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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Vleminckx C, Wallace H, Barregård L, Benford D, Broberg K, Dogliotti E, Fletcher T, Rylander L, Abrahantes JC, Gómez Ruiz JÁ, Steinkellner H, Tauriainen T, Schwerdtle T. Update of the risk assessment of inorganic arsenic in food. EFSA J 2024; 22:e8488. [PMID: 38239496 PMCID: PMC10794945 DOI: 10.2903/j.efsa.2024.8488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.
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Zinia SS, Yang KH, Lee EJ, Lim MN, Kim J, Kim WJ. Effects of heavy metal exposure during pregnancy on birth outcomes. Sci Rep 2023; 13:18990. [PMID: 37923810 PMCID: PMC10624662 DOI: 10.1038/s41598-023-46271-0] [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: 04/25/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Exposure to heavy metals such as lead, cadmium, and mercury poses serious health risks to pregnant women because of their high toxicity. In this study, we investigated the associations of heavy metal exposure with birth outcomes of Korean infants. Data of 5,215 women between 2015 and 2019 were analyzed. This study was part of the Korean Children's Environmental Health (Ko-CHENS) study. Linear regression and logistic regression analyses were used to examine effects of concentrations of lead, cadmium, and mercury on birth weight, small for gestational age, and large for gestational age after adjusting for maternal age groups, parity, infant sex, education, income, smoking, drinking, body mass index, stillbirth, premature birth, diabetes, hypertension, and gestational diabetes. Besides adjusting for these covariates, each metal was mutually adjusted to estimate birth weight and large for gestational age status. Maternal cadmium concentrations during early pregnancy (β = - 39.96; 95% confidence interval (CI): - 63.76, - 16.17) and late pregnancy (β = - 37.24; 95% CI - 61.63, - 12.84) were significantly associated with birth weight. Cadmium levels during early pregnancy (adjusted OR = 0.637; 95% CI 0.444, 0.912) were also associated with large for gestational age status. Our findings suggest that prenatal cadmium exposure, even at a low level of exposure, is significantly associated with low birth weight.
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Affiliation(s)
- Sabrina Shafi Zinia
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Ki-Hyeok Yang
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Eun Ju Lee
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Myoung-Nam Lim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Jeeyoung Kim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, 24341, Republic of Korea.
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3
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Ashley-Martin J, Fisher M, Belanger P, Cirtiu CM, Arbuckle TE. Biomonitoring of inorganic arsenic species in pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:921-932. [PMID: 35948664 PMCID: PMC10733137 DOI: 10.1038/s41370-022-00457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Exposure assessment of inorganic arsenic is challenging due to the existence of multiple species, complexity of arsenic metabolism, and variety of exposure sources. Exposure assessment of arsenic during pregnancy is further complicated by the physiological changes that occur to support fetal growth. Given the well-established toxicity of inorganic arsenic at high concentrations, continued research into the potential health effects of low-level exposure on maternal and fetal health is necessary. Our objectives were to review the value of and challenges inherent in measuring inorganic arsenic species in pregnancy and highlight related research priorities. We discussed how the physiological changes of pregnancy influence arsenic metabolism and necessitate the need for pregnancy-specific data. We reviewed the biomonitoring challenges according to common and novel biological matrices and discussed how each matrix differs according to half-life, bioavailability, availability of laboratory methods, and interpretation within pregnancy. Exposure assessment in both established and novel matrices that accounts for the physiological changes of pregnancy and complexity of speciation is a research priority. Standardization of laboratory method for novel matrices will help address these data gaps. Research is particularly lacking in contemporary populations of pregnant women without naturally elevated arsenic drinking water concentrations (i.e. <10 µg/l).
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Affiliation(s)
- Jillian Ashley-Martin
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Mandy Fisher
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Patrick Belanger
- INSPQ, Centre de toxicologie du Québec, Direction de la santé environnementale, au travail et de la toxicology, Quebec, QC, Canada
| | - Ciprian Mihai Cirtiu
- INSPQ, Centre de toxicologie du Québec, Direction de la santé environnementale, au travail et de la toxicology, Quebec, QC, Canada
| | - Tye E Arbuckle
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada
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Zhao L, Li T, Wang H, Fan YM, Xiao Y, Wang X, Wang S, Sun P, Wang P, Jiangcuo Z, Tong L, Wang L, Peng W. Association of co-exposure to metal(loid)s during pregnancy with birth outcomes in the Tibetan plateau. CHEMOSPHERE 2023; 342:140144. [PMID: 37704082 DOI: 10.1016/j.chemosphere.2023.140144] [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: 06/01/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
Maternal metal (loid)s exposure has been related to birth outcomes but the results are still inconclusive. Most previous studies have discussed the single metal (loid)s, neglecting the scene of co-exposure. We examined the associations of both single metal (loid)s and metal mixtures with birth outcomes in a birth cohort from the Tibetan Plateau, including body weight, body length, head circumference, small for gestational age (SGA), and Ponderal index (PI). In our analysis of 1069 women, we measured 29 metal (loid)s in urine samples in the third trimester. The associations of single metal (loid)s with categorical or continuous birth outcomes were evaluated using a generalized linear mixed-effects model or linear mixed-effects model, respectively. The least absolute shrinkage and selection operator, Bayesian kernel machine, and Quantile g-computation regression were used to explore the joint association. We also evaluated the interactive effects of ethnicity and altitude on the effect of metal (loid)s on birth outcomes. Copper (Cu) concentration in maternal urine was positively associated with SGA, birth weight, birth length, and head circumference in the single pollutant models. For instance, Cu was associated with an increased risk of SGA [OR (95% CI) = 1.56 (1.23, 1.97); P < 0.001]. We didn't find significant joint association of metal mixtures with birth outcomes except a positive association between the mixture of Cu, Magnesium (Mg), and Iron (Fe) with the risk of SGA when the exposure level was above its 80th percentile, and Cu dominated the adverse association in a non-linear manner. Living altitude modified the associations of Cu with SGA and the positive association was only found in participants living at high altitude. In conclusion, maternal urinary metal (loid)s, especially Cu, was the dominant harmful metal (loid)s when associated with SGA on the Tibetan Plateau.
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Affiliation(s)
- Lei Zhao
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Tiemei Li
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Haijing Wang
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Yue-Mei Fan
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Yuancan Xiao
- Qinghai Provincial Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, China
| | - Xuejun Wang
- Department of Anesthesiology, Qinghai Red Cross Hospital, Xining, China
| | - Shulin Wang
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Pin Sun
- Department of Occupational Health and Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Pinhua Wang
- Department of Obstetrics and Gynecology, Qinghai Red Cross Hospital, Xining, China
| | | | - Li Tong
- Department of Traditional Chinese Medicine, Medical College of Qinghai University, Xining, China; Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Qinghai, China
| | - Liehong Wang
- Department of Obstetrics and Gynecology, Qinghai Red Cross Hospital, Xining, China.
| | - Wen Peng
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China; Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Qinghai, China.
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Shen Z, Lu Y, Song Z, Li J, Li W, Li S, Wang M, Feng Y, Wang S, Zhang Y, Wu W. Prenatal polymetallic exposure and small for gestational age: A case-control study in Taiyuan, China. J Trace Elem Med Biol 2023; 79:127243. [PMID: 37413925 DOI: 10.1016/j.jtemb.2023.127243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Studies focused on independent effects of metals on small for gestational age, failing to account for potential interdependence among metals. METHODS In this case-control study, we selected 187 pregnant women and 187 matched controls from the First Hospital of Shanxi Medical University. Determination of 12 elements in the venous blood of pregnant women before delivery by ICP-MS. Logistic regression, weighted quantile sum regression (WQSR) and Bayesian kernel machine regression (BKMR) were used to estimate the overall effect and identify important mixture components that drive the associations with SGA. RESULTS An increased risk of SGA was associated with As (OR= 1.06,95%CI: 1.01,1.12), Cd (OR= 1.24,95%CI: 1.04,1.47) and Pb (OR= 1.05,95%CI: 1.02,1.08), while Zn (OR= 0.58,95%CI: 0.45,0.76) and Mn (OR= 0.97,95%CI: 0.94,0.99) were protective factors for SGA. In the WQSR positive model, the mixture of heavy metals has a positive combined effect on SGA (OR= 1.74,95%CI: 1.15, 2.62), with Sb and Cd having the highest weights. The BKMR models confirmed that the metal mixture was associated with decreased risk of SGA when the concentration of 12 metals was between the 30th percentile and the 65th percentile, and Zn and Cd had the greatest independent effect. Zn and SGA may not be linearly correlated, higher Zn level may reduce the effect of Cd on the risk of SGA. CONCLUSIONS Our study suggested that exposure to multiple metals was associated with risk of SGA, and the observed association with multiple metals was dominated by Zn, Cd. Sb exposure during pregnancy may also increase the risk of SGA.
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Affiliation(s)
- Zhitong Shen
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yue Lu
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Zexin Song
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Jinbo Li
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Wangjun Li
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Shan Li
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Mengru Wang
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yongliang Feng
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Suping Wang
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China.
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Weiwei Wu
- Department of Epidemiology, School of Public Health, Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China.
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Borghese MM, Fisher M, Ashley-Martin J, Fraser WD, Trottier H, Lanphear B, Johnson M, Helewa M, Foster W, Walker M, Arbuckle TE. Individual, Independent, and Joint Associations of Toxic Metals and Manganese on Hypertensive Disorders of Pregnancy: Results from the MIREC Canadian Pregnancy Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47014. [PMID: 37079392 PMCID: PMC10117658 DOI: 10.1289/ehp10825] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Toxic metals, such as lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg), may be associated with a higher risk of gestational hypertension and preeclampsia, whereas manganese (Mn) is an essential metal that may be protective. OBJECTIVES We estimated the individual, independent, and joint associations of Pb, Cd, As, Hg, and Mn on the risk of developing gestational hypertension and preeclampsia in a cohort of Canadian women. METHODS Metal concentrations were analyzed in first and third trimester maternal blood (n=1,560). We measured blood pressure after 20 wk gestation to diagnose gestational hypertension, whereas proteinuria and other complications defined preeclampsia. We estimated individual and independent (adjusted for coexposure) relative risks (RRs) for each doubling of metal concentrations and examined interactions between toxic metals and Mn. We used quantile g-computation to estimate the joint effect of trimester-specific exposures. RESULTS Each doubling of third trimester Pb (RR=1.54; 95% CI: 1.06, 2.22) and first trimester blood As (RR=1.25; 95% CI: 1.01, 1.58) was independently associated with a higher risk of developing preeclampsia. First trimester blood As (RR=3.40; 95% CI: 1.40, 8.28) and Mn (RR=0.63; 95% CI: 0.42, 0.94) concentrations were associated with a higher and lower risk, respectively, of developing gestational hypertension. Mn modified the association with As such that the deleterious association with As was stronger at lower concentrations of Mn. First trimester urinary dimethylarsinic acid concentrations were not associated with gestational hypertension (RR=1.31; 95% CI: 0.60, 2.85) or preeclampsia (RR=0.92; 95% CI: 0.68, 1.24). We did not observe overall joint effects for blood metals. DISCUSSION Our results confirm that even low blood Pb concentrations are a risk factor for preeclampsia. Women with higher blood As concentrations combined with lower Mn in early pregnancy were more likely to develop gestational hypertension. These pregnancy complications impact maternal and neonatal health. Understanding the contribution of toxic metals and Mn is of public health importance. https://doi.org/10.1289/EHP10825.
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Affiliation(s)
- Michael M. Borghese
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Mandy Fisher
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Jillian Ashley-Martin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - William D. Fraser
- Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Helen Trottier
- Department of Social and Preventive Medicine, Université de Montreal, Montreal, Quebec, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Markey Johnson
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Michael Helewa
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Warren Foster
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Mark Walker
- Department of Obstetrics, Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Tye E. Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
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7
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Taniguchi Y, Yamazaki S, Nakayama SF, Sekiyama M, Michikawa T, Isobe T, Iwai-Shimada M, Kobayashi Y, Nitta H, Oba M, Kamijima M. Maternal Metals Exposure and Infant Weight Trajectory: The Japan Environment and Children's Study (JECS). ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:127005. [PMID: 36516017 PMCID: PMC9749893 DOI: 10.1289/ehp10321] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND To our knowledge, the association of maternal exposure to metallic elements with weight trajectory pattern from the neonatal period has not been investigated. OBJECTIVES The goals of this study were to identify infant growth trajectories in weight in the first 3 y of life and to determine the associations of maternal blood levels of lead, cadmium, mercury, selenium, and manganese with growth trajectory. METHODS This longitudinal study, part of the Japan Environment and Children Study, enrolled 103,099 pregnant women at 15 Regional Centres across Japan between 2011 and 2014. Lead, cadmium, mercury, selenium, and manganese levels were measured in blood samples collected in the second (14-27 wk gestational age) or third trimester (≥28wk). Growth trajectory of 99,014 children was followed until age 3 y. Raw weight values were transformed to age- and sex-specific weight standard deviation (SD) scores, and latent-class group-based trajectory models were estimated to determine weight trajectories. Associations between maternal metallic element levels and weight trajectory were examined using multinomial logistic regression models after confounder adjustment. RESULTS We identified 5 trajectory patterns based on weight SD score: 4.74% of infants were classified in Group I, very small to small; 31.26% in Group II, moderately small; 21.91% in Group III, moderately small to moderately large; 28.06% in Group IV, moderately large to normal; and 14.03% in Group V, moderately large to large. On multinomial logistic regression, higher maternal lead and selenium levels tended to be associated with increased odds ratios (ORs) of poor weight SD score trajectories (Groups I and II), in comparison with Group III. Higher levels of mercury were associated with decreased ORs, whereas higher levels of manganese were associated with increased ORs of "moderately large" trajectories (Groups IV and V). DISCUSSION Maternal lead, mercury, selenium, and manganese blood levels affect infant growth trajectory pattern in the first 3 y of life. https://doi.org/10.1289/EHP10321.
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Affiliation(s)
- Yu Taniguchi
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Shin Yamazaki
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Shoji F. Nakayama
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Makiko Sekiyama
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, Toho University School of Medicine, Ota, Japan
| | - Tomohiko Isobe
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Miyuki Iwai-Shimada
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Yayoi Kobayashi
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Hiroshi Nitta
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Mari Oba
- Department of Medical Statistics, Toho University School of Medicine, Ota, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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8
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Dou Y, Yin Y, Li Z, Du J, Jiang Y, Jiang T, Guo W, Qin R, Li M, Lv H, Lu Q, Qiu Y, Lin Y, Jin G, Lu C, Ma H, Hu Z. Maternal exposure to metal mixtures during early pregnancy and fetal growth in the Jiangsu Birth Cohort, China. ENVIRONMENTAL RESEARCH 2022; 215:114305. [PMID: 36096164 DOI: 10.1016/j.envres.2022.114305] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Previous epidemiological studies have reported that prenatal exposure to metals might have influence on fetal growth. Most studies assessed the effect of individual metals, while the investigation on the relationship between multiple metal exposure and fetal growth is sparse. The objective of the present study is to assess the joint impact of metal mixtures on fetal growth during pregnancy. A total of 1275 maternal-infant pairs from the Jiangsu Birth Cohort (JBC) Study were included to investigate the effect of maternal metal exposure on fetal biometry measures at 22-24, 30-32, and 34-36 weeks of gestation. Lead (Pb), arsenic (As), cadmium (Cd), mercury (Hg), chromium (Cr), vanadium(V), thallium (Tl) and barium (Ba) were measured by inductively coupled plasma mass spectrometry (ICP-MS) in maternal urine samples collected in the first trimester. We used general linear models and restricted cubic splines to test dose-response relationships between single metals and fetal growth. The weighted quantile sum (WQS) models were then applied to evaluate the overall effect of all these metals. We observed inverse associations of exposure to Pb, V and Cr with estimated fetal weight (EFW) at 34-36 weeks of gestation. Notably, maternal exposure to metal mixtures was significantly associated with reduced EFW at 34-36 weeks of gestation after adjusting for some covariates and confounders (aβ -0.05 [95% CI: 0.09, -0.01], P = 0.023), and this association was mainly driven by Cr (30.41%), Pb (23.92%), and Tl (15.60%). These findings indicated that prenatal exposure to metal mixtures might impose adverse effects on fetal growth.
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Affiliation(s)
- Yuanyan Dou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yin Yin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Tao Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Wenhui Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Mei Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yun Qiu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Chuncheng Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
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9
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Identification of noninvasive diagnostic biomarkers for ectopic pregnancy using data-independent acquisition (DIA)proteomics: a pilot study. Sci Rep 2022; 12:19992. [PMID: 36411308 PMCID: PMC9678856 DOI: 10.1038/s41598-022-23374-8] [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: 04/23/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
At present, the diagnosis of ectopic pregnancy mainly depends on transvaginal ultrasound and β-hCG. However, these methods may delay diagnosis and treatment time. Therefore, we aimed to screen for serological molecular markers for the early diagnosis of ectopic pregnancy (EP).Using data-independent acquisition (DIA)proteomics, the differential proteins in serum were selected between the intrauterine pregnancy (IP) and EP groups. Then, the expression levels of these differential proteins were measured by enzyme-linked immunosorbent assay. The diagnostic value of the serum biomarkers was evaluated by receiver operating characteristic curve analysis.GSTO1, ECM-1 and β-hCG showed significant differences between the EP and IP groups (P < 0.05). The combination of GSTO1/ECM-1/β-hCG had an area under the curve of 0.93 (95% CI 0.88-0.99), a sensitivity of 88.89% (95% CI 73.94-96.89) and a specificity of 86.11% (95% CI 70.50-95.33) with a likelihood ratio of 6.40.The combination of GSTO1/ECM-1/β-hCG may be developed into a possible approach for the early diagnosis of EP.
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10
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Wang Y, Wang S, Wang Y, Lu A, Cao L, Wang J, Gao Z, Yan C. Effects of prenatal exposure to arsenic on neonatal birth size in Wujiang, China. CHEMOSPHERE 2022; 299:134441. [PMID: 35358562 DOI: 10.1016/j.chemosphere.2022.134441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/07/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
To investigate prenatal exposure to arsenic and its effect on birth size, we conducted a cross-sectional study in Wujiang City, Jiangsu, China, from June 2009 to June 2010. A total of 1722 mother-infant pairs were included in the study. A questionnaire was administered to the pregnant women and umbilical cord blood(UCB) samples were collected. Arsenic concentration in UCB was detected by inductively coupled plasma emission mass spectroscopy (ICP-MS). The birth size included birth weight, birth body length and head circumference of the newborns. The effects of arsenic exposure on birth size were assessed by multiple linear regression analysis. Arsenic concentrations in UCB ranged from 0.11 to 30.36 μg/L, the median was 1.71 μg/L. In this range of exposure, arsenic concentration was significantly negatively associated with birth weight, especially among male infants. Our results showed that prenatal exposure to arsenic level was low in Wujiang City, China. However, low prenatal arsenic exposure could have negative effects on birth weight. Our research provided evidence for the adverse effects of prenatal low-level arsenic exposure on the intrauterine growth of the fetus.
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Affiliation(s)
- Yaqian Wang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Susu Wang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yihong Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anxin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lulu Cao
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ju Wang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhenyan Gao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chonghuai Yan
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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11
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Habibian Sezavar A, Abyareh M, Fahimi R, Nyasulu PS, Abyadeh M. The association between maternal cadmium exposure and small for gestational age: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1469-1477. [PMID: 33656412 DOI: 10.1080/09603123.2021.1892035] [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: 05/26/2020] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
Several observational studies have found an association between maternal Cadmium (Cd) exposure and Small for Gestational Age (SGA). However, these findings are inconsistent. We conducted this meta-analysis to evaluate the relationship between maternal cadmium exposure and SGA risk. A comprehensive search was performed through PubMed, Scopus, Embase, Web of Science, Cochrane Library and OpenGrey to retrieve all pertinent studies published before October 2020. A combined odds ratio (OR) and corresponding 95% confidence interval (CI) were employed to examine this correlation. As a result, nine eligible studies met the inclusion criteria and were included in a systematic review, of those six studies containing sample type of blood were included in meta-analysis, and present meta-analysis showed that maternal cadmium exposure increased the risk of SGA 1.31 times (OR = 1.31; 95% CI = 1.16-1.47 for highest versus lowest category of cadmium). This meta-analysis suggests that maternal Cd exposure may be a risk factor for SGA. However, large prospective studies from different ethnic populations with consideration of other influencing parameters are needed to confirm this finding.
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Affiliation(s)
- Ahmad Habibian Sezavar
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mostafa Abyareh
- Department of Environment, Faculty of Natural Resources, Yazd University, Yazd, Iran
| | - Reza Fahimi
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Peter Suwirakwenda Nyasulu
- Division of Epidemiology & Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Morteza Abyadeh
- Department of Molecular Systems Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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12
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Wang X, Pu Y, Ai S, Liu H, He S, Li Z, Dang Y. Associations of maternal blood mercury with preeclampsia and birth outcomes. Clin Chim Acta 2022; 531:361-367. [PMID: 35483441 DOI: 10.1016/j.cca.2022.04.991] [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: 02/14/2022] [Revised: 04/04/2022] [Accepted: 04/21/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mercury (Hg) is a highly toxic substance, and its harmful effects on maternal and infant health have been reported. Yet, the associations of Hg exposure with preeclampsia (PE) and adverse birth outcomes are not well understood. OBJECTIVE The aim of this study was to investigate the potential effects of maternal Hg exposure on PE and birth outcomes. METHODS We conducted a case-control study with 84 participants in China. Logistic models were used to estimate odds ratios for PE risk and birth outcomes according to maternal blood Hg levels, adjusting for potential confounding factors. RESULTS Elevated blood Hg levels were associated with increased risks of mild PE (aOR, 7.03; 95% CI, 1.61, 30.62; P < 0.01) and severe PE (aOR, 47.55; 95% CI, 5.27, 429.05; P < 0.05). We also found that increased blood Hg levels were associated with low birth weight (aOR, 1.12; 95% CI, 1.00, 1.25; P < 0.05) and preterm birth (PTB) (aOR, 1.22; 95% CI, 1.08, 1.38; P < 0.05). CONCLUSIONS Our study provided evidence that elevated blood Hg levels were significantly associated with an increased risk of PE. In addition, our findings support that increased blood Hg levels might be associated with low birth weight and PTB.
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Affiliation(s)
- Xiaxue Wang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Yudong Pu
- Institute of the Songshan Lake (SSL) Central Hospital of Dongguan City, Dongguan 523326, China.
| | - Shiwei Ai
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Haixia Liu
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Shuzhen He
- Institute of the Songshan Lake (SSL) Central Hospital of Dongguan City, Dongguan 523326, China.
| | - Zhilan Li
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Yuhui Dang
- Institute of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou 730000, China.
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13
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Ruan F, Zhang J, Liu J, Sun X, Li Y, Xu S, Xia W. Association between prenatal exposure to metal mixtures and early childhood allergic diseases. ENVIRONMENTAL RESEARCH 2022; 206:112615. [PMID: 34968434 DOI: 10.1016/j.envres.2021.112615] [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: 09/15/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
The association between prenatal exposure to the metal mixture and allergic diseases is poorly understood. We aimed to explore the individual effect and the combined effect of prenatal exposure to vanadium (V), chromium (Cr), nickel (Ni), arsenic (As), cadmium (Cd), thallium (Tl), and lead (Pb) on early childhood allergic diseases based on a birth cohort study that included 628 mother-infant pairs. Metals were measured in maternal urine samples collected in the first, second, and third trimesters. Children were prospectively followed up at age 4 years to collect information on allergic rhinitis, wheeze, and eczema status. By applying logistic regression models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR), the different statistical analyses revealed urinary metals were only associated with early childhood allergic rhinitis. The averaged prenatal As exposure was significantly associated with an increased OR for allergic rhinitis in both single-metal (OR = 2.04, 95% CI: 1.35, 3.07) and multiple-metal logistic regression models (OR = 1.78, 95% CI: 1.15, 2.78). The WQS index of mixed metal exposure was positively associated with allergic rhinitis (OR = 1.66, 95% CI: 1.26, 2.19), and As and Tl had the largest weights in the WQS index (weighted 0.51 and 0.29, respectively). The BKMR analysis also showed the overall effect of the metal mixture was significantly associated with allergic rhinitis when all the metals were at their 55th percentile or above, compared to their 50th percentile. The effect of As and Tl on the risk of allergic rhinitis was significant when all of the other metals were fixed at the specific percentiles. Our findings suggest that prenatal co-exposure to higher levels of the seven metals increases the risk of allergic rhinitis in children, and As and Tl may contribute most to the combined risk.
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Affiliation(s)
- Fengyu Ruan
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jingjing Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Juan Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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14
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Howe CG, Nozadi SS, Garcia E, O'Connor TG, Starling AP, Farzan SF, Jackson BP, Madan JC, Alshawabkeh AN, Cordero JF, Bastain TM, Meeker JD, Breton CV, Karagas MR. Prenatal metal(loid) mixtures and birth weight for gestational age: A pooled analysis of three cohorts participating in the ECHO program. ENVIRONMENT INTERNATIONAL 2022; 161:107102. [PMID: 35081493 PMCID: PMC8891091 DOI: 10.1016/j.envint.2022.107102] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND A growing number of studies have identified both toxic and essential metals which influence fetal growth. However, most studies have conducted single-cohort analyses, which are often limited by narrow exposure ranges, and evaluated metals individually. The objective of the current study was to conduct an environmental mixture analysis of metal impacts on fetal growth, pooling data from three geographically and demographically diverse cohorts in the United States participating in the Environmental Influences on Child Health Outcomes program. METHODS The pooled sample (N = 1,002) included participants from the MADRES, NHBCS, and PROTECT cohorts. Associations between seven metals (antimony, cadmium, cobalt, mercury, molybdenum, nickel, tin) measured in maternal urine samples collected during pregnancy (median: 16.0 weeks gestation) and birth weight for gestational age z-scores (BW for GA) were investigated using Bayesian Kernel Machine Regression (BKMR). Models were also stratified by cohort and infant sex to investigate possible heterogeneity. Chromium and uranium concentrations fell below the limits of detection for most participants and were evaluated separately as binary variables using pooled linear regression models. RESULTS In the pooled BKMR analysis, antimony, mercury, and tin were inversely and linearly associated with BW for GA, while a positive linear association was identified for nickel. The inverse association between antimony and BW for GA was observed in both males and females and for all three cohorts but was strongest for MADRES, a predominantly low-income Hispanic cohort in Los Angeles. A reverse j-shaped association was identified between cobalt and BW for GA, which was driven by female infants. Pooled associations were null for cadmium, chromium, molybdenum, and uranium, and BKMR did not identify potential interactions between metal pairs. CONCLUSIONS Findings suggest that antimony, an understudied metalloid, may adversely impact fetal growth. Cohort- and/or sex-dependent associations were identified for many of the metals, which merit additional investigation.
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Affiliation(s)
- Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood, Ave, Rochester, NY 14642, USA
| | - Anne P Starling
- Department of Epidemiology, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg, Campus Box 7435, Chapel Hill, NC 27599, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, 39 College St, Hanover, NH 03755, USA
| | - Juliette C Madan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA; Departments of Pediatrics and Psychiatry, Children's Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Akram N Alshawabkeh
- Department of Engineering, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA
| | - José F Cordero
- Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, 101 Buck Rd, Athens, GA 30602, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA
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15
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Ashrap P, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Performance of urine, blood, and integrated metal biomarkers in relation to birth outcomes in a mixture setting. ENVIRONMENTAL RESEARCH 2021; 200:111435. [PMID: 34097892 PMCID: PMC8403638 DOI: 10.1016/j.envres.2021.111435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Studies on the health effects of metal mixtures typically utilize biomarkers measured in a single biological medium, such as blood or urine. However, the ability to evaluate mixture effects are limited by the uncertainty whether a unified medium can fully capture exposure for each metal. Therefore, it is important to compare and assess metal mixtures measured in different media in epidemiology studies. OBJECTIVES The aim of this study was to examine the mixture predictive performance of urine and blood metal biomarkers and integrated multi-media biomarkers in association with birth outcomes. METHODS In our analysis of 847 women from the Puerto Rico PROTECT Cohort, we measured 10 essential and non-essential metals in repeated and paired samples of urine and blood during pregnancy. For each metal, we integrated exposure estimates from paired urine and blood biomarkers into multi-media biomarkers (MMBs), using intraclass-correlation coefficient (ICC) and weighted quantile sum (WQS) approaches. Using Ridge regressions, four separate Environmental risk scores (ERSs) for metals in urine, blood, MMBICC, and MMBWQS were computed as a weighted sum of the 10 metal concentrations. We then examined associations between urine, blood, and multi-media biomarker ERSs and birth outcomes using linear and logistic regressions, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. The performance of each ERS was evaluated with continuous and tertile estimates and 95% confidence intervals of the odds ratio of preterm birth using area under the curve (AUC). RESULTS Pb was the most important contributor of blood ERS as well as the two integrated multi-media biomarker ERSs. Individuals with high ERS (3rd tertile) showed increased odds of preterm birth compared to individuals with low ERS (1st tertile), with 2.8-fold (95% CI, 1.49 to 5.40) for urine (specific gravity corrected); 3.2- fold (95% CI, 1.68 to 6.25) for blood; 3.9-fold (95% CI, 1.72 to 8.66) for multi-media biomarkers composed using ICC; and 5.2-fold (95% CI, 2.34 to 11.42) for multi-media biomarkers composed using WQS. The four ERSs had comparable predictive performances (AUC ranging from 0.64 to 0.68) when urine is examined with specific gravity corrected concentrations. CONCLUSIONS Within a practical metal panel, measuring metals in either urine or blood may be an equally good approach to evaluate the metals as a mixture. Applications in practical study design require validation of these methods with other cohorts, larger panels of metals and within the context of other adverse health effects of interest.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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16
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Gokoel AR, Shankar A, Abdoel Wahid F, Hindori-Mohangoo AD, Covert HH, Wickliffe JK, Harville EW, Zijlmans WCWR, Lichtveld MY. The Cumulative Risk of Prenatal Exposures to Chemical and Non-Chemical Stressors on Birth Outcomes in Suriname. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147683. [PMID: 34300134 PMCID: PMC8305475 DOI: 10.3390/ijerph18147683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 01/21/2023]
Abstract
The cumulative exposure to chemical and non-chemical stressors may have an impact on birth outcomes. The aim of this study is to examine the cumulative exposure of a mixture of chemicals (mercury, lead, selenium and tin) and non-chemical stressors (social support, perceived stress, probable depression and BMI) on birth outcomes (birthweight, gestational age at birth, and Apgar score at 5 min). The study population is a subset (n = 384) of the Caribbean Consortium for Research in Environmental and Occupational Health–MeKiTamara prospective cohort study. Associations between the latent chemical construct, non-chemical stressors and birth outcomes were assessed using path models. The results showed a significant direct relationship between perceived stress and birthweight (β = −0.17), however even though the relationship between perceived stress and depression was significant in all three path models (β = 0.61), the association between depression and birth outcomes was not significant. Perceived stress was significantly associated with community engagement (β = −0.12) and individual resilience (β = −0.12). BMI (β = 0.12) was also significantly directly associated with birthweight. The latent chemical construct did not show an association with the birth outcomes. Our data indicate the need for the development of a support system for pregnant women by involving them in prenatal care programs to reduce maternal stress, which may also influence depression and (in)directly improve the birth outcomes. Interventions regarding weight management for women of childbearing age are necessary to halt obesity and its negative effects on birth outcomes.
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Affiliation(s)
- Anisma R. Gokoel
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname;
- Correspondence:
| | - Arti Shankar
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Firoz Abdoel Wahid
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (F.A.W.); (M.Y.L.)
| | - Ashna D. Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA; (A.D.H.-M.); (H.H.C.)
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - Hannah H. Covert
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA; (A.D.H.-M.); (H.H.C.)
| | - Jeffrey K. Wickliffe
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Emily W. Harville
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Wilco C. W. R. Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname;
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA; (A.D.H.-M.); (H.H.C.)
| | - Maureen Y. Lichtveld
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (F.A.W.); (M.Y.L.)
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17
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Goto Y, Mandai M, Nakayama T, Yamazaki S, Nakayama SF, Isobe T, Sato T, Nitta H. Association of prenatal maternal blood lead levels with birth outcomes in the Japan Environment and Children's Study (JECS): a nationwide birth cohort study. Int J Epidemiol 2021; 50:156-164. [PMID: 33141187 DOI: 10.1093/ije/dyaa162] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite dramatic declines in prenatal maternal blood lead levels (BLLs) in most developed countries, little is known about the effects of extremely low-level (<1.0 µg/dL) lead exposure on fetal growth. METHODS We measured maternal BLL during the second or third trimester of pregnancy and assessed birth outcomes, including birthweight, preterm birth (<37 gestational weeks) risk, small for gestational age births (SGA; birthweight <10th percentile) and low birthweight (LBW; <2500 g). The association between birthweight and maternal BLL was estimated using linear and quadratic spline models. Multivariable logistic models were used to examine the risk of binary responses. RESULTS From 103 099 pregnant women, 20 000 blood samples were randomly selected for analysis. The maternal BLL range was 0.16-7.4 µg/dL, and the median was 0.63 µg/dL. After adjusting for covariates, the linear model showed that each 0.1 μg/dL increase in maternal BLL was associated with a 5.4 g decrease in mean birthweight [95% confidence interval (CI), 3.4 to 7.5 g]. The risk of SGA [adjusted odds ratio (aOR), 1.03; 95% CI, 1.02 to 1.05) and LBW (aOR, 1.03; 95% CI, 1.02 to 1.05) increased, whereas the risk of preterm delivery did not (aOR, 0.99; 95% CI, 0.97 to 1.02). CONCLUSIONS Even at a maternal BLL below 1.0 µg/dL, prenatal lead exposure was associated with decreased birthweight and increased risk of SGA and LBW, but not preterm delivery. The adverse effect estimates of prenatal lead exposure on birth outcomes were quantitatively small and clinically limited at this low level.
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Affiliation(s)
| | - Marie Mandai
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Shin Yamazaki
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Tomohiko Isobe
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
| | - Tosiya Sato
- Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan
| | - Hiroshi Nitta
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
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Tikhonov C, Schwartz H, Marushka L, Chan HM, Batal M, Sadik T, Ing A, Fediuk K. Regionally representative hair mercury levels in Canadian First Nations adults living on reserves. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:97-112. [PMID: 34181227 PMCID: PMC8239105 DOI: 10.17269/s41997-021-00508-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 03/11/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The primary objective of this participatory study was to assess the current body burden of mercury among First Nations adults. METHODS The First Nations Food, Nutrition and Environment Study (2008-2018) collected regionally representative data from First Nations adults living on reserves south of the 60th parallel. Mercury was analyzed in hair as a preferred biomarker for prolonged exposure. Hair samples, a 5 mm bundle cut from the occipital region, were collected from the participants who gave consent and measured for total mercury concentrations using cold vapor atomic fluorescence spectrophotometry. RESULTS In total, 3404 First Nations adults living in 92 communities provided hair samples. This represents 52.5% of the respondents to the household surveys. The mean hair mercury concentrations were 0.56 μg/g among all participants and 0.34 μg/g among women of childbearing age (WCBA). There were 64 exceedances of Health Canada's mercury biomonitoring guidelines (44 WCBA, 8 women aged 51+ years, 3 men aged 19-50 years, and 9 men aged 51+ years). CONCLUSION Current mercury exposure no longer presents a significant clinical health risk in most of the First Nations population south of the 60th parallel across Canada. However, mercury exposure continues to be an ongoing environmental public health concern that requires continued monitoring and assessment. Women of childbearing age (19-50 years) and older individuals living in northern ecozones and Quebec have higher mercury exposures, often exceeding Health Canada's guidelines. Careful risk communication and risk management programs need to focus on northern ecozones and Quebec.
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Affiliation(s)
- Constantine Tikhonov
- First Nations and Inuit Health Branch, Indigenous Services Canada, Ottawa, ON, Canada.
| | - Harold Schwartz
- First Nations and Inuit Health Branch, Indigenous Services Canada, Ottawa, ON, Canada
| | - Lesya Marushka
- First Nations and Inuit Health Branch, Indigenous Services Canada, Ottawa, ON, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, ON, K1N 6N5, Canada
| | - Malek Batal
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, C.P. 6128, succ. Centre-Ville, Montréal, QC, H3T 1A8, Canada
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSS du Centre-sud-de-l'Île-de-Montréal (CReSP), 7101 Avenue du Parc, Montréal, QC, H3N 1X7, Canada
| | - Tonio Sadik
- Assembly of First Nations, 55 Metcalfe Street, Suite 1600, Ottawa, ON, K1P 6L5, Canada
| | - Amy Ing
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, C.P. 6128, succ. Centre-Ville, Montréal, QC, H3T 1A8, Canada
| | - Karen Fediuk
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, ON, K1N 6N5, Canada
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Signes-Pastor AJ, Desai G, García-Villarino M, Karagas MR, Kordas K. Exposure to a mixture of metals and growth indicators in 6-11-year-old children from the 2013-16 NHANES. EXPOSURE AND HEALTH 2021; 13:173-184. [PMID: 34151044 PMCID: PMC8210664 DOI: 10.1007/s12403-020-00371-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/09/2020] [Accepted: 07/03/2020] [Indexed: 05/18/2023]
Abstract
Lead (Pb), mercury (Hg) and fluoride (F) exposure during childhood is of concern owing to their toxicity. Also, evidence suggests that high and low exposure levels to manganese (Mn) and selenium (Se) during this vulnerable period are associated with an increased risk of adverse health effects. A reduced growth is associated with high Pb and F exposure; however, little is known about their impact on children's body size, and there is a lack of consensus on the effects of Hg, Mn, and Se exposure on children's anthropometric measures. This is particularly true for childhood metal co-exposures at levels relevant to the general population. We investigated the joint effects of exposure to a metal mixture (Pb, Mn, Hg, and Se in blood and F in plasma) on 6-11-year-old US children's anthropometry (n = 1,634). Median F, Pb, Mn, Hg, and Se concentrations were 0.3 μmol/L, 0.5 μg/dL, 10.2 μg/L, 0.3 μg/L, and 178.0 μg/L, respectively. The joint effects of the five metals were modeled using Bayesian kernel machine and linear regressions. Pb and Mn showed opposite directions of associations with all outcome measured, where Pb was inversely associated with anthropometry. For body mass index and waist circumference, the effect estimates for Pb and Mn appeared stronger at high and low concentrations of the other metals of the mixture, respectively. Our findings suggest that metal co-exposures may influence children's body mass and linear growth indicators, and that such relations may differ by the exposure levels of the components of the metal mixture.
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Affiliation(s)
| | - Gauri Desai
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Miguel García-Villarino
- Unit of Molecular Cancer Epidemiology- IUOPA-CIBERESP, Department of Medicine, University of Oviedo, Oviedo
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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20
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Padmanabhan V, Song W, Puttabyatappa M. Praegnatio Perturbatio-Impact of Endocrine-Disrupting Chemicals. Endocr Rev 2021; 42:295-353. [PMID: 33388776 PMCID: PMC8152448 DOI: 10.1210/endrev/bnaa035] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/07/2023]
Abstract
The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes receiving considerable attention in recent years is gestational exposure to endocrine-disrupting chemicals (EDCs). Humans are exposed to a multitude of environmental chemicals with known endocrine-disrupting properties, and evidence suggests exposure to these EDCs have the potential to disrupt the maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes-a risk factor for adult-onset noncommunicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediators involved, and the research directions on which to focus future investigations to help alleviate the adverse effects of EDC exposure.
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Affiliation(s)
| | - Wenhui Song
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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21
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Padmanabhan V, Moeller J, Puttabyatappa M. Impact of gestational exposure to endocrine disrupting chemicals on pregnancy and birth outcomes. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 92:279-346. [PMID: 34452689 DOI: 10.1016/bs.apha.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the advent of industrialization, humans are exposed to a wide range of environmental chemicals, many with endocrine disrupting potential. As successful maintenance of pregnancy and fetal development are under tight hormonal control, the gestational exposure to environmental endocrine disrupting chemicals (EDC) have the potential to adversely affect the maternal milieu and support to the fetus, fetal developmental trajectory and birth outcomes. This chapter summarizes the impact of exposure to EDCs both individually and as mixtures during pregnancy, the immediate and long-term consequences of such exposures on the mother and fetus, the direct and indirect mechanisms through which they elicit their effects, factors that modify their action, and the research directions to focus future investigations.
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Affiliation(s)
| | - Jacob Moeller
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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22
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Lee MS, Eum KD, Golam M, Quamruzzaman Q, Kile ML, Mazumdar M, Christiani DC. Umbilical Cord Blood Metal Mixtures and Birth Size in Bangladeshi Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:57006. [PMID: 33989040 PMCID: PMC8121379 DOI: 10.1289/ehp7502] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 04/09/2021] [Accepted: 04/23/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Studies have evaluated environmental exposure to toxic metals such as arsenic (As), cadmium (Cd), manganese (Mn), or lead (Pb) on birth size; however, information on potential effects of exposures to metal mixtures is limited. OBJECTIVES We assessed the association between metal mixtures (As, Cd, Mn, Pb) in umbilical cord blood and neonate size in Bangladeshi children. METHODS In this birth cohort study, pregnant women who were ≥18 years of age with an ultrasound-confirmed singleton pregnancy of ≤16wk gestation were recruited from two Bangladesh clinics between 2008 and 2011. Neonate size metrics were measured at the time of delivery. Metals in cord blood were measured using inductively coupled plasma mass spectrometry. We employed multivariable linear regression and Bayesian kernel machine regression (BKMR) to estimate associations of individual metals and metal mixtures with birth size parameters. RESULTS Data from 1,088 participants was assessed. We found a significant negative association between metal mixture and birth length and head circumference when all metal concentrations were above the 60th and 55th percentiles, respectively, compared with the median. An interquartile range (IQR) increase in log Cd concentration {log[Cd (in micrograms per deciliter)] IQR=2.51} was associated with a 0.13-standard deviation (SD) decrease in mean birth length (95% CI: -0.25, -0.02) and a 0.17-SD decrease in mean head circumference (95% CI: -0.28, -0.05), based on linear regression models adjusted for covariates and the other metals. An IQR increase in log Mn concentration {log[Mn (in micrograms per deciliter)] IQR=0.69} was associated with a 0.07-SD decrease in mean birth weight (95% CI: -0.15, 0.002). DISCUSSION Metal mixtures in cord blood were associated with reduced birth size in Bangladeshi children. Results from linear regression models adjusted and the BKMR mixtures analyses suggest adverse effects of Cd and Mn, as individual metal exposures, on birth size outcomes. https://doi.org/10.1289/EHP7502.
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Affiliation(s)
- Mi-Sun Lee
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ki-Do Eum
- Department of Civil and Environmental Engineering, School of Engineering, Tufts University, Medford, Massachusetts, USA
| | | | | | - Molly L. Kile
- College of Public Health and Human Science, Oregon State University, Corvallis, Oregon, USA
| | - Maitreyi Mazumdar
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - David C. Christiani
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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23
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Iwai-Shimada M, Kobayashi Y, Isobe T, Nakayama SF, Sekiyama M, Taniguchi Y, Yamazaki S, Michikawa T, Oda M, Mitsubuchi H, Sanefuji M, Ohga S, Mise N, Ikegami A, Suga R, Shimono M. Comparison of Simultaneous Quantitative Analysis of Methylmercury and Inorganic Mercury in Cord Blood Using LC-ICP-MS and LC-CVAFS: The Pilot Study of the Japan Environment and Children's Study. TOXICS 2021; 9:toxics9040082. [PMID: 33918897 PMCID: PMC8069649 DOI: 10.3390/toxics9040082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
Prenatal exposure to methylmercury (MeHg) affects child development after birth. However, many epidemiological studies have evaluated total mercury levels without analyzing speciation. Biomonitoring of MeHg and inorganic mercury (IHg) is essential to reveal each exposure level. In this study, we compared a high-throughput analysis for mercury speciation in blood using liquid chromatography-inductively coupled plasma-mass spectrometry (LC-ICP-MS) and liquid chromatography-cold vapor atomic fluorescence spectrometry (LC-CVAFS). The validated LC-ICP-MS method was applied to 101 maternal blood and 366 cord blood samples in the pilot study of the Japan Environment and Children’s Study (JECS). The accuracy of the LC-CVAFS method ranged 90–115% determined by reference material analysis. To evaluate the reliability of 366 cord blood samples, fifty cord blood samples were randomly selected and analyzed using LC-CVAFS. The median (5th–95th percentile) concentrations of MeHg and IHg were 5.4 (1.9–15) and 0.33 (0.12–0.86) ng/mL, respectively, in maternal blood, and 6.3 (2.5–15) and 0.21 (0.08–0.49) ng/mL, respectively, in cord blood. Inter-laboratory comparison showed a relatively good agreement between LC-ICP-MS and LC-CVAFS. The median cord blood:maternal blood ratios of MeHg and IHg were 1.3 and 0.5, respectively. By analyzing speciation, we could focus on the health effects of each chemical form.
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Affiliation(s)
- Miyuki Iwai-Shimada
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Yayoi Kobayashi
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Tomohiko Isobe
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Shoji F. Nakayama
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
- Correspondence:
| | - Makiko Sekiyama
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Yu Taniguchi
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Shin Yamazaki
- Japan Environment and Children’s Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan; (M.I.-S.); (Y.K.); (T.I.); (M.S.); (Y.T.); (S.Y.)
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo 143-8540, Japan;
| | - Masako Oda
- The Southern Kyusyu and Okinawa Regional Centre, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan;
| | - Hiroshi Mitsubuchi
- Department of Neonatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan;
| | - Masafumi Sanefuji
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (M.S.); (S.O.)
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Shouichi Ohga
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (M.S.); (S.O.)
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Nathan Mise
- Department of Environmental and Preventive Medicine, Jichi Medical University, Tochigi 329-0498, Japan; (N.M.); (A.I.)
| | - Akihiko Ikegami
- Department of Environmental and Preventive Medicine, Jichi Medical University, Tochigi 329-0498, Japan; (N.M.); (A.I.)
| | - Reiko Suga
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (R.S.); (M.S.)
| | - Masayuki Shimono
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (R.S.); (M.S.)
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Ashrap P, Aker A, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Psychosocial status modifies the effect of maternal blood metal and metalloid concentrations on birth outcomes. ENVIRONMENT INTERNATIONAL 2021; 149:106418. [PMID: 33548848 PMCID: PMC7897320 DOI: 10.1016/j.envint.2021.106418] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Metal exposure and psychosocial stress in pregnancy have each been associated with adverse birth outcomes, including preterm birth and low birth weight, but no study has examined the potential interaction between them. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between metals and birth outcomes among pregnant women in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) birth cohort study. METHODS In our analysis of 682 women from the PROTECT study, we measured 16 essential and non-essential metals in blood samples at two time points. We administered questionnaires to collect information on depression, perceived stress, social support, and life experience during pregnancy. Using K-means clustering, we categorized pregnant women into one of two groups: "good" and "poor" psychosocial status. We then evaluated whether the effect of blood metals (geometric average) on adverse birth outcomes (gestational age, preterm birth [overall and spontaneous], birth weight z-score, small for gestation [SGA], large for gestation [LGA]) vary between two clusters of women, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. RESULTS Blood manganese (Mn) was associated with an increased odds ratio (OR) of overall preterm birth (OR/interquartile range [IQR] = 2.76, 95% confidence interval [CI] = 1.25, 6.12) and spontaneous preterm birth (OR/IQR: 3.68, 95% CI: 1.20, 6.57) only among women with "poor" psychosocial status. The association between copper (Cu) and SGA was also statistically significant only among women having "poor" psychosocial status (OR/IQR: 2.81, 95% CI: 1.20, 6.57). We also observed associations between nickel (Ni) and preterm birth and SGA that were modified by psychosocial status during pregnancy. CONCLUSIONS Presence of "poor" psychosocial status intensified the adverse associations between Mn and preterm birth, Cu and SGA, and protective effects of Ni on preterm. This provides evidence that prenatal psychosocial stress may modify vulnerability to metal exposure.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Amira Aker
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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Karakis I, Landau D, Gat R, Shemesh N, Tirosh O, Yitshak-Sade M, Sarov B, Novack L. Maternal metal concentration during gestation and pediatric morbidity in children: an exploratory analysis. Environ Health Prev Med 2021; 26:40. [PMID: 33765932 PMCID: PMC7995788 DOI: 10.1186/s12199-021-00963-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/12/2021] [Indexed: 01/28/2023] Open
Abstract
Background The majority of studies linking exposure to metals with certain health outcomes focus on known toxic metals. Alternatively, this study assesses the extent to which exposure to a wider range of metals during gestation is associated with childhood morbidity. Methods We analyzed the concentrations of 25 metals found in urine samples of 111 pregnant women of Arab-Bedouin origin collected prior to birth. In addition, we collected medical records on their offspring for six years following birth, including every interaction with HMOs, local hospitals, and pharmacies. Results The main types of morbidities diagnosed and treated during this period were preterm births, malformations, asthma-like morbidity, cardiovascular and behavioral problems, and obesity. Multivariable analysis showed that offspring born before term were more likely to have been exposed to elevated maternal concentrations of zinc, thallium, aluminum, manganese, and uranium, all with adjusted relative risk above 1.40 for an increase by each quintile. Likewise, children with asthma had been exposed to higher levels of magnesium, strontium, and barium at gestation, while behavioral outcomes were associated with elevated biometals, i.e., sodium, magnesium, calcium, selenium, and zinc, as well as higher levels of lithium, cobalt, nickel, strontium, cadmium, vanadium, arsenic, and molybdenum. A heatmap of adjusted relative risk estimates indicates the considerable implications that exposure to metals may have for preterm birth and developmental outcomes. Conclusions The current study shows that perinatal exposure to metals is adversely associated with pediatric morbidity. Further such analyses on additional samples are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00963-z.
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Affiliation(s)
- Isabella Karakis
- Environmental Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Daniella Landau
- Neonatology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Roni Gat
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nofar Shemesh
- Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ofir Tirosh
- The Fredy and Nadine Herrmann Institute of Earth Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Maayan Yitshak-Sade
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Batia Sarov
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel. .,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. .,Negev Environmental Health Research Institute, Soroka University Medical Center, Sderot Rager 151, 84101, Beer-Sheva, Israel.
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26
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Amegah AK, Sewor C, Jaakkola JJK. Cadmium exposure and risk of adverse pregnancy and birth outcomes: a systematic review and dose-response meta-analysis of cohort and cohort-based case-control studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:299-317. [PMID: 33510430 DOI: 10.1038/s41370-021-00289-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/26/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There are several inconsistencies in the epidemiological literature on the strength of the association between cadmium exposure and adverse pregnancy and birth outcomes, and the threshold dose of adverse effect. OBJECTIVES We therefore conducted a systematic review and dose-response meta-analysis to evaluate the available evidence to influence clinical decision making and better tailor public health interventions. METHODS PubMed and Scopus databases were searched up to January, 2019. Eighteen prospective studies satisfied the inclusion criteria. Random effects model was used to compute summary-effect estimates. RESULTS Cadmium exposure resulted in 42.11 g (95% confidence interval [CI]: -69.03, -15.18) reduction in birth weight, and 0.105 cm (95% CI: -0.181, -0.029) reduction in head circumference per 1 µg/l increment in blood/urine cadmium levels. Cadmium exposure also resulted in 21% (RR = 1.21; 95% CI: 1.02, 1.43), 32% (RR = 1.32; 95% CI: 1.05, 1.67) and 10% (RR = 1.10; 95% CI: 0.96, 1.27) increased risk of low birth weight (LBW), preterm birth (PTB), and small-for-gestational age (SGA), respectively. Risk for all outcomes decreased with decreasing exposure. In fixed effects dose-response meta-regression analyses, we found no evidence of association of cadmium exposure with LBW and SGA. For PTB, a 1 µg/l increment in cadmium exposure corresponded to 0.5% (OR = 1.005, 95% CI: 1.003, 1.007) increase in PTB risk. CONCLUSIONS Cadmium exposure was associated with risk of adverse birth outcomes. Regarding PTB, the formal dose-response meta-analyses suggests a causal association.
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Affiliation(s)
- A Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Christian Sewor
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
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Sezavar AH, Pourhassan B, Kakavandi NR, Hooshangi Shayeste MR, Abyadeh M. Association of maternal blood lead concentration with the risk of small for gestational age: A dose-response meta-analysis. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:293-300. [PMID: 33492189 DOI: 10.1080/19338244.2021.1874857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In spite of growing evidence for the negative effect of lead, knowledge about the dose-response relationship of maternal blood lead level (BLL) and the risk of small for gestational age (SGA) is limited. We performed this meta-analysis to evaluate the dose-response relation between maternal BLL and the risk of SGA. A systematic search through Embase and PubMed was performed. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated. The nonlinear and linear relationships between maternal BLL and the risk of SGA were also investigated. Results from 51,065 patients showed a significant association between maternal BLL and risk of SGA in highest versus lowest analysis (OR: 1.54; 95% CI: 1.12-2.10, p = 0.007). While there was no association in linear dose-response (OR: 1.02; 95% CI: 1.00-1.04, p = 0.021) meta-analysis, a direct relationship was observed in the nonlinear model (nonlinearity p < 0.001). Results of this dose-response meta-analysis showed that maternal BLL higher than ∼ 0.3 µg/dL is directly associated with the risk of SGA.
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Affiliation(s)
- Ahmad Habibian Sezavar
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahman Pourhassan
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Rahimi Kakavandi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Morteza Abyadeh
- Department of Molecular Systems Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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Howe CG, Claus Henn B, Eckel SP, Farzan SF, Grubbs BH, Chavez TA, Hodes TL, Faham D, Al-Marayati L, Lerner D, Quimby A, Twogood S, Richards MJ, Meeker JD, Bastain TM, Breton CV. Prenatal Metal Mixtures and Birth Weight for Gestational Age in a Predominately Lower-Income Hispanic Pregnancy Cohort in Los Angeles. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:117001. [PMID: 33141601 PMCID: PMC7608819 DOI: 10.1289/ehp7201] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Reduced fetal growth increases the risk for adverse health outcomes. Growing evidence suggests that metal exposures contribute to reduced fetal growth, but little is known about the effects of complex metal mixtures. OBJECTIVES We investigated the impact of a complex mixture of metals on birth weight for gestational age (BW for GA) in the Maternal and Developmental Risks from Environmental and Social Stressors study, a predominately lower-income Hispanic pregnancy cohort in Los Angeles, California. METHODS Cadmium (Cd), cobalt (Co), mercury (Hg), nickel (Ni), molybdenum (Mo), lead (Pb), antimony (Sb), tin (Sn), and thallium (Tl) were measured by inductively coupled plasma mass spectrometry (ICP-MS) in maternal urine samples collected in early pregnancy (median GA: 13.1 wk). Speciated urinary arsenic (As) (inorganic+monomethyl+dimethyl As) was measured by high-performance liquid chromatography coupled to ICP-MS. Primary analyses focused on a mixture of seven metals that have previously been associated individually with fetal growth (i.e., As, Cd, Co, Hg, Ni, Pb, Tl) (n=262). In exploratory analyses, we additionally examined three metals that have been less studied in relation to fetal growth (i.e., Mo, Sb, Sn). Covariate-adjusted Bayesian kernel machine regression was used to investigate metal mixture associations with BW for GA z-scores. RESULTS In primary analyses, Hg and Ni ranked highest as predictors of BW for GA. An inverse linear association was estimated for Hg, whereas a positive association was estimated for Ni at low-to-moderate concentrations. A potential interaction between Hg and Ni was also identified. In our exploratory analysis, Sb ranked highest as a predictor of BW for GA, followed by Hg and Ni. CONCLUSIONS Our findings suggest that in this understudied population, Hg may reduce fetal growth, whereas Ni may promote fetal growth. We also identified Sb as a potential metal of concern for this population, which merits additional investigation. https://doi.org/10.1289/EHP7201.
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Affiliation(s)
- Caitlin G. Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sandrah P. Eckel
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, Los Angeles, California, USA
| | - Thomas A. Chavez
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Tahlia L. Hodes
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Dema Faham
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, Los Angeles, California, USA
- Eisner Health, Los Angeles, California, USA
| | | | - Alyssa Quimby
- Department of Obstetrics and Gynecology, Keck School of Medicine, Los Angeles, California, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sara Twogood
- Department of Obstetrics and Gynecology, Keck School of Medicine, Los Angeles, California, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Theresa M. Bastain
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Carrie V. Breton
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Young JL, Cai L. Implications for prenatal cadmium exposure and adverse health outcomes in adulthood. Toxicol Appl Pharmacol 2020; 403:115161. [PMID: 32721433 DOI: 10.1016/j.taap.2020.115161] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 02/08/2023]
Abstract
Cadmium is a ubiquitous, non-essential metal that has earned a spot on the World Health Organizations top 10 chemicals of major public health concern. The mechanisms of cadmium-induced adverse health outcomes, such as cardiovascular disease, renal toxicity and cancer, are well studied in adults. However, the implications for early life exposures to low-level cadmium leading to increased risk of developing diseases in adulthood remains elusive. Epidemiological investigation of the long term implications of cadmium-associated adverse birth outcomes are limited and studies do not extend into adulthood. This review will summarize the literature on the non-lethal, adverse health effects associated with prenatal and early life exposure to cadmium and the implications of these exposures in the development of diseases later in life. In addition, this review will highlight possible mechanisms responsible for these outcomes as well as address the inconsistencies in the literature. More recent studies have addressed sex as a biological variable, showing prenatal cadmium exposure elicits sex-specific outcomes that would otherwise be masked by pooling male and female data. Furthermore, researchers have begun to investigate the role of prenatal and early life cadmium exposures in the development of diet-induced diseases with evidence of altered essential metal homeostasis as a likely mechanism for cadmium-enhanced, diet-induced diseases. Although novel experimental models are beginning to be established to study the association between prenatal cadmium exposure and adverse health outcomes in adulthood, the studies are few, highlighting a major need for further investigation.
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Affiliation(s)
- Jamie L Young
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Lu Cai
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; Departments of Pediatrics and Radiation Oncology, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, KY 40202, USA.
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30
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Kabamba M, Tuakuila J. Toxic metal (Cd, Hg, Mn, Pb) partition in the maternal/foetal unit: A systematic mini - review of recent epidemiological studies. Toxicol Lett 2020; 332:20-26. [PMID: 32569801 DOI: 10.1016/j.toxlet.2020.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 02/02/2023]
Abstract
The aim of this study was to summarise the available information regarding the partition of toxic metal (Cd, Hg, Mn, Pb) levels in the maternal/foetal unit from large epidemiological studies. We performed a systematic search of PubMed/MedLine, EMBASE, and ISI Web of Science for papers on Cd, total Hg, Mn or Pb levels in the maternal/cord blood that were published in English (n > = 200; 2010-2017). Data on year of publication, sample size, location, year of survey, and main results were extracted. We found a total of 35 papers. Most studies included large convenience samples of healthy pregnant women. The maternal/cord blood was properly used as a biomarker of prenatal exposure to toxic metals. The partition of these toxic metal levels in the maternal/foetal unit was metal-specific. Cd median levels (IQR) in cord blood reported worldwide were much lower [∼ 70 % < LOD = ± 0.11 μg/L] than those found in maternal blood [0.23 μg/L (0.15-0.35), ∼ 65 % > LOD]. Considering that Cd was under LOD in 70 % of the cord blood, Cd cord:maternal ratio as well as Cd cord proportion were not provided. Total Hg median levels (IQR) in cord blood [0.75 μg/L (0.40-1.19), ∼30 % < LOD = ±0.35 μg/L] were usually higher than in maternal blood [0.55 μg/L (0.40-0.85), ∼ 10 % < LOD = ±0.15 μg/L]. Hg cord:maternal ratio was 1.34 (1.00-1.91), and infants born would have Hg cord:(cord + maternal) proportion ranged from 0.50 to 0.63. Mn was the only metal that was detected in 100 % in both maternal (LOD : ±0.50 μg/L) and cord (LOD = ±0.2 μg/L) blood. Mn median levels (IQR) in cord blood [32.96 μg/L (26.90-40.10)] were 2 times higher than in maternal blood [14.01 μg/L (11.50-17.58)]. Mn cord:maternal ratio was 2.35 (1.09-3.80), and infants born would have Mn proportion ranged from 0.52 to 0.79. Pb median levels (IQR) in cord blood [5.79 μg/L (4.34-8.38), ∼ 5% < LOD : ±2.07 μg/L] were usually equal to or lower than those reported in maternal blood [8.07 μg/L (5.79-10.76), ∼ 1% < LOD = ±1.03 μg/L]. Pb cord:maternal ratio was 0.71 (0.59-0.96), and infants born would have Pb proportion ranged from 0.37 to 0.49. Globally, the results indicate that total Hg and Mn levels were lower in maternal blood but higher in cord blood. However, much greater variability was seen with Cd and Pb. At delivery, total Hg and Pb levels in maternal blood were strong predictors of cord blood levels. Our findings empty that understanding the partition, levels and correlations of toxic metals in the maternal/cord blood may help to elucidate the adverse effects of these metals on foetuses and neonates.
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Affiliation(s)
- M Kabamba
- Faculty of Sciences, University of Kinshasa, Democratic Republic of Congo
| | - J Tuakuila
- Faculty of Sciences, University of Kinshasa, Democratic Republic of Congo; Faculty of Health Sciences, University of Sherbrooke, Quebec, Canada.
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31
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Ashrap P, Watkins DJ, Mukherjee B, Boss J, Richards MJ, Rosario Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Maternal blood metal and metalloid concentrations in association with birth outcomes in Northern Puerto Rico. ENVIRONMENT INTERNATIONAL 2020; 138:105606. [PMID: 32179314 PMCID: PMC7198231 DOI: 10.1016/j.envint.2020.105606] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND In previous studies, exposures to heavy metals such as Pb and Cd have been associated with adverse birth outcomes; however, knowledge on effects at low levels of exposure and of other elements remain limited. METHOD We examined individual and mixture effects of metals and metalloids on birth outcomes among 812 pregnant women in the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort. We measured 16 essential and non-essential metal(loid)s in maternal blood collected at 16-20 and 24-28 weeks gestation. We used linear and logistic regression to independently examine associations between geometric mean (GM) concentrations of each metal across visits and gestational age, birthweight z-scores, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). We evaluated effect modification with infant sex*metal interaction terms. To identify critical windows of susceptibility, birth outcomes were regressed on visit-specific metal concentrations. Furthermore, average metal concentrations were divided into tertiles to examine the potential for non-linear relationships. We used elastic net (ENET) regularization to construct Environmental Risk Score (ERS) as a metal risk score and Bayesian Kernel Machine Regression (BKMR) to identify individual metals most critical to each outcome, accounting for correlated exposures. RESULTS In adjusted models, an interquartile range (IQR) increase in GM lead (Pb) was associated with 1.63 higher odds of preterm birth (95%CI = 1.17, 2.28) and 2 days shorter gestational age (95% CI = -3.1, -0.5). Manganese (Mn) and zinc (Zn) were also associated with higher odds of preterm birth and shorter gestational age; the associations were strongest among the highest tertile for Mn and among females for Zn. Mercury (Hg) was associated with higher risk of preterm birth at the later window of pregnancy. Ni measured later in pregnancy was associated with lower odds of SGA. ENET and BKMR models selected similar metals as "important" predictors of birth outcomes. The association between ERS and preterm birth was assessed and the third tertile of ERS was significantly associated with an elevated odds ratio of 2.13 (95% CI = 1.12, 5.49) for preterm birth compared to the first tertile. CONCLUSION As the PROTECT cohort has lower Pb concentrations (GM = 0.33 μg/dL) compared to the mainland US, our findings suggest that low-level prenatal lead exposure, as well as elevated Mn and Zn exposure, may adversely affect birth outcomes. Improved understanding on environmental factors contributing to preterm birth, together with sustainable technologies to remove contamination, will have a direct impact in Puerto Rico and elsewhere.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Jonathan Boss
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | | | - Zaira Rosario
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, Puerto Rico, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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Scott-Richardson M, Ruiz MO, Smith RL. Examining the Relationship Between Low Birth Weight Occurrence and Passive Measures of Environmental Arsenic by Census Tract in Escambia and Santa Rosa Counties, Florida. ENVIRONMENTAL HEALTH INSIGHTS 2020; 14:1178630220913053. [PMID: 32341650 PMCID: PMC7169366 DOI: 10.1177/1178630220913053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/14/2020] [Indexed: 06/11/2023]
Abstract
Arsenic is a public health concern because of its widespread distribution and high toxicity, even when doses are small. Low birth weight (LBW) occurrence, birth weights less than 2500 g, may be associated with prenatal exposure of arsenic from environmental factors and consuming contaminated drinking water and food. The objective of this study was to examine whether mothers living in areas of Escambia and Santa Rosa counties with varying levels of background arsenic in surface soil and water were associated with the occurrence of LBW. Inverse distance weight in ArcGIS was used to interpolate arsenic concentrations from environmental samples and estimate arsenic concentrations by census tracts in the two counties. After excluding multiple births and displaced geocoding addresses, birth data were obtained for the years of 2005 (n = 5845), 2010 (n = 5569), and 2015 (n = 5770) from the Bureau of Vital Statistics at the Florida Department of Health to assess temporal differences. Generalized linear models were used to analyze and compare the association between child and maternal demographic information, socioeconomic characteristics, and the environmental estimates of arsenic with LBW. No significant association was found between environmental arsenic concentration and LBW, suggesting that environmental contamination of the pregnant mother's census tract may not be a useful proxy in assessing risk for LBW.
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Affiliation(s)
- Maya Scott-Richardson
- Maya Scott-Richardson, Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, 2001 S. Lincoln Ave., Urbana, IL 61802, USA.
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Watson CV, Lewin M, Ragin-Wilson A, Jones R, Jarrett JM, Wallon K, Ward C, Hilliard N, Irvin-Barnwell E. Characterization of trace elements exposure in pregnant women in the United States, NHANES 1999-2016. ENVIRONMENTAL RESEARCH 2020; 183:109208. [PMID: 32058143 PMCID: PMC8243358 DOI: 10.1016/j.envres.2020.109208] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 05/19/2023]
Abstract
OBJECTIVE The objective of the current study is to report on urine, blood and serum metal concentrations to characterize exposures to trace elements and micronutrient levels in both pregnant women and women of child-bearing age in the U.S. National Health and Nutrition Examination Survey (NHANES) years 1999-2016. METHODS Urine and blood samples taken from NHANES participants were analyzed for thirteen urine metals, three blood metals, three serum metals, speciated mercury in blood and speciated arsenic in urine. Adjusted and unadjusted least squares geometric means and 95% confidence intervals were calculated for all participants among women aged 15-44 years. Changes in exposure levels over time were also examined. Serum cotinine levels were used to adjust for smoke exposure, as smoking is a source of metal exposure. RESULTS Detection rates for four urine metals from the ATSDR Substance Priority List: arsenic, lead, mercury and cadmium were ~83-99% for both pregnant and non-pregnant women of child bearing age. A majority of metal concentrations were higher in pregnant women compared to non-pregnant women. Pregnant women had higher mean urine total arsenic, urine mercury, and urine lead; however, blood lead and mercury were higher in non-pregnant women. Blood lead, cadmium, mercury, as well as urine antimony, cadmium and lead in women of childbearing age decreased over time, while urine cobalt increased over time. CONCLUSIONS Pregnant women in the US have been exposed to several trace metals, with observed concentrations for some trace elements decreasing since 1999.
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Affiliation(s)
- Christina Vaughan Watson
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Michael Lewin
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angela Ragin-Wilson
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffery M Jarrett
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristen Wallon
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cynthia Ward
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nolan Hilliard
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Irvin-Barnwell
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Song L, Liu B, Wang L, Wu M, Zhang L, Liu Y, Bi J, Yang S, Zhang B, Xia W, Xu S, Chen R, Cao Z, Wang Y. Exposure to arsenic during pregnancy and newborn mitochondrial DNA copy number: A birth cohort study in Wuhan, China. CHEMOSPHERE 2020; 243:125335. [PMID: 31765894 DOI: 10.1016/j.chemosphere.2019.125335] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Arsenic (As) is a widely distributed environmental chemical with potentially different toxicities. However, little is known about the impact of maternal As exposure on newborn mitochondrial DNA copy number (mtDNAcn), which may lie on the pathway linking As exposure to adverse health impacts. OBJECTIVES We aimed to explore whether maternal As exposure was associated with newborn mtDNAcn. METHODS We conducted a birth cohort study of 762 mother-infant pairs in Wuhan, China, 2013-2015. Cord blood mtDNAcn was determined using qPCR. Maternal urinary As levels in each trimester were quantified by ICP-MS. Multiple informant models were used to examine the associations of repeated urinary As levels with cord blood mtDNAcn. RESULTS The median urinary As levels in the first, second, and third trimesters were 17.2 μg/L, 16.0 μg/L, and 17.0 μg/L, respectively. In the multivariate model, each doubling increase in the first-trimester urinary As level was associated with a 6.6% (95% CI: -12.4%, -0.5%) decrease in cord blood mtDNAcn. The highest versus lowest quintile of first-trimester urinary As level was associated with a 19.0% (95% CI: -32.9%, -2.2%) lower cord blood mtDNAcn. No significant associations of urinary As levels in the second and third trimesters with cord blood mtDNAcn were observed. The inverse relationship between first-trimester urinary As level and cord blood mtDNAcn was more pronounced among female infants. CONCLUSIONS First-trimester As exposure was related to decreased cord blood mtDNAcn. The potential health impacts of decreased mtDNAcn in early life need to be further clarified.
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Affiliation(s)
- Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bingqing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lulin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lina Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yunyun Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianing Bi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Senbei Yang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Zhongqiang Cao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Barn P, Gombojav E, Ochir C, Boldbaatar B, Beejin B, Naidan G, Galsuren J, Legtseg B, Byambaa T, Hutcheon JA, Janes C, Janssen PA, Lanphear BP, McCandless LC, Takaro TK, Venners SA, Webster GM, Palmer CD, Parsons PJ, Allen RW. Coal smoke, gestational cadmium exposure, and fetal growth. ENVIRONMENTAL RESEARCH 2019; 179:108830. [PMID: 31678728 DOI: 10.1016/j.envres.2019.108830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Gestational cadmium exposure may impair fetal growth. Coal smoke has largely been unexplored as a source of cadmium exposure. We investigated the relationship between gestational cadmium exposure and fetal growth, and assessed coal smoke as a potential source of airborne cadmium, among non-smoking pregnant women in Ulaanbaatar, Mongolia, where coal combustion in home heating stoves is a major source of outdoor and indoor air pollution. METHODS This observational study was nested within the Ulaanbaatar Gestation and Air Pollution Research (UGAAR) study, a randomized controlled trial of portable high efficiency particulate air (HEPA) filter air cleaner use during pregnancy, fetal growth, and early childhood development. We measured third trimester blood cadmium concentrations in 374 out of 465 participants who had a live birth. We used multiple linear and logistic regression to assess the relationships between log2-transformed maternal blood cadmium concentrations and birth weight, length, head circumference, ponderal index, low birth weight, small for gestational age, and preterm birth in crude and adjusted models. We also evaluated the relationships between log2-transformed blood cadmium concentrations and the density of coal-burning stoves within 5000 m of each participant's apartment as a proxy of coal smoke emissions from home heating stoves. RESULTS The median (25th,75th percentile) blood cadmium concentration was 0.20 (0.15, 0.29) μg/L. A doubling of blood cadmium was associated with a 95 g (95% CI: 34, 155 g) reduction in birth weight in adjusted models. An interquartile range increase in coal stove density (from 3.4 to 4.9 gers/hectare) surrounding participants' apartments was associated with a 12.2% (95% CI: 0.3, 25.6%) increase in blood cadmium concentrations. CONCLUSIONS Gestational cadmium exposure was associated with reduced birth weight. In settings where coal is a widely used fuel, cadmium may play a role in the putative association between air pollution and impaired fetal growth.
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Affiliation(s)
- Prabjit Barn
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Enkhjargal Gombojav
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia
| | - Chimedsuren Ochir
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia
| | - Buyantushig Boldbaatar
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia
| | - Bolor Beejin
- Ministry of Health of Mongolia, Olympic Street-2, Government Building VIII, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Gerel Naidan
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia
| | - Jargalsaikhan Galsuren
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia
| | - Bayarkhuu Legtseg
- Sukhbaatar District Health Center, 11 Horoo, Tsagdaagiin Gudamj, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Tsogtbaatar Byambaa
- Ministry of Health of Mongolia, Olympic Street-2, Government Building VIII, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Jennifer A Hutcheon
- Faculty of Medicine, Department of Obstetrics & Gynaecology, University of British Columbia, 4500 Oak Street, Vancouver, V6H 2N1, Canada
| | - Craig Janes
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, N2L 3G1, Canada
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, V6T 1Z3, Canada
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Lawrence C McCandless
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Scott A Venners
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Glenys M Webster
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Christopher D Palmer
- New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY, 12144, USA
| | - Patrick J Parsons
- New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY, 12144, USA
| | - Ryan W Allen
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada.
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Ashley-Martin J, Dodds L, Arbuckle TE, Lanphear B, Muckle G, Bouchard MF, Fisher M, Asztalos E, Foster W, Kuhle S. Blood metal levels and early childhood anthropometric measures in a cohort of Canadian children. ENVIRONMENTAL RESEARCH 2019; 179:108736. [PMID: 31541908 DOI: 10.1016/j.envres.2019.108736] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/03/2019] [Accepted: 09/07/2019] [Indexed: 05/18/2023]
Abstract
Fetal exposure to some toxic metals has been associated with reduced fetal growth, but the impact of contemporary, low-level metals on anthropometric measures in childhood is not well understood. Our primary objective was to quantify associations between childhood levels of toxic metals and concurrently measured body mass index (BMI) in a population of Canadian preschool-aged children. We collected biomonitoring data and anthropometric measures on 480 children between the ages of two and five years in the Maternal-Infant Research on Environmental Chemicals (MIREC) Child Development Plus study. Concentrations of four toxic metals (lead, arsenic, cadmium, and mercury) were measured in whole blood collected from pregnant women and their children. Blood levels of key essential elements were also measured in children. Children's weight, height, and BMI z-scores were calculated using the World Health Organization growth standards. We used a series of linear regression models, adjusted for potential parental confounders, concurrently measured metals and elements, and prenatal blood metal levels, to evaluate associations between tertiles of each toxic metal and anthropometric measures. We tested for effect modification by sex. Of the 480 children, 449 (94%) were singleton births and had complete biomonitoring and anthropometric data. The majority of children had detectable concentrations of metals. In the adjusted models, girls with blood lead concentrations in the highest tertile (>0.82 μg/dL) had, on average, 0.26 (95% Cl: -0.55, 0.03) lower BMI z-scores than those in the referent category. In contrast, boys with lead levels in the highest tertile had, on average, 0.14 higher BMI z-scores (95% Cl: -0.14, 0.41) (p-value heterogeneity = 0.04). In this population of Canadian preschool-aged children with low-level blood lead concentrations, we observed effect modification by sex in the association between Pb and BMI but no statistically significant associations in the sex-specific strata. Child blood levels of As, Cd, and Hg were not associated with childhood BMI, weight, or height in boys or girls.
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Affiliation(s)
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Tye E Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | - Gina Muckle
- Laval University and Quebec CHU Research Center, Quebec City, QC, Canada
| | | | - Mandy Fisher
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | | | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, NS, Canada.
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Zilversmit Pao L, Harville EW, Wickliffe JK, Shankar A, Buekens P. The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3700. [PMID: 31581440 PMCID: PMC6801557 DOI: 10.3390/ijerph16193700] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 02/06/2023]
Abstract
Metals, stress, and sociodemographics are commonly studied separately for their effects on birth outcomes, yet often jointly contribute to adverse outcomes. This study analyzes two methods for measuring cumulative risk to understand how maternal chemical and nonchemical stressors may contribute to small for gestational age (SGA). SGA was calculated using sex-specific fetal growth curves for infants of pregnant mothers (n = 2562) enrolled in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Study. The exposures (maternal lead, mercury, cadmium, Cohen's perceived stress, Edinburgh depression scores, race/ethnicity, income, and education) were grouped into three domains: metals, psychosocial stress, and sociodemographics. In Method 1 we created cumulative risk scores using tertiles. Method 2 employed weighted quantile sum (WQS) regression. For each method, logistic models were built with three exposure domains individually and race/ethnicity, adjusting for age, parity, pregnancy weight gain, and marital status. The adjusted effect of overall cumulative risk with three domains, was also modeled using each method. Sociodemographics was the only exposure associated with SGA in unadjusted models ((odds ratio) OR: 1.35, 95% (confidence interval) CI: 1.08, 1.68). The three cumulative variables in adjusted models were not significant individually, but the overall index was associated with SGA (OR: 1.17, 95% CI: 1.02, 1.35). In the WQS model, only the sociodemographics domain was significantly associated with SGA. Sociodemographics tended to be the strongest risk factor for SGA in both risk score and WQS models.
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Affiliation(s)
- Leah Zilversmit Pao
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Emily W Harville
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Jeffrey K Wickliffe
- Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Arti Shankar
- Global Biostatistics and Data Science, Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Pierre Buekens
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
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Meyrueix L, Adair L, Norris SA, Ideraabdullah F. Assessment of placental metal levels in a South African cohort. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:500. [PMID: 31321551 PMCID: PMC6681656 DOI: 10.1007/s10661-019-7638-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
The placenta plays an important role in mediating the effect of maternal metal exposure on fetal development, acting as both barrier and transporter. Term-placenta metal levels serve as an informative snapshot of maternal/fetal exposure during pregnancy and could be used to predict offspring short- and long-term health outcomes. Here, we measured term-placenta metal levels of 11 metals in 42 placentas from the Soweto First 1000 days cohort (S1000, Soweto-Johannesburg, SA). We compared these placental metal concentrations with previously reported global cohort measurements to determine whether this cohort is at increased risk of exposure. Placental metals were tested for correlations to understand potential interactions between metals. Since these samples are from a birth cohort study, we also performed exploratory analyses to determine whether metal levels were associated with placenta and birth outcomes. Most S1000 placental metal levels were similar to other cohorts; however, cadmium (Cd) levels up to 50-fold lower, and essential elements nickel (Ni) and chromium (Cr) level up to 6- and 16-fold lower, respectively. Cd, Se, and Ni were associated with placenta and birth outcomes. Studies are ongoing to examine underlying mechanisms and how these developmental differences affect long-term health.
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Affiliation(s)
- Laetitia Meyrueix
- Nutrition Department, University of North Carolina-Chapel Hill, 120 Mason Farm Rd, CB# 7264, Chapel Hill, NC, 27599, USA
| | - Linda Adair
- Nutrition Department, University of North Carolina-Chapel Hill, 120 Mason Farm Rd, CB# 7264, Chapel Hill, NC, 27599, USA
| | - Shane A Norris
- MRC Developmental Health Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, 2000, South Africa
| | - Folami Ideraabdullah
- Nutrition Department, University of North Carolina-Chapel Hill, 120 Mason Farm Rd, CB# 7264, Chapel Hill, NC, 27599, USA.
- MRC Developmental Health Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, 2000, South Africa.
- Nutrition Research Institute, University of North Carolina-Chapel Hill, 120 Mason Farm Rd, CB# 7264, Chapel Hill, NC, 27599, USA.
- Genetics Department, University of North Carolina-Chapel Hill, 120 Mason Farm Rd, CB# 7264, Chapel Hill, NC, 27599, USA.
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Li A, Zhuang T, Shi J, Liang Y, Song M. Heavy metals in maternal and cord blood in Beijing and their efficiency of placental transfer. J Environ Sci (China) 2019; 80:99-106. [PMID: 30952357 DOI: 10.1016/j.jes.2018.11.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/04/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
This study aimed to determine the effect of exposure to heavy metals in pregnant women in Beijing, China. We also evaluated the association of these heavy metals with birth weight and length of newborns. We measured the levels of 10 heavy metals, including lead (Pb), titanium (Ti), manganese (Mn), nickel (Ni), cadmium (Cd), chromium (Cr), antimony (Sb), stannum (Sn), vanadium (V), and arsenic (As), in 156 maternal and cord blood pairs. An inductively coupled plasma mass spectrometry method was used for measurement. Pb, As, Ti, Mn, and Sb showed high detection rates (>50%) in both maternal and cord blood. Fourteen (9%) mothers had blood Pb levels greater than the United States Center for Disease Control allowable threshold limit for children (50 μg/L). In prenatal exposure to these heavy metals, there was no significant association between any heavy metal and birth weight/length. Moreover, we estimated the placental transfer efficiency of each heavy metal, and the median placental transfer efficiency ranged from 49.6% (Ni) to 194% (Mn) (except for Cd and Sn). The level and detection rate of Cd in maternal blood were much higher than that in cord blood, which suggested that Cd had difficulty in passing the placental barrier. Prospective research should focus on the source and risk of heavy metals in non-occupationally exposed pregnant women in Beijing.
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Affiliation(s)
- Aijing Li
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China; Key Laboratory of Environmental Nanotechnology and Health Effects, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Taifeng Zhuang
- Department of Pediatrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Jianbo Shi
- Key Laboratory of Environmental Nanotechnology and Health Effects, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yong Liang
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
| | - Maoyong Song
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China; Key Laboratory of Environmental Nanotechnology and Health Effects, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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40
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Li H, Zheng J, Wang H, Huang G, Huang Q, Feng N, Xiao J. Maternal cosmetics use during pregnancy and risks of adverse outcomes: a prospective cohort study. Sci Rep 2019; 9:8030. [PMID: 31142815 PMCID: PMC6541712 DOI: 10.1038/s41598-019-44546-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/20/2019] [Indexed: 11/09/2022] Open
Abstract
To probe into the associations between maternal personal cosmetics use during pregnancy and risk of adverse outcomes, and explore the potential dose-response relationships, we carried out a prospective cohort study involving 9710 pregnant women in Zhuzhou City and Xiangtan City in Hunan province during 2016-2017. A structured questionnaire was used to collection information for the pregnant women and their pregnancy outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by binary or multinomial logistic regressions. The study population included 4652 (47.9%) cosmetics non-users and 5058 (52.1%) cosmetics users. Cosmetics use was associated with an increased risk of small for gestational age (SGA) (aOR = 1.23, 95%CI 1.04 to 1.44), compared with cosmetics non-users. A positive dose-response relationship between frequency of cosmetics use and SGA was observed, although a borderline association was found at low use frequency (1-2 times per week; aOR = 1.18, 95%CI 0.99 to 1.40) and moderate use frequency (3-4 times per week; aOR = 1.23, 95%CI 0.92 to 1.64). High-frequency of cosmetics use (≥5 times per week) was significantly correlated with a higher risk of SGA (aOR = 1.83, 95%CI 1.25 to 2.69). No significant association between personal cosmetics use and the risk of preterm birth, low birth weight, macrosomia, or large for gestational age was observed. The present study suggests that personal cosmetics use will increase the risk of SGA, but further research is required to determine which cosmetic products may account for the higher risk of SGA.
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Affiliation(s)
- Huixia Li
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
| | - Jianfei Zheng
- Department of Emergency and Intensive Care Medicine, Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China
| | - Hua Wang
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
- Department of Maternal Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
| | - Guangwen Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
| | - Qun Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
| | - Na Feng
- Department of Health Care, Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen, 518067, Guangdong Province, China
| | - Juan Xiao
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
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Iwai-Shimada M, Kameo S, Nakai K, Yaginuma-Sakurai K, Tatsuta N, Kurokawa N, Nakayama SF, Satoh H. Exposure profile of mercury, lead, cadmium, arsenic, antimony, copper, selenium and zinc in maternal blood, cord blood and placenta: the Tohoku Study of Child Development in Japan. Environ Health Prev Med 2019; 24:35. [PMID: 31101007 PMCID: PMC6525413 DOI: 10.1186/s12199-019-0783-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/11/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The effects of prenatal exposure to toxic elements on birth outcomes and child development have been an area of concern. This study aimed to assess the profile of prenatal exposure to toxic elements, arsenic (As), bismuth (Bi), cadmium (Cd), mercury (total mercury (THg), methylmercury (MHg), inorganic mercury (IHg)), lead (Pb), antimony (Sb) and tin (Sn), and essential trace elements, copper (Cu), selenium (Se) and zinc (Zn), using the maternal blood, cord blood and placenta in the Tohoku Study of Child Development of Japan (N = 594-650). METHODS Inductively coupled plasma mass spectrometry was used to determine the concentrations of these elements (except mercury). Levels of THg and MeHg were measured using cold vapour atomic absorption spectrophotometry and a gas chromatograph-electron capture detector, respectively. RESULTS Median concentrations (25th-75th) of As, Cd, Pb, Sb, Sn and THg in the maternal blood were 4.06 (2.68-6.81), 1.18 (0.74-1.79), 10.8 (8.65-13.5), 0.2 (0.06-0.40) and 0.2 (0.1-0.38) ng mL-1 and 5.42 (3.89-7.59) ng g-1, respectively. Median concentrations (25th-75th) of As, Cd, Pb, Sb, Sn and THg in the cord blood were 3.68 (2.58-5.25), 0.53 (0.10-1.25), 9.89 (8.02-12.5), 0.39 (0.06-0.92) and 0.2 (0.2-0.38) ng mL-1 and 9.96 (7.05-13.8) ng g-1, respectively. CONCLUSIONS THg and Sb levels in the cord blood were twofold higher than those in the maternal blood. Cord blood to maternal blood ratios for As, Cd and Sb widely varied between individuals. To understand the effects of prenatal exposure, further research regarding the variations of placental transfer of elements is necessary.
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Affiliation(s)
- Miyuki Iwai-Shimada
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.
| | - Satomi Kameo
- Department of Nutrition, College of Nutrition, Koshien University, Takarazuka, Hyogo, Japan
| | - Kunihiko Nakai
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kozue Yaginuma-Sakurai
- Department of Human Health and Nutrition, Faculty of Comprehensive Human Sciences, Shokei Gakuin University, Sendai, Miyagi, Japan
| | - Nozomi Tatsuta
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | | | - Shoji F Nakayama
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
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Punshon T, Li Z, Jackson BP, Parks WT, Romano M, Conway D, Baker ER, Karagas MR. Placental metal concentrations in relation to placental growth, efficiency and birth weight. ENVIRONMENT INTERNATIONAL 2019; 126:533-542. [PMID: 30851484 PMCID: PMC6475117 DOI: 10.1016/j.envint.2019.01.063] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 05/19/2023]
Abstract
The quality of the intrauterine environment, in which the placenta plays a critical role, affects birth outcomes and lifelong health. The effect of metal contaminants on the growth and functioning of the placenta have not been widely reported but may provide insights into how metal exposures lead to these outcomes. We examined relationships between placental concentrations of cadmium (Cd), arsenic (As), mercury (Hg) and lead (Pb) and measures of placental growth and functioning (placental weight, placental efficiency (the log ratio of placental weight and birth weight), chorionic disc area and disc eccentricity) as part of the New Hampshire Birth Cohort Study (N = 1159). We additionally examined whether these associations were modified by placental concentrations of essential elements zinc (Zn) and selenium (Se). Associations were evaluated using generalized linear models. Multivariable-adjusted differences in placental weight were - 7.81 g (95% CI: -15.42, -2.48) with every ng/g increase in the Cd concentration of placenta (p-Value = 0.0009). Greater decrements in placental weight and efficiency associated with placental Cd were observed for females. For placentae with below median Zn and Se concentrations, decrements in placental weight were - 8.81 g (95% CI: -16.85, -0.76) and - 13.20 g (95% CI: -20.70, -5.70) respectively. The Cd concentration of placenta was also associated with reductions in placental efficiency both overall, and in Zn- and Se-stratified models. No appreciable differences were observed with other elements (As, Hg or Pb) and with other placental measures (chorionic disc area and disc eccentricity). In structural equation models, placental weight was a mediator in the relation between placental Cd concentration and reduced birth weight. Our findings suggest a role of interacting essential and contaminant elements on birth weight that may be mediated by changes in the growth and function of the placenta.
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Affiliation(s)
- Tracy Punshon
- Dartmouth College, Department of Biology, 78 College Street, Hanover, NH 03755, USA.
| | - Zhigang Li
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Brian P Jackson
- Dartmouth College, Department of Earth Sciences, 6105 Sherman Fairchild Hall, Hanover, NH 03755, USA
| | - W Tony Parks
- Dartmouth College, Department of Biology, 78 College Street, Hanover, NH 03755, USA; Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, USA
| | - Megan Romano
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | | | - Emily R Baker
- Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, USA
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Sharma BM, Sáňka O, Kalina J, Scheringer M. An overview of worldwide and regional time trends in total mercury levels in human blood and breast milk from 1966 to 2015 and their associations with health effects. ENVIRONMENT INTERNATIONAL 2019; 125:300-319. [PMID: 30735961 DOI: 10.1016/j.envint.2018.12.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 05/10/2023]
Abstract
BACKGROUND Mercury is a pollutant of global concern. To protect human health and environment from mercury pollution, the Minamata Convention on mercury entered into force in 2017. OBJECTIVES To support a future effectiveness evaluation of the convention, this study assesses worldwide and regional time trends of total mercury levels in human blood and breast milk across different population sub-groups in the last half-century prior to entry-into-force of the Minamata Convention. This study also provides an overview of the epidemiological literature showing evidence of associations between mercury exposure (in terms of total mercury levels in whole blood, cord blood, and breast milk) and human health. METHODS We searched electronic databases to identify articles published prior to June 14, 2017 and reported total mercury levels in any of three biological matrices (whole blood, cord blood, or breast milk) and/or associations with human health. Temporal trends of total mercury levels in the selected biological matrices across different population sub-groups were estimated using a linear fit of the log-transformed data. In parallel, statistical methods were employed to assess any possible effect of sources of inhomogeneity (i.e. study and population characteristics such as age, sex, ethnicity, source of exposure, sampling period, and geographical region) in the collected studies. Furthermore, a summary of significant and relevant associations between mercury exposure and human health conditions in children and adults was prepared. FINDINGS We found significant declines in total mercury levels in whole blood, cord blood, and breast milk between 1966 and 2015. A regional overview of total mercury levels in whole blood, cord blood, and breast milk suggests the highest levels in South America, followed by Africa or Asia whereas the population groups from Europe or North America displayed the lowest levels of total mercury in the selected biological matrices. We observed conclusive consistent associations of mercury exposure with selected health conditions, especially neurodevelopment and neurotoxicity in children and adults. For several other health conditions, reported findings in the collected studies do not support conclusive associations. We also found that several studies demonstrated significant associations between mercury exposure below the USEPA reference level and various health conditions. CONCLUSIONS This study provides a worldwide and regional overview of trends in total mercury levels in human blood and breast milk and associated health risks prior to entry-into-force of the Minamata Convention and calls for further epidemiological investigations from across the globe to fully understand the health implications of mercury exposure.
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Affiliation(s)
- Brij Mohan Sharma
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic.
| | - Ondřej Sáňka
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic
| | - Jiří Kalina
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic
| | - Martin Scheringer
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic; Institute of Biogeochemistry and Pollutant Dynamics, ETH Zürich, 8092 Zürich, Switzerland
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Ganguli A, Rai P, Balachandran S, Gupta R, Sharma R, Neogi SB. Heavy Metals in Indigenous Preparations Used for Sex Selection During Pregnancy in India. Biol Trace Elem Res 2019; 188:239-244. [PMID: 29909490 DOI: 10.1007/s12011-018-1411-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/06/2018] [Indexed: 12/29/2022]
Abstract
Indigenous preparations (IPs) have evoked a considerable interest in alleviating infections and chronic diseases and improving wellbeing. While such formulations have been a part of traditional practice in several countries and many have been reviewed scientifically for their claims, several of them until date remain to be investigated. A class of IPs for sex selection by Indian pregnant women exists with an aim of begetting a male offspring. In view of the leads obtained from our previous studies on detrimental effects of the newborn, for instance stillbirths and congenital malformations, we attempted to investigate the samples for heavy metal toxicity. Three samples were chosen following phytochemical analysis and reproductive toxicity of such preparations under in vivo conditions. The selected samples were examined for heavy metals-lead, cadmium, arsenic, and mercury using Microwave-assisted atomic absorption spectroscopy. The upper limit level of lead, mercury, and cadmium was found to be 18.56, 0.11, and 0.84 mg/kg respectively whereas arsenic was not detected. The levels of lead and mercury were found to be manifolds high in the IP samples that were primarily contributed by its constituents. The results of our study indicate the potential risk conferred upon, to both the mother and fetus on account of high levels of lead, mercury, and cadmium.
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Affiliation(s)
| | - Pragya Rai
- Public Health Foundation of India, Indian Institute of Public Health, Delhi, India
| | | | | | - Rashmi Sharma
- Science for Equity, Empowerment and Development (SEED) Division, Department of Science and Technology, Delhi, India
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Lee WC, Sinha SK, Arbuckle TE, Fisher M. Estimation in generalized linear models under censored covariates with an application to MIREC data. Stat Med 2018; 37:4539-4556. [PMID: 30168157 DOI: 10.1002/sim.7942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/25/2018] [Accepted: 07/22/2018] [Indexed: 11/07/2022]
Abstract
In many biological experiments, certain values of a biomarker are often nondetectable due to low concentrations of an analyte or the limitations of a chemical analysis device, resulting in left-censored values. There is an increasing demand for the analysis of data subject to detection limits in clinical and environmental studies. In this paper, we develop a novel statistical method for the maximum likelihood estimation in generalized linear models with covariates subject to detection limits. Simulations are carried out to study the relative performance of the proposed estimators, as compared to other existing estimators. The proposed method is also applied to a real dataset from the Maternal-Infant Research on Environmental Chemicals cohort study, where we investigate how different chemical mixtures affect the health outcomes of infants and pregnant women.
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Affiliation(s)
- Wan-Chen Lee
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Sanjoy K Sinha
- School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | - Tye E Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Mandy Fisher
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
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Ashley-Martin J, Dodds L, Arbuckle TE, Bouchard MF, Shapiro GD, Fisher M, Monnier P, Morisset AS, Ettinger AS. Association between maternal urinary speciated arsenic concentrations and gestational diabetes in a cohort of Canadian women. ENVIRONMENT INTERNATIONAL 2018; 121:714-720. [PMID: 30321846 DOI: 10.1016/j.envint.2018.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Epidemiological and toxicological evidence suggests that maternal total arsenic (As) levels are associated with an elevated risk of gestational diabetes (GDM). Uncertainty remains regarding the metabolic toxicity of specific arsenic species, comprised of both organic and inorganic sources of arsenic exposure. OBJECTIVES We assessed associations between speciated As and GDM using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study. METHODS Concentrations of speciated As [(inorganic (trivalent, pentavalent)), methylated arsenic species metabolites (monomethylarsonic acid (MMA), dimethylarsinic acid (DMA)), and organic (arsenobetaine)] were measured in first trimester maternal urine samples. GDM cases were identified in accordance with Canadian guidelines. Multivariable regression models were used to estimate associations between speciated As and GDM, evaluate potential interaction between speciated As exposures, and assess fetal sex-specific findings. RESULTS Among 1243 women who had a live, singleton birth and no previous history of diabetes, 4% met the diagnostic criteria for GDM. Our analyses focused on DMA and arsenobetaine as these were the subtypes with detectable concentrations in at least 40% of samples. Compared to women in the lowest tertile of DMA (<1.49 μg As/L), women with concentrations exceeding 3.52 μg As/L (3rd tertile) experienced an increased risk of GDM (aOR = 3.86; 95% CI: 1.18, 12.57) (p-value for trend across tertiles = 0.04). When restricted to women carrying male infants, the magnitude of this association increased (aOR 3rd tertile = 4.71; 95% CI: 1.05, 21.10). CONCLUSIONS These results suggest a positive relation between DMA and GDM; potential differences in risk by fetal sex requires further investigation.
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Deyssenroth MA, Gennings C, Liu SH, Peng S, Hao K, Lambertini L, Jackson BP, Karagas MR, Marsit CJ, Chen J. Intrauterine multi-metal exposure is associated with reduced fetal growth through modulation of the placental gene network. ENVIRONMENT INTERNATIONAL 2018; 120:373-381. [PMID: 30125854 PMCID: PMC6288802 DOI: 10.1016/j.envint.2018.08.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND Intrauterine metal exposures and aberrations in placental processes are known contributors to being born small for gestational age (SGA). However, studies to date have largely focused on independent effects, failing to account for potential interdependence among these markers. OBJECTIVES We evaluated the inter-relationship between multi-metal indices and placental gene network modules related to SGA status to highlight potential molecular pathways through which in utero multi-metal exposure impacts fetal growth. METHODS Weighted quantile sum (WQS) regression was performed using a panel of 16 trace metals measured in post-partum maternal toe nails collected from the Rhode Island Child Health Study (RICHS, n = 195), and confirmation of the derived SGA-related multi-metal index was conducted using Bayesian kernel machine regression (BKMR). We leveraged existing placental weighted gene coexpression network data to examine associations between the SGA multi-metal index and placental gene expression. Expression of select genes were assessed using RT-PCR in an independent birth cohort, the New Hampshire Birth Cohort Study (NHBCS, n = 237). RESULTS We identified a multi-metal index, predominated by arsenic (As) and cadmium (Cd), that was positively associated with SGA status (Odds ratio = 2.73 [1.04, 7.18]). This index was also associated with the expression of placental gene modules involved in "gene expression" (β = -0.02 [-0.04, -0.01]) and "metabolic hormone secretion" (β = 0.02 [0.00, 0.05]). We validated the association between cadmium exposure and the expression of GRHL1 and INHBA, genes in the "metabolic hormone secretion" module, in NHBCS. CONCLUSION We present a novel approach that integrates the application of advanced bioinformatics and biostatistics methods to delineate potential placental pathways through which trace metal exposures impact fetal growth.
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Affiliation(s)
- Maya A Deyssenroth
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shelley H Liu
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 20019, USA
| | - Shouneng Peng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Luca Lambertini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH 03755, USA
| | | | - Carmen J Marsit
- Department of Environmental Health, Emory University, Atlanta, GA 30322, USA
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Singh L, Anand M, Singh S, Taneja A. Environmental toxic metals in placenta and their effects on preterm delivery-current opinion. Drug Chem Toxicol 2018; 43:531-538. [PMID: 30257569 DOI: 10.1080/01480545.2018.1515216] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Preterm birth is a significant public reproductive health concern globally; Furthermore, preterm birth has long-lasting medical and pecuniary burdens on the society. Moreover, preterm birth is well-established as the underlying cause of low birth weight in infants as well as neonatal mortality. A growing body of literature suggests that the etiology of preterm delivery in women is elusive; however, countless environmental factors are considered responsible for preterm birth. Environmental contaminants that are toxic metals such as lead, cadmium, arsenic, and mercury are familiar confounding factors for preterm birth globally. Recent studies have indicated that these toxic heavy metals induce oxidative stress in the trophoblastic placental tissue by producing reactive oxygen species that alter the mechanism of antioxidants possibly leading to preterm birth. Moreover, no obvious mechanism underlying metal-induced oxidative stress in the placenta has been identified until date. Consequently, this review offers an outline of the currently existing scientific information on the association of toxic metals and redox status of the placental tissue with preterm birth. Furthermore, this study critically recognizes the gaps related to the deleterious effect of metals on the gestation period in scientific literature.
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Affiliation(s)
- Laxmi Singh
- Department of Chemistry, Dr. B. R. Ambedkar University, Khandari Campus, Agra, India
| | - Madhu Anand
- Department of Chemistry, Dr. B. R. Ambedkar University, Khandari Campus, Agra, India
| | - Saroj Singh
- Department of Obstetrician and Gynecology, S.N. Medical College, Agra, India
| | - Ajay Taneja
- Department of Chemistry, Dr. B. R. Ambedkar University, Khandari Campus, Agra, India
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Hameed ERA, Sherif LS, Samie OMA, Ahmed HH, Ahmed A, Atta H, Waheed H, Fahmy RF. Mercury Materno-fetal Burden and Its Nutritional Impact. Open Access Maced J Med Sci 2018; 6:1652-1658. [PMID: 30337982 PMCID: PMC6182524 DOI: 10.3889/oamjms.2018.364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/09/2018] [Accepted: 08/18/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Mercury exists worldwide in food, water and air throwing its health hazards on all body systems. AIM: To show the influence of the presence of mercury in pregnant mothers’ blood on its level in the umbilical cord blood; and to display the relationship between the different foodstuff on the mercury levels in pregnant mothers’ and umbilical cord blood. PATIENTS AND METHODS: This cross-sectional study was conducted on randomly chosen 113 pregnant mothers at the time of labour and on their newborns. Full history, sociodemographic data and food frequency questionnaire for dietary assessment were recorded. The Maternal and neonatal anthropometric measurements together with the Apgar scoring were also measured. Serum mercury levels in both mothers’ and umbilical cord blood were measured using the Inductively Coupled Plasma Mass Spectrometry (ICP-MS). RESULTS: A high percentage of mothers (82.3%) were exposed to passive smoking. There was a statistically significant positive correlation between the maternal and fetal umbilical cord blood mercury levels (p = 0.002). There was an insignificant negative correlation between the maternal blood and fetal umbilical cord blood mercury levels on one side and each of the different foodstuff on the other side (fish, vegetables, fruits and proteins, for example, meat and legumes). An insignificant positive correlation was found between dairy products and of the maternal blood and umbilical cord blood mercury levels. CONCLUSION: The fetal umbilical cord blood mercury levels correlate positively with the maternal blood mercury. The different foodstuff can influence the maternal and umbilical cord blood mercury levels whether by increase or decrease. Strict measures should be taken to decrease environmental mercury contamination with attention to pregnant mothers.
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Affiliation(s)
- Enas R Abdel Hameed
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Lobna S Sherif
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Ola M Abdel Samie
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Hanaa H Ahmed
- Hormones Department, Medical Research Division, National Research Center, Cairo, Egypt
| | | | - Hala Atta
- El-Galaa Teaching Hospital, Cairo, Egypt
| | - Hisham Waheed
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Reham F Fahmy
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
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50
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Kosik-Bogacka D, Łanocha-Arendarczyk N, Kot K, Malinowski W, Szymański S, Sipak-Szmigiel O, Pilarczyk B, Tomza-Marciniak A, Podlasińska J, Tomska N, Ciosek Ż. Concentrations of mercury (Hg) and selenium (Se) in afterbirth and their relations with various factors. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2018; 40:1683-1695. [PMID: 29492803 DOI: 10.1007/s10653-018-0081-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/21/2018] [Indexed: 05/17/2023]
Abstract
The aim of the study was to evaluate Hg and Se concentrations and Se:Hg molar ratios in the placenta, umbilical cord and fetal membranes, and to examine the relationship between the concentrations of the elements and selected factors. The study material consisted of the placenta, umbilical cord and fetal membranes obtained from 91 healthy women from northwestern and central Poland. In our study mean Hg and Se concentrations in afterbirth were ~ 0.01 mg/kg dry weight (dw) and ≤ 0.5 mg/kg dw, respectively. Correlation analysis showed negative relationships between placenta weight and Se concentration in the placenta and umbilical cord, as well as between placenta length and Se levels in the umbilical cord. We found negative correlations between THg concentration in the placenta and birth weight and between Se concentration in the placenta and umbilical cord and the morphological parameters of the placenta. Furthermore, we noted new types of interactions in specific parts of the afterbirth. In our study, Se:THg molar ratios ranged from 5 to 626; these values indicate protection against Hg toxicity.
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Affiliation(s)
- Danuta Kosik-Bogacka
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Natalia Łanocha-Arendarczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Karolina Kot
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Witold Malinowski
- Department of Obstetrical and Gynecological Nursing, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Sławomir Szymański
- Department of Obstetrical and Gynecological Nursing, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Olimpia Sipak-Szmigiel
- Department of Obstetrical and Gynecological Nursing, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Bogumiła Pilarczyk
- Department of Animal Hygiene and Prophylaxis, West Pomeranian University of Technology, Judyma 6, 71-466, Szczecin, Poland
| | - Agnieszka Tomza-Marciniak
- Department of Animal Hygiene and Prophylaxis, West Pomeranian University of Technology, Judyma 6, 71-466, Szczecin, Poland
| | - Joanna Podlasińska
- Department of Ecology, Environmental Management and Protection, Słowackiego 17, 71-434, Szczecin, Poland
| | - Natalia Tomska
- Laboratory of Medical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210, Szczecin, Poland
| | - Żaneta Ciosek
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland
- Laboratory of Medical Rehabilitation, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210, Szczecin, Poland
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