Triin Veber
- Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
| | | | - Tanel Tamm
- Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
| | - Leena Albreht
- Environmental Health Department, Estonian Health Board, 10617 Tallinn, Estonia
| | - Erik Teinemaa
- Estonian Environmental Research Centre, 10617 Tallinn, Estonia
| | - Kati Orru
- Institute of Social Science, University of Tartu, 51003 Tartu, Estonia
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
- Section of Sustainable Health, Umeå University, 901 87 Umea, Sweden
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13
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Yu Z, Zhang X, Zhang J, Feng Y, Zhang H, Wan Z, Xiao C, Zhang H, Wang Q, Huang C. Gestational exposure to ambient particulate matter and preterm birth: An updated systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 212:113381. [PMID: 35523275 DOI: 10.1016/j.envres.2022.113381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/17/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
Previous studies on gestational particulate matter (PM) exposure and preterm birth (PTB) showed inconsistent results, and no study systematically examined the short-term effect of PM exposure on PTB subtypes. To investigate both long- and short-term effects of the evidence to date in general population, we searched for epidemiological studies on PM exposure and PTB that published in PubMed, Web of Science, Embase and Cochrane Library up to March 31, 2022. The protocol for this review was registered with PROSPERO (CRD42021265202). Heterogeneity was assessed by Cochran's Q test and I2 statistic. Publication bias was evaluated using funnel plots and Egger's tests. Subgroup analysis, meta-regression and sensitivity analysis were performed. Of 16,801 records, 84 eligible studies were finally included. The meta-analysis of long-term effect showed that per 10 μg/m3 increase in PM2.5 and PM10 during entire pregnancy were associated with PTB, the pooled odds ratios (ORs) were 1.084 (95% CI: 1.055-1.113) and 1.034 (95% CI: 1.018-1.049). Positive associations were found between PM2.5 in second trimester and PTB subtypes. For the short-term exposure, we observed that PTB was positively associated with a 10 μg/m3 increment in PM2.5 on lag day 2 and 3, the pooled ORs and 95% CIs were 1.003 (1.001-1.004) and 1.003 (1.001-1.005), with I2 of 65.30% and 76.60%. PM10 exposure on ave day 1 increased the risk of PTB, the pooled OR was 1.001 (95% CI: 1.000, 1.001). We also found that PM10 exposure in 2 weeks prior to birth increased PTB risk. Our results support the hypothesis of both long- and short-term PM2.5 exposure increase the risk of PTB. Further well-designed longitudinal studies and investigations into potential biological mechanisms are warranted.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention; Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Yang Feng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Han Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chenglong Xiao
- School of Earth Sciences, Chengdu University of Technology, Chengdu, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China; National Health Commission Key Laboratory of Birth Defects Prevention; Key Laboratory of Population Defects Prevention, Zhengzhou, China.
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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14
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Gheissari R, Liao J, Garcia E, Pavlovic N, Gilliland FD, Xiang AH, Chen Z. Health Outcomes in Children Associated with Prenatal and Early-Life Exposures to Air Pollution: A Narrative Review. TOXICS 2022; 10:toxics10080458. [PMID: 36006137 PMCID: PMC9415268 DOI: 10.3390/toxics10080458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/04/2023]
Abstract
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
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Affiliation(s)
- Roya Gheissari
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Nathan Pavlovic
- Sonoma Technology Inc., 1450 N. McDowell Blvd., Suite 200, Petaluma, CA 94954, USA
| | - Frank D. Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Anny H. Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91107, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
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15
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Yadav M, Singh NK, Sahu SP, Padhiyar H. Investigations on air quality of a critically polluted industrial city using multivariate statistical methods: Way forward for future sustainability. CHEMOSPHERE 2022; 291:133024. [PMID: 34813843 DOI: 10.1016/j.chemosphere.2021.133024] [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: 06/09/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 06/13/2023]
Abstract
Industrially developed cities affect public health, and can directly cause inconvenience to the nearby societies especially due to their associated air pollution. In this context, the present study was conducted in Jharsuguda district of Odisha state (India), which is a well-known worldwide hub of industrial clusters. The study area is having mainly medium to large scale industries which makes it prone to poor air quality. A total of twelve air pollutants, namely, PM10, PM2.5, SO2, NO2, CO, O3, NH3, and heavy metals (Cu, Mn, Ni, Pb, Zn) were monitored during winter season, at the 16 locations of study area. The air quality data was further assessed using multivariate analysis, and the obtained information was presented using histogram plots, box plots, cluster analysis, principal component analysis (PCA), analysis of variance (ANOVA) analysis, and air quality index (AQI). The statistical analysis results revealed that PM10 and PM2.5 levels exceeded the permissible limits of study area, ∼40 and 30% of sampling times, respectively. Contrary, values of other pollution parameters were observed to be well within the permissible limits. The cluster analysis distinguishingly summarized the monitoring data into four clusters types, named as severely polluted, moderately polluted, satisfactory, and fine. The PCA analysis of monitored data resulted in identification of prominent emission sources of analyzed pollutants. These sources were mainly found to be associated with coal burning in power plants, agricultural activities, vehicular emissions, and mining activities. The minimum AQI was observed as 87 at Orient (mine no. 4) and Kinjirma which is under satisfactory category, whereas maximum AQI was observed at Bhedabahal with a value of 132 which is under moderate category. Overall, the results of this study indicated that the air pollution of industrial areas must be evaluated thoroughly on regular basis, considering the sustainability of societies and expanding industries.
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Affiliation(s)
- Manish Yadav
- Central Mine Planning and Design Institute, India.
| | - Nitin Kumar Singh
- Department of Environmental Science and Engineering, Marwadi Education Foundation's Group of Institutions, Rajkot, 360003, India.
| | | | - Hirendrasinh Padhiyar
- Department of Environmental Science and Engineering, Marwadi Education Foundation's Group of Institutions, Rajkot, 360003, India.
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Sharpe RM. Location, location, location-where you are born may determine your reproductive (and more general) health. Hum Reprod 2021; 36:1171-1174. [PMID: 33728440 DOI: 10.1093/humrep/deab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard M Sharpe
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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