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Woodbury ML, Cintora P, Ng S, Hadley PA, Schantz SL. Examining the relationship of acetaminophen use during pregnancy with early language development in children. Pediatr Res 2023:10.1038/s41390-023-02924-4. [PMID: 38081897 PMCID: PMC11164826 DOI: 10.1038/s41390-023-02924-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 03/21/2024]
Abstract
BACKGROUND Acetaminophen is the only analgesic considered safe for use throughout pregnancy. Recent studies suggest that use during pregnancy may be associated with poorer neurodevelopmental outcomes in children, but few have examined language development. METHODS The Illinois Kids Development Study is a prospective birth cohort in east-central Illinois. Between December 2013 and March 2020, 532 newborns were enrolled and had exposure data available. Participants reported the number of times they took acetaminophen six times across pregnancy. Language data were collected at 26.5-28.5 months using the MacArthur-Bates Communicative Development Inventories (CDI; n = 298), and 36-38 months using the Speech and Language Assessment Scale (SLAS; n = 254). RESULTS Taking more acetaminophen during the second or third trimester was associated with marginally smaller vocabularies and shorter utterance length (M3L) at 26.5-28.5 months. More acetaminophen use during the third trimester was also associated with increased odds of M3L scores ≤25th percentile in male children. More use during the second or third trimester was associated with lower SLAS scores at 36-38 months. Third trimester use was specifically related to lower SLAS scores in male children. CONCLUSIONS Higher prenatal acetaminophen use during pregnancy may be associated with poorer early language development. IMPACT Taking more acetaminophen during pregnancy, particularly during the second and third trimesters, was associated with poorer scores on measures of language development when children were 26.5-28.5 and 36-38 months of age. Only male children had lower scores in analyses stratified by child sex. To our knowledge, this is the first study that has used a standardized measure of language development to assess the potential impact of prenatal exposure to acetaminophen on language development. This study adds to the growing body of literature suggesting that the potential impact of acetaminophen use during pregnancy on fetal neurodevelopment should be carefully evaluated.
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Affiliation(s)
- Megan L Woodbury
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
- College of Engineering, Northeastern University, Boston, MA, USA.
| | - Patricia Cintora
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Shukhan Ng
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Pamela A Hadley
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Mustieles V, Lascouts A, Pozo OJ, Haro N, Lyon-Caen S, Jedynak P, Bayat S, Thomsen C, Sakhi AK, Sabaredzovic A, Slama R, Ouellet-Morin I, Philippat C. Longitudinal Associations between Prenatal Exposure to Phthalates and Steroid Hormones in Maternal Hair Samples from the SEPAGES Cohort. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:19202-19213. [PMID: 37931007 DOI: 10.1021/acs.est.3c03401] [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: 11/08/2023]
Abstract
We assessed phthalate-hormone associations in 382 pregnant women of the new-generation SEPAGES cohort (2014-2017, France) using improved exposure and outcome assessments. Metabolites from seven phthalate compounds and the replacement di(isononyl)cyclohexane-1,2-dicarboxylate (DINCH) were measured in within-subject pools of repeated urine samples collected at the second and third pregnancy trimesters (≈21 samples/trimester). Metabolites from five steroid hormones were measured in maternal hair samples collected at delivery, reflecting cumulative levels over the previous weeks to months. Adjusted linear regression and Bayesian weighted quantile sum (BWQS) mixture models were performed. Each doubling in third-trimester urinary mono-benzyl phthalate (MBzP) concentrations was associated with an average increase of 13.3% (95% CI: 2.65, 24.9) for ∑cortisol, 10.0% (95% CI: 0.26, 20.7) for ∑cortisone, 17.3% (95% CI: 1.67, 35.4) for 11-dehydrocorticosterone, and 16.2% (95% CI: 2.20, 32.1) for testosterone, together with a suggestive 10.5% (95% CI: -1.57, 24.1) increase in progesterone levels. Each doubling in second-trimester urinary di-isononyl phthalate (DiNP) concentrations was inversely associated with testosterone levels (-11.6%; 95% CI: -21.6, -0.31). For most hormones, a nonsignificant trend toward a positive phthalate mixture effect was observed in the third but not in the second trimester. Our study showed that exposure to some phthalate metabolites, especially MBzP, may affect adrenal and reproductive hormone levels during pregnancy.
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Affiliation(s)
- Vicente Mustieles
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Aurélien Lascouts
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Oscar J Pozo
- Applied Metabolomics Research Group, Hospital del Mar Research Institute (IMIM), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Noemí Haro
- Applied Metabolomics Research Group, Hospital del Mar Research Institute (IMIM), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Paulina Jedynak
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Sam Bayat
- Department of Pulmonology and Physiology, CHU Grenoble Alpes, 38700 Grenoble, France
- Grenoble Alpes University - Inserm UA07, 38400 Grenoble, France
| | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Amrit K Sakhi
- Department of Food Safety, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Azemira Sabaredzovic
- Department of Food Safety, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Isabelle Ouellet-Morin
- Research Center, Institut Universitaire en Santé Mentale de Montréal, H1N 3M5 Québec, Canada; School of Criminology, Université de Montréal, H3C 3J7 Québec, Canada
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health (EDES), Institute for Advanced Biosciences, 38000 Grenoble, France
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Mustieles V, Rolland M, Pin I, Thomsen C, Sakhi AK, Sabaredzovic A, Muckle G, Guichardet K, Slama R, Philippat C. Early-Life Exposure to a Mixture of Phenols and Phthalates in Relation to Child Social Behavior: Applying an Evidence-Based Prioritization to a Cohort with Improved Exposure Assessment. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87006. [PMID: 37556305 PMCID: PMC10411634 DOI: 10.1289/ehp11798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/10/2023] [Accepted: 06/26/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Previous studies aiming at relating exposure to phenols and phthalates with child social behavior characterized exposure using one or a few spot urine samples, resulting in substantial exposure misclassification. Moreover, early infancy exposure was rarely studied. OBJECTIVES We aimed to examine the associations of phthalates and phenols with child social behavior in a cohort with improved exposure assessment and to a priori identify the chemicals supported by a higher weight of evidence. METHODS Among 406 mother-child pairs from the French Assessment of Air Pollution exposure during Pregnancy and Effect on Health (SEPAGES) cohort, 25 phenols/phthalate metabolites were measured in within-subject pools of repeated urine samples collected at the second and third pregnancy trimesters (∼ 21 samples/trimester) and at 2 months and 1-year of age (∼ 7 samples/period). Social behavior was parent-reported at 3 years of age of the child using the Social Responsiveness Scale (SRS). A structured literature review of the animal and human evidence was performed to prioritize the measured phthalates/phenols based on their likelihood to affect social behavior. Both adjusted linear regression and Bayesian Weighted Quantile Sum (BWQS) regression models were fitted. False discovery rate (FDR) correction was applied only to nonprioritized chemicals. RESULTS Prioritized compounds included bisphenol A, bisphenol S, triclosan (TCS), diethyl-hexyl phthalate (Σ DEHP ), mono-ethyl phthalate (MEP), mono-n -butyl phthalate (MnBP), and mono-benzyl phthalate (MBzP). With the exception of bisphenols, which showed a mixed pattern of positive and negative associations in pregnant mothers and neonates, few prenatal associations were observed. Most associations were observed with prioritized chemicals measured in 1-y-old infants: Each doubling in urinary TCS (β = 0.78 ; 95% CI: 0.00, 1.55) and MEP (β = 0.92 ; 95% CI: - 0.11 , 1.96) concentrations were associated with worse total SRS scores, whereas MnBP and Σ DEHP were associated with worse Social Awareness (β = 0.25 ; 95% CI: 0.01, 0.50) and Social Communication (β = 0.43 ; 95% CI: - 0.02 , 0.89) scores, respectively. BWQS also suggested worse total SRS [Beta 1 = 1.38 ; 95% credible interval (CrI): - 0.18 , 2.97], Social Awareness (Beta 1 = 0.37 ; 95% CrI: 0.06, 0.70), and Social Communication (Beta 1 = 0.91 ; 95% CrI: 0.31, 1.53) scores per quartile increase in the mixture of prioritized compounds assessed in 1-y-old infants. The few associations observed with nonprioritized chemicals did not remain after FDR correction, with the exception of benzophenone-3 exposure in 1-y-old infants, which was suggestively associated with worse Social Communication scores (corrected p = 0.07 ). DISCUSSION The literature search allowed us to adapt our statistical analysis according to the weight of evidence and create a corpus of experimental and epidemiological knowledge to better interpret our findings. Early infancy appears to be a sensitive exposure window that should be further investigated. https://doi.org/10.1289/EHP11798.
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Affiliation(s)
- Vicente Mustieles
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Matthieu Rolland
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Isabelle Pin
- Pediatric Department, Grenoble Alpes University Hospital, La Tronche, France
| | | | | | | | - Gina Muckle
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, Canada
| | - Karine Guichardet
- Pediatric Department, Grenoble Alpes University Hospital, La Tronche, France
| | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
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Oulhote Y, Rouget F, Michineau L, Monfort C, Desrochers-Couture M, Thomé JP, Kadhel P, Multigner L, Cordier S, Muckle G. Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother-child cohort in Guadeloupe. Environ Health 2023; 22:21. [PMID: 36843015 PMCID: PMC9969702 DOI: 10.1186/s12940-023-00970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, resulting in a widespread contamination. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affects visual and fine motor developments during infancy and childhood, with greater susceptibility in boys. OBJECTIVE To assess the associations between pre- and postnatal exposures to chlordecone and cognitive and behavioral functions in school-aged children from Guadeloupe. METHODS We examined 576 children from the TIMOUN mother-child cohort in Guadeloupe at 7 years of age. Concentrations of chlordecone and other environmental contaminants were measured in cord- and children's blood at age 7 years. Cognitive abilities of children were assessed with the Wechsler Intelligence Scale for Children-IV (WISC-IV), and externalizing and internalizing problem behaviors documented with the Strengths and Difficulties Questionnaire (SDQ) completed by the child's mother. We estimated covariate-adjusted associations between cord- and 7-years chlordecone concentrations and child outcomes using structural equations modeling, and tested effect modification by sex. RESULTS Geometric means of blood chlordecone concentrations were 0.13 µg/L in cord blood and 0.06 µg/L in children's blood at age 7 years. A twofold increase in cord blood concentrations was associated with 0.05 standard deviation (SD) (95% Confidence Interval [CI]: 0.0, 0.10) higher internalizing problem scores, whereas 7-years chlordecone concentrations were associated with lower Full-Scale IQ scores (FSIQ) and greater externalized behavioral problem scores. A twofold increase in 7-year chlordecone concentrations was associated with a decrease of 0.67 point (95% CI: -1.13, -0.22) on FSIQ and an increase of 0.04 SD (95% CI: 0.0, 0.07) on externalizing problems. These associations with Cognitive abilities were driven by decreases in perceptive reasoning, working memory and verbal comprehension. Associations between 7-year exposure and perceptive reasoning, working memory, and the FSIQ were stronger in boys, whereas cord blood and child blood associations with internalizing problems were stronger in girls. CONCLUSIONS These results suggests that cognitive abilities and externalizing behavior problems at school age are impaired by childhood, but not in utero, exposure to chlordecone, and that prenatal exposure is related to greater internalizing behavioral problems.
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Affiliation(s)
- Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Florence Rouget
- CHU De Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France
| | - Léah Michineau
- Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France
| | - Christine Monfort
- Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France
| | - Mireille Desrochers-Couture
- Population Health and Optimal Health Practices Research Unit, CHU De Québec Research Centre; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Rue Des Bibliothèques, Québec City, Québec, G1V 0A6, Canada
| | - Jean-Pierre Thomé
- LEAE-CART (Laboratoire d'Ecologie Animale Et d'Ecotoxicologie-Centre De Recherche Analytique Et Technologique), Université De Liège, B-4000, Liège, Belgium
| | - Philippe Kadhel
- CHU De de La Guadeloupe, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Pointe-À-Pitre, France
| | - Luc Multigner
- Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France
| | - Sylvaine Cordier
- Univ Rennes, Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France.
| | - Gina Muckle
- Population Health and Optimal Health Practices Research Unit, CHU De Québec Research Centre; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Rue Des Bibliothèques, Québec City, Québec, G1V 0A6, Canada.
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Zhao Y, Skandali N, Bethlehem RAI, Voon V. Mesial Prefrontal Cortex and Alcohol Misuse: Dissociating Cross-sectional and Longitudinal Relationships in UK Biobank. Biol Psychiatry 2022; 92:907-916. [PMID: 35589437 DOI: 10.1016/j.biopsych.2022.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/24/2022] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol misuse is a major global public health issue. The disorder is characterized by aberrant neural networks interacting with environment and genetics. Dissecting the neural substrates and functional networks that relate to longitudinal changes in alcohol use from those that relate to alcohol misuse cross-sectionally is important to elucidate therapeutic approaches. METHODS To assess how neuroimaging data, including T1, resting-state functional magnetic resonance imaging, and diffusion-weighted imaging, relate to alcohol misuse cross-sectionally and longitudinally in the UK Biobank, this study analyzed range of alcohol misuse in a population-based normative sample of 24,784 participants, ages 45 to 81 years old, in a cross-sectional analysis and a sample of 3070 participants in a longitudinal analysis 2 years later. RESULTS Cross-sectional analysis showed that alcohol use is associated with a reduction in dorsal anterior cingulate cortex and dorsomedial prefrontal cortex gray matter concentration and functional resting-state connectivity (nodal degree: t24,422 = -12.99, p < 1 × 10-17). Reduced dorsal anterior cingulate cortex/dorsomedial prefrontal cortex functional connections to the ventrolateral prefrontal cortex, amygdala, and striatum relate to greater alcohol use. In a longitudinal analysis, higher resting-state nodal degree (t3036 = -3.27, p = .0011) and T1 gray matter concentration in the ventromedial prefrontal cortex relate to reduced alcohol intake frequency 2 years later. Higher ventromedial prefrontal cortex and frontoparietal executive network functional connectivity is associated with lower subsequent drinking longitudinally. CONCLUSIONS Dorsal versus ventromedial prefrontal regions are differentially related to alcohol misuse cross-sectionally or longitudinally in a large UK Biobank normative dataset. Our study provides a comprehensive understanding of the neurobiological substrates of alcohol use as a state or prospectively, thereby providing potential targets for clinical treatment.
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Affiliation(s)
- Ying Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Nikolina Skandali
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Valerie Voon
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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Welch BM, Keil AP, Buckley JP, Calafat AM, Christenbury KE, Engel SM, O'Brien KM, Rosen EM, James-Todd T, Zota AR, Ferguson KK. Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth: A Pooled Study of 16 US Cohorts. JAMA Pediatr 2022; 176:895-905. [PMID: 35816333 PMCID: PMC9274448 DOI: 10.1001/jamapediatrics.2022.2252] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/04/2022] [Indexed: 01/16/2023]
Abstract
Importance Phthalate exposure is widespread among pregnant women and may be a risk factor for preterm birth. Objective To investigate the prospective association between urinary biomarkers of phthalates in pregnancy and preterm birth among individuals living in the US. Design, Setting, and Participants Individual-level data were pooled from 16 preconception and pregnancy studies conducted in the US. Pregnant individuals who delivered between 1983 and 2018 and provided 1 or more urine samples during pregnancy were included. Exposures Urinary phthalate metabolites were quantified as biomarkers of phthalate exposure. Concentrations of 11 phthalate metabolites were standardized for urine dilution and mean repeated measurements across pregnancy were calculated. Main Outcomes and Measures Logistic regression models were used to examine the association between each phthalate metabolite with the odds of preterm birth, defined as less than 37 weeks of gestation at delivery (n = 539). Models pooled data using fixed effects and adjusted for maternal age, race and ethnicity, education, and prepregnancy body mass index. The association between the overall mixture of phthalate metabolites and preterm birth was also examined with logistic regression. G-computation, which requires certain assumptions to be considered causal, was used to estimate the association with hypothetical interventions to reduce the mixture concentrations on preterm birth. Results The final analytic sample included 6045 participants (mean [SD] age, 29.1 [6.1] years). Overall, 802 individuals (13.3%) were Black, 2323 (38.4%) were Hispanic/Latina, 2576 (42.6%) were White, and 328 (5.4%) had other race and ethnicity (including American Indian/Alaskan Native, Native Hawaiian, >1 racial identity, or reported as other). Most phthalate metabolites were detected in more than 96% of participants. Higher odds of preterm birth, ranging from 12% to 16%, were observed in association with an interquartile range increase in urinary concentrations of mono-n-butyl phthalate (odds ratio [OR], 1.12 [95% CI, 0.98-1.27]), mono-isobutyl phthalate (OR, 1.16 [95% CI, 1.00-1.34]), mono(2-ethyl-5-carboxypentyl) phthalate (OR, 1.16 [95% CI, 1.00-1.34]), and mono(3-carboxypropyl) phthalate (OR, 1.14 [95% CI, 1.01-1.29]). Among approximately 90 preterm births per 1000 live births in this study population, hypothetical interventions to reduce the mixture of phthalate metabolite levels by 10%, 30%, and 50% were estimated to prevent 1.8 (95% CI, 0.5-3.1), 5.9 (95% CI, 1.7-9.9), and 11.1 (95% CI, 3.6-18.3) preterm births, respectively. Conclusions and Relevance Results from this large US study population suggest that phthalate exposure during pregnancy may be a preventable risk factor for preterm delivery.
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Affiliation(s)
- Barrett M. Welch
- National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina
| | | | - Jessie P. Buckley
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Kate E. Christenbury
- Social & Scientific Systems, Inc, a DLH Holdings Company, Raleigh, North Carolina
| | | | - Katie M. O'Brien
- National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina
| | - Emma M. Rosen
- University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Ami R. Zota
- Milken School of Public Health, George Washington University, Washington, DC
| | - Kelly K. Ferguson
- National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina
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Sprowles JL, Monaikul S, Aguiar A, Gardiner J, Monaikul N, Kostyniak P, Schantz SL. Associations of concurrent PCB and PBDE serum concentrations with executive functioning in adolescents. Neurotoxicol Teratol 2022; 92:107092. [DOI: 10.1016/j.ntt.2022.107092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022]
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Cumulative and independent effects of experiences of social adversity on support for violent radicalization during the COVID-19 pandemic: the mediating role of depression. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1221-1233. [PMID: 35149881 PMCID: PMC9091156 DOI: 10.1007/s00127-022-02244-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/28/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Social adversity experiences have increased during the pandemic and are potential risk factors for both depression and support for violent radicalization (VR). However, the cumulative and independent effects of various social adversity experiences on support for VR have yet to be explored. This paper examines the cumulative and independent effects of COVID- and non-COVID-related discrimination, exposure to violence, traditional and cyberbullying victimization on support for VR. In addition, we investigate whether depression mediates the relationship between these forms of social adversity and support for VR. METHODS A total of 6003 young adults (Mage = 27, SDage = 4.40, range 18-35) living in metropolitan areas in Canada responded to an online survey. We used multivariable regression models, controlling for socio-demographic characteristics, to infer covariate adjusted associations between social adversity measures and support for VR. Additionally, we conducted a formal mediation analysis to estimate the proportion mediated by depression. RESULTS There was a cumulative relationship between experiences of social adversity and support for VR (β = 1.52; 95% CI: 1.32, 1.72). COVID-related discrimination and cyberbullying victimization were independently associated with stronger support for VR. Depression partially mediated the effect of cumulative social adversity, COVID-related discrimination and cyberbullying on support for VR. CONCLUSION Prevention programs during the present pandemic should prioritize decreasing discrimination and providing psychosocial support to depressed young adults who experience social adversity. Practitioners should prioritize developing programs that foster digital literacy skills and critical thinking among young adults to address the concerning impact of cyberbullying on support for VR.
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Verbeek JH, Whaley P, Morgan RL, Taylor KW, Rooney AA, Schwingshackl L, Hoving JL, Vittal Katikireddi S, Shea B, Mustafa RA, Murad MH, Schünemann HJ. An approach to quantifying the potential importance of residual confounding in systematic reviews of observational studies: A GRADE concept paper. ENVIRONMENT INTERNATIONAL 2021; 157:106868. [PMID: 34530289 DOI: 10.1016/j.envint.2021.106868] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/04/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
Small relative effect sizes are common in observational studies of exposure in environmental and public health. However, such effects can still have considerable policy importance when the baseline rate of the health outcome is high, and many persons are exposed. Assessing the certainty of the evidence based on these effect sizes is challenging because they can be prone to residual confounding due to the non-randomized nature of the evidence. When applying GRADE, a precise relative risk >2.0 increases the certainty in an existing effect because residual confounding is unlikely to explain the association. GRADE also suggests rating up when opposing plausible residual confounding exists for other effect sizes. In this concept paper, we propose using the E-value, defined as the smallest effect size of a confounder that still can reduce an observed RR to the null value, and a reference confounder to assess the likelihood of residual confounding. We propose a 4-step approach. 1. Assess the association of interest for relevant exposure levels. 2. Calculate the E-value for this observed association. 3. Choose a reference confounder with sufficient strength and information and assess its effect on the observed association using the E-value. 4. Assess how likely it is that residual confounding will still bias the observed RR. We present three case studies and discuss the feasibility of the approach.
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Affiliation(s)
- Jos H Verbeek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - Paul Whaley
- Lancaster Environment Centre, Lancaster University, UK
| | | | - Kyla W Taylor
- National Institute of Environment Health Science, USA
| | | | - Lukas Schwingshackl
- Medical Center - University of Freiburg; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jan L Hoving
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Valcke M, Bourgault MH, Gagné M, Levallois P. A probabilistic toxicokinetic modeling approach to the assessment of the impact of daily variations of lead concentrations in tap water from schools and daycares on blood lead levels in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 775:145866. [PMID: 36524623 DOI: 10.1016/j.scitotenv.2021.145866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 06/17/2023]
Abstract
The aim of this study was to assess the impact of exposure to tap water lead concentration ([Pb]TW) occurring in schools or daycares on blood lead level (BLL) of attending children. Given the potentially wide variations in space and time of ([Pb]TW) documented in the literature, a simple probabilistic toxicokinetic (STK) model that allows the simulation of the time-varying evolution of BLL in response to these variations was developed. Thus, basic toxicokinetic equations were assembled to simulate BLL in a typical infant, toddler and pupil. The STK model's steady-state BLL predictions showed good correspondence when validated against Integrated Exposure and Uptake BioKinetic model predictions for comparable [Pb]TW values. Exposures to three distributions of [Pb]TW in specific sets of Canadian schools and daycares documented in the scientific literature were simulated probabilistically with Monte Carlo simulations. For the highest distribution of [Pb]TW simulated (median, 90th percentile = 24, 412 μg/L), average annual BLL (median, 97.5th percentile) varies between 1.5 and 6.4 μg/dL in infant and 1.1 and 3 μg/dL in pupils. Toddler's results were midway between those from the infants and pupils. Under this exposure scenario, the infant may present BLL > 5 μg/dL for a significant number of days over the course of the academic year (median; 97.5th: 17; 227 days). However, peak exposure may remain unnoticed if rare and drowned out by the background BLL. In conclusion, even if they may be sparse, peak exposure episodes to [Pb]TW in schools and daycares may suffice to increased BLL in attending individuals. This finding emphasizes the need for further characterization of [Pb]TW in schools and daycares in order to identify potentially problematic institutions and therefore avoid undesirable exposures for the children attending them.
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Affiliation(s)
- Mathieu Valcke
- Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, 190 boul. Crémazie Est, Montréal, Québec H2P 1E2, Canada; Département de santé environnementale et de santé au travail, École de santé publique de l'Université de Montréal, Canada.
| | - Marie-Hélène Bourgault
- Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, 190 boul. Crémazie Est, Montréal, Québec H2P 1E2, Canada
| | - Michelle Gagné
- Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, 190 boul. Crémazie Est, Montréal, Québec H2P 1E2, Canada
| | - Patrick Levallois
- Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, 945 avenue Wolfe, Québec, (Quebec) G1V 5B3, Canada; Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC, Canada.
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11
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Lee M, Ohde S. PM 2.5 and Diabetes in the Japanese Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126653. [PMID: 34205663 PMCID: PMC8296336 DOI: 10.3390/ijerph18126653] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/24/2022]
Abstract
Growing evidence suggests that PM2.5 is associated with diabetes mellitus (DM). Although DM is a major public health concern, there has not yet been a study of this association in Japan. We used health examination data from 66,885 individuals in Tokyo, Japan 2005–2019. Cox proportional hazards models were used to evaluate an association between annual exposure to PM2.5 and glycated hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG). An increase of 1 μg/m3 in the annual average of PM2.5 concentration was associated (HR = 1.029; 95% CI = 1.004–1.055) with an increase in diabetes (incident + prevalent). For incident DM, a greater PM2.5 level was associated with more DM (HR = 1.029; 95% CI, 1.003–1.055). Compared to HbA1c, FPG showed a stronger association with the annual exposure to PM2.5 (HR = 1.065; 95% CI, 1.040–1.091). We found that greater exposure to PM2.5 in the long-term was associated with an increased risk of diabetes, and that the magnitude of association became stronger as the exposure duration increased. Omorogieva Ojo
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Affiliation(s)
- Mihye Lee
- Correspondence: ; Tel./Fax: +81-3-3541-5151
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12
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Kosterman R, Epstein M, Bailey JA, Oesterle S, Furlong M, Hawkins JD. Adult Social Environments and the Use of Combustible and Electronic Cigarettes: Opportunities for Reducing Smoking in the 30s. Nicotine Tob Res 2021; 23:518-526. [PMID: 31970409 PMCID: PMC7885773 DOI: 10.1093/ntr/ntaa019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/21/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years-particularly in the 30s and beyond-to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated. METHODS Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves. RESULTS At age 30, 32% of the sample reported past-month cigarette use. Using structural equation modeling, results showed high stability in cigarette use from age 30 to 39. After accounting for this stability, cigarette-using social environments at age 33 predicted personal beliefs or norms about smoking (eg, acceptability and social costs), which in turn predicted combustible cigarette use at age 39. Cigarette-using environments, however, directly predicted electronic cigarette use at age 39, with no significant role for beliefs about smoking. CONCLUSIONS Cigarette use was highly stable across the 30s, but social environmental factors provided significant partial mediation of this stability. Pathways were different for combustible and electronic cigarette use, however, with personal smoking norms playing an important role for the former but not the latter. IMPLICATIONS This study addresses the need for longitudinal investigation of social mechanisms and cigarette use in the 30s. Findings reinforce efforts to prevent the uptake of cigarettes prior to the 30s because, once started, smoking is highly stable. But social environmental factors remain viable intervention targets in the 30s to disrupt this stability. Addressing personal norms about smoking's acceptability and social costs is likely a promising approach for combustible cigarette use. Electronic cigarettes, however, present a new challenge in that many perceived social costs of cigarette use do not readily translate to this relatively recent technology.
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Affiliation(s)
- Rick Kosterman
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Jennifer A Bailey
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ
| | - Madeline Furlong
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
| | - J David Hawkins
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA
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13
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Hu JMY, Arbuckle TE, Janssen P, Lanphear BP, Braun JM, Platt RW, Chen A, Fraser WD, McCandless LC. Associations of prenatal urinary phthalate exposure with preterm birth: the Maternal-Infant Research on Environmental Chemicals (MIREC) Study. Canadian Journal of Public Health 2020; 111:333-341. [PMID: 32441020 DOI: 10.17269/s41997-020-00322-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 04/13/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To examine the relation between prenatal urinary phthalate metabolite concentrations and preterm birth (PTB). METHODS The data were drawn from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pan-Canadian cohort of 1857 pregnant women enrolled between 2008 and 2011. We quantified urinary concentrations of 7 phthalate metabolites that were detected in > 70% of urine samples collected during the first trimester. Gestational age was obtained from either the last menstrual period or early ultrasound. We used Cox proportional hazard models to examine the associations of urinary phthalate metabolite concentrations, plus the molar sum of di-2-ethylhexyl phthalate metabolites (∑DEHP), with time to delivery before 37 weeks of gestation. We also examined PTB by clinical presentation. PTBs presented with either spontaneous labour or premature rupture of the membrane were considered spontaneous PTB (sPTB). Additionally, we used multiple linear regression to model changes in mean gestational age in relation to phthalate exposure. RESULTS We found no evidence of an association between first trimester phthalate metabolite concentrations and PTB among the MIREC study participants. For example, each 2-fold increase in any of the 7 phthalate concentrations or ∑DEHP was associated with hazard ratios (HRs) for PTB ranging from 0.95 to 1.07 with 95% confidence intervals including the null. An assessment of non-linear trends showed some evidence of non-monotonic dose-response relationships between phthalates and PTB. Furthermore, male infants exposed to MCPP showed higher sPTB risk compared with female infants. CONCLUSION Phthalate exposure during early pregnancy is not clearly associated with the risk of PTB among this Canadian population.
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Affiliation(s)
- Janice M Y Hu
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada
| | - Patricia Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Robert W Platt
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - William D Fraser
- Department d'obstétrique et gynécologie, Université de Sherbrooke, Quebec, Canada
| | - Lawrence C McCandless
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Affiliation(s)
- Christine Till
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Rivka Green
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver,
British Columbia, Canada
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15
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Oulhote Y, Lanphear B, Braun JM, Webster GM, Arbuckle TE, Etzel T, Forget-Dubois N, Seguin JR, Bouchard MF, MacFarlane A, Ouellet E, Fraser W, Muckle G. Gestational Exposures to Phthalates and Folic Acid, and Autistic Traits in Canadian Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:27004. [PMID: 32073305 PMCID: PMC7064316 DOI: 10.1289/ehp5621] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND The etiology of autism spectrum disorder is poorly understood. Few studies have investigated the link between endocrine-disrupting chemicals and autistic traits. We examined the relationship between gestational phthalates and autistic traits in 3- to 4-y-old Canadian children. We also investigated potential effect modification by sex and folic acid supplementation. METHODS We enrolled 2,001 women>18 years of age during the first trimester of pregnancy between 2008 and 2011 from 10 cities in Canada. At 3-4 years of age, 610 children underwent neuropsychological assessments including the Social Responsiveness Scale-II (SRS-2) as a measure of autistic traits and social impairment. We measured 11 phthalate metabolites in maternal first trimester urine samples and assessed folic acid supplementation from reported intakes. We estimated covariate-adjusted differences in SRS-2 T-scores with a doubling in phthalate concentrations in 510 children with complete data. RESULTS Mean total SRS T-score was 45.3 (SD=6.1). Children with higher gestational exposure to mono-n-butyl (MBP) and mono-3-carboxypropyl (MCPP) concentrations exhibited significantly higher total SRS T-scores, indicating greater overall social impairment, as well as higher scores on subdomains, indicating deficits in social cognition, social communication, social motivation, and restricted interests/repetitive behaviors. A doubling in MBP or MCPP concentrations was associated with 0.6 (95% CI: 0.1, 1.0) and 0.5 (95% CI: 0.1, 0.8) higher total SRS T-scores. Associations were consistently and significantly stronger in boys (βMBP=1.0; 95% CI: 0.4, 1.6; n=252) compared with girls (βMBP=0.1; 95% CI: -0.6, 0.7; n=258) and among children who had lower prenatal folic acid supplementation (<400μg/d) (βMBP=1.3; 95% CI: 0.4, 2.3; n=59) compared with those who had adequate folic acid supplementation (≥400μg/d) (βMBP=0.4; 95% CI: -0.1, 0.8; n=451). CONCLUSIONS Higher gestational concentrations of some phthalate metabolites were associated with higher scores of autistic traits as measured by the SRS-2 in boys, but not girls; these small size effects were mitigated by first trimester-of-pregnancy folic acid supplementation. https://doi.org/10.1289/EHP5621.
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Affiliation(s)
- Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, Massachusetts, USA
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre and School of Psychology, Laval University, Quebec, Quebec, Canada
| | - Bruce Lanphear
- Child and Family Research Institute, BC Children’s Hospital Research Institute and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Glenys M. Webster
- Child and Family Research Institute, BC Children’s Hospital Research Institute and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Tye E. Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Taylor Etzel
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Nadine Forget-Dubois
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre and School of Psychology, Laval University, Quebec, Quebec, Canada
| | - Jean R. Seguin
- CHU Sainte-Justine Research Centre and Department of Psychiatry, School of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Maryse F. Bouchard
- CHU Sainte-Justine Research Centre and Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
| | | | - Emmanuel Ouellet
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre and School of Psychology, Laval University, Quebec, Quebec, Canada
| | - William Fraser
- Centre de Sherbrooke Research Centre, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Gina Muckle
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre and School of Psychology, Laval University, Quebec, Quebec, Canada
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Pyatak EA, Carlson M, Vigen CLP, Blanchard J, Niemiec SS, Sideris J, Baranek GT. Contextualizing the Positive Effects of the Well Elderly 2 Trial: A Response to Schelly and Ohl (2019). Am J Occup Ther 2020; 73:7306205100p1-7306205100p11. [PMID: 31891349 DOI: 10.5014/ajot.2019.038752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE A recent reanalysis of data from the Well Elderly (WE) 2 study purportedly indicated that the intervention did not achieve clinically meaningful or statistically significant effects; this article addresses these criticisms. OBJECTIVE To contextualize the WE 2 study as targeting a nonclinical population and demonstrate that the intervention produced substantively important, statistically significant effects. DESIGN Secondary analysis of WE 2 intervention-based pre-post change scores. SETTING The original trial occurred primarily in senior centers and senior housing facilities in greater Los Angeles. PARTICIPANTS Independent-living older adults (N = 324) who were assessed before and after intervention. INTERVENTION The WE intervention, a version of the Lifestyle Redesign® (LR) approach, was administered by occupational therapists over 6 mo by means of group and individual sessions. OUTCOMES AND MEASURES The 36-item Short Form Health Survey, the Life Satisfaction Index-Z, and the Center for Epidemiologic Studies Depression Scale. RESULTS The WE intervention was associated with statistically significant improvement on 10 of 12 outcome variables that were examined. CONCLUSIONS AND RELEVANCE Because the WE intervention was hypothesized to reduce age-related decline and followed a population-oriented approach, the expectation that average results would be clinically meaningful was inappropriate. The intervention produced positive effects across a wide array of outcome domains. In settings in which clinical meaningfulness is an appropriate index of intervention outcomes, evidence suggests that LR produces effects that are clinically meaningful. As an evidence-based intervention, LR should be considered useful both in population-oriented contexts and in addressing discrete health conditions. WHAT THIS ARTICLE ADDS Valid analyses demonstrate that the positive experimental effects of the WE 2 study are, in fact, genuine and cost-effective, and LR in clinically oriented contexts has produced statistically significant, clinically meaningful results. Clearly and accurately representing the evidence base of occupational therapy in prevention and chronic care is of critical importance to advance the field as a whole.
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Affiliation(s)
- Elizabeth A Pyatak
- Elizabeth A. Pyatak, PhD, OTR/L, CDE, FAOTA, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles; .,E. A. Pyatak and M. Carlson contributed equally to the conceptualization and writing of this article and should be considered co-first authors
| | - Mike Carlson
- Mike Carlson, PhD, is Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Cheryl L P Vigen
- Cheryl L. P. Vigen, PhD, is Associate Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Jeanine Blanchard
- Jeanine Blanchard, PhD, OTR/L, is Project Manager, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Stacey Schepens Niemiec
- Stacey Schepens Niemiec, PhD, OTR/L, is Assistant Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - John Sideris
- John Sideris, PhD, is Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Grace T Baranek
- Grace T. Baranek, PhD, OTR/L, FAOTA, is Associate Dean, Chair, and Mrs. T. H. Chan Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Rousseau C, Hassan G, Miconi D, Lecompte V, Mekki-Berrada A, El Hage H, Oulhote Y. From social adversity to sympathy for violent radicalization: the role of depression, religiosity and social support. Arch Public Health 2019; 77:45. [PMID: 31666951 PMCID: PMC6813961 DOI: 10.1186/s13690-019-0372-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/26/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Discrepancies among studies suggest that the relation between social adversity and sympathy for violent radicalization (SVR) is multifaceted and may differ according to social context. This paper examines the role of depression, religiosity and social support in the relation between social adversity (i.e., discrimination and exposure to violence) and SVR among college students in Quebec, Canada. METHODS A total of 1894 students responded to an online questionnaire posted on the internet of eight colleges. Multilevel analyses were first conducted to account for the clustered nature of the data, followed by mediation and moderation analyses. RESULTS First generation migrants reported less SVR than second generation youth and non-immigrants. The mediating and/or moderating role of depression, religiosity and social support was examined through causal inference models. Depression mediated the relation between social adversity and SVR, with depression scores accounting for 47% and 25% of the total effect between discrimination and exposure to violence and SVR scores, respectively. Religiosity and social support moderated the association between social adversity and SVR. CONCLUSIONS These results suggest that prevention programs should consider violent radicalization as a systemic issue which involves both minorities and the majority, although the specific balance between risk and protective factors may be influenced by local dynamics. They also question intervention measures targeting specifically migrants or ethno-cultural communities because of the risk of increasing profiling and stigmatization. Prevention programs should prioritize decreasing discrimination in colleges, as well as the provision of psychosocial support to depressed youth who experience social adversity.
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Affiliation(s)
- Cécile Rousseau
- Division of Social and Cultural Psychiatry, SHERPA Research Center, McGill University, CIUSSS Centre-Ouest-de-l’lle-de-Montreal, CSSS de la Montagne (Park Extension), 7085 Hutchison, Suite 204.2, Montreal, QC H3N 1Y9 Canada
| | - Ghayda Hassan
- UQAM, J.-A.-DeSeve Pavillon, Suite DS-1900, 320 Sainte-Catherine St. E., Montreal, QC H2X 1L7 Canada
| | - Diana Miconi
- CLSC Parc Extension, McGill University, 7085 Hutchison, Room 304-AA, Montreal, QC H3N 1Y9 Canada
| | - Vanessa Lecompte
- McGill University, James Administration Building, 845 Sherbrooke St. W., Room 400, Montreal, QC H3A 0G4 Canada
| | - Abdelwahed Mekki-Berrada
- Anthropology Department, Laval University, Charles-De Koninck Pavillon, Suite 6403, 1030 Sciences humaines Av., Quebec City, QC G1V 0A6 Canada
| | - Habib El Hage
- Rosemont College, C.P. 8888, succursale Centre-ville, Montreal, QC H3C 3P8 Canada
| | - Youssef Oulhote
- School of Public health and Health Sciences, University of Massachusetts at Amherst, Arnold House, 716 North Pleasant Street, Amherst, MA 01003 Canada
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Oulhote Y, Coull B, Bind MA, Debes F, Nielsen F, Tamayo I, Weihe P, Grandjean P. Joint and independent neurotoxic effects of early life exposures to a chemical mixture: A multi-pollutant approach combining ensemble learning and g-computation. Environ Epidemiol 2019; 3:e063. [PMID: 32051926 PMCID: PMC7015154 DOI: 10.1097/ee9.0000000000000063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Exposure to mercury (Hg) is associated with adverse developmental effects. However, Hg occurs with a multitude of chemicals. We assessed the associations of developmental exposure to multiple pollutants with children's neurodevelopment using a novel approach. METHODS Hg, polychlorinated biphenyls (PCBs), and perfluoroalkyl substances were measured in maternal and children's blood at 5-years (n=449 and 419). At 7-years, children were administered Boston Naming Test (BNT) and the Strengths and Difficulties Questionnaire (SDQ). We used the G-formula combined with SuperLearner to estimate independent and joint effects of chemicals at both ages. We constructed flexible exposure-response relationships and assessed interactions. RESULTS Most chemicals showed negative relationships with BNT scores. An inter-quartile range (IQR) increase in maternal Hg and perfluorooctanoic acid (PFOA) was associated with 0.15 standard deviation [SD] (95% Confidence Interval [CI]: -0.29,-0.03) and 0.14 SD (95%CI: -0.26,-0.05) lower scores in BNT, whereas a joint IQR increase in the mixture of chemicals was associated with 0.48 SD (95%CI: -0.69,-0.25) lower scores in BNT. An IQR increase in PFOA was associated with 0.11 SD (95%CI: 0.02,0.26) higher total SDQ difficulties scores. Maternal ∑PCBs concentrations were associated with lower SDQ scores (β=-0.09 SD; 95%CI: -0.19,0), whereas 5-years ∑PCBs showed a negative association (β=-0.09 SD; 95%CI: -0.21,0). Finally, a joint IQR increase in the mixture was associated with 0.22 SD (95%CI: 0.04,0.4) higher SDQ scores. CONCLUSIONS Using a novel statistical approach, we confirmed associations between prenatal mercury exposure and lower cognitive function. The potential developmental effects of PFASs need additional attention.
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Affiliation(s)
- Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, UMASS- Amherst, Amherst, Massachusetts
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Brent Coull
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Marie-Abele Bind
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts
| | - Frodi Debes
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
| | - Flemming Nielsen
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ibon Tamayo
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts
| | - Pal Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Vearrier D, Greenberg MI. The implementation of medical monitoring programs following potentially hazardous exposures: a medico-legal perspective. Clin Toxicol (Phila) 2017. [PMID: 28644057 DOI: 10.1080/15563650.2017.1334913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. METHODS We searched the MEDLINE database using the Ovid® search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance"). The titles and abstracts of the resulted articles were reviewed for relevance. We expanded our search to include non-peer-reviewed publications and gray literature and resources using the same terms as utilized in the MEDLINE search. There were a total of 48 relevant peer-reviewed and non-peer-reviewed publications. Publications excluded contained no information relevant to medical monitoring following potentially harmful toxicologic exposures, discussed only worker screening/surveillance and/or population biomonitoring, contained redundant information, or were superseded by more recent information. Approaches to medical monitoring: A consensus exists in the peer-reviewed medical literature, legal literature, and government publications that for medical monitoring to be a beneficial public health activity, careful consideration must be given to potential benefits and harms of the program. Characteristics of the exposure, the adverse human health effect, the screening test, and the natural history of the disease are important in determining whether an exposed population will reap a net benefit or harm from a proposed monitoring program. Broader interpretations of medical monitoring: Some have argued that medical monitoring programs should not be limited to exposure-related outcomes but should duplicate general preventive medicine efforts to improve public health outcomes although an overall reduction of morbidity, mortality and disability by modifying correctable risk factors and disease conditions. This broader approach is inconsistent with the targeted approach advocated by the Agency for Toxic Substances and Disease Registry and the United States Preventive Services Task Force and the bulk of the peer-reviewed medical literature. Medical monitoring in legal contexts: Numerous medical monitoring actions have been litigated. Legal rationales for allowing medical monitoring claims often incorporate some of the scientific criteria for the appropriateness of monitoring programs. In the majority of cases in which plaintiffs were awarded medical monitoring relief, plaintiffs were required to demonstrate both that the condition for which medical monitoring was sought could be detected early, and that early detection and treatment will improve morbidity and mortality. However, the treatment of medical monitoring claims varies significantly depending upon jurisdiction. Examples of large-scale, comprehensive medical monitoring programs: Large-scale, comprehensive medical monitoring programs have been implemented, such as the Fernald Medical Monitoring Program and the World Trade Center Health Program, both of which exceeded the scope of medical monitoring typically recommended in the peer-reviewed medical literature and the courts. The Fernald program sought to prevent death and disability due to non-exposure-related conditions in a manner similar to general preventive medicine. The World Trade Center Health Program provides comprehensive medical care for World Trade Center responders and may be viewed as a large-scale, federally--funded research effort, which distinguishes it from medical monitoring in a medico-legal context. Synthesis of public health approaches to medical monitoring: Medical monitoring may be indicated following a hazardous exposure in limited circumstances. General causation for a specific adverse health effect must be either established by scientific consensus through a formal causal analysis using a framework such as the Bradford-Hill criteria. The exposure must be characterized and must be of sufficient severity that the exposed population has a significantly elevated risk of an adverse health effect. Monitoring must result in earlier detection of the condition than would otherwise occur and must confer a benefit in the form of primary, secondary or tertiary prevention. Outcome tables may be of use in describing the potential benefits and harms of a proposed monitoring program. CONCLUSIONS In the context of litigation, plaintiffs may seek medical monitoring programs after documented or putative exposures. The role of the clinical toxicologist, in this setting, is to evaluate the scientific justifications and medical risks and assist the courts in determining whether monitoring would be expected to result in a net public health benefit.
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Affiliation(s)
- David Vearrier
- a Department of Emergency Medicine , Drexel University College of Medicine , Philadelphia , PA , USA
| | - Michael I Greenberg
- a Department of Emergency Medicine , Drexel University College of Medicine , Philadelphia , PA , USA
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Mustieles V, Pérez-Lobato R, Olea N, Fernández MF. Bisphenol A: Human exposure and neurobehavior. Neurotoxicology 2015; 49:174-84. [DOI: 10.1016/j.neuro.2015.06.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 06/08/2015] [Accepted: 06/08/2015] [Indexed: 12/21/2022]
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Multifactorial Origin of Neurodevelopmental Disorders: Approaches to Understanding Complex Etiologies. TOXICS 2015; 3:89-129. [PMID: 29056653 PMCID: PMC5634696 DOI: 10.3390/toxics3010089] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/06/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
A significant body of evidence supports the multifactorial etiology of neurodevelopmental disorders (NDDs) affecting children. The present review focuses on early exposure to environmental chemicals as a risk factor for neurodevelopment, and presents the major lines of evidence derived from epidemiological studies, underlying key uncertainties and research needs in this field. We introduce the exposome concept that, encompassing the totality of human environmental exposures to multiple risk factors, aims at explaining individual vulnerability and resilience to early chemical exposure. In this framework, we synthetically review the role of variable gene backgrounds, the involvement of epigenetic mechanisms as well as the function played by potential effect modifiers such as socioeconomic status. We describe laboratory rodent studies where the neurodevelopmental effects of environmental chemicals are assessed in the presence of either a “vulnerable” gene background or adverse pregnancy conditions (i.e., maternal stress). Finally, we discuss the need for more descriptive and “lifelike” experimental models of NDDs, to identify candidate biomarkers and pinpoint susceptible groups or life stages to be translated to large prospective studies within the exposome framework.
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Susceptibility Based Upon Chemical Interaction with Disease Processes: Potential Implications for Risk Assessment. Curr Environ Health Rep 2014. [DOI: 10.1007/s40572-014-0030-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Chatham-Stephens K, Caravanos J, Ericson B, Landrigan P, Fuller R. The pediatric burden of disease from lead exposure at toxic waste sites in low and middle income countries. ENVIRONMENTAL RESEARCH 2014; 132:379-83. [PMID: 24853976 DOI: 10.1016/j.envres.2014.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 03/28/2014] [Accepted: 04/05/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND The impact of lead from toxic waste sites on children in low and middle income countries has not been calculated due to a lack of exposure data. We sought to calculate this impact in Disability Adjusted Life Years (DALYs). MATERIALS AND METHODS Using an Integrated Exposure Uptake Biokinetic (IEUBK) model, we converted soil and drinking water lead levels from sites in the Blacksmith Institute's Toxic Sites Identification Program (TSIP) into mean blood lead levels (BLLs). We then calculated the incidence of mild mental retardation (MMR) and DALYs resulting from these BLLs. RESULTS The TSIP included 200 sites in 31 countries with soil (n=132) or drinking water (n=68) lead levels, representing 779,989 children younger than 4 years of age potentially exposed to lead. Environmental lead levels produced a range of BLLs from 1.56 to 104.71 µg/dL. These BLLs equated to an estimated loss of 5.41-8.23 IQ points, resulting in an incidence of MMR of 6.03 per 1000 population and 76.1 DALYs per 1000 population. DISCUSSION Soil and water lead levels at toxic waste sites predict BLLs that lower the intelligence quotient (IQ), with the resulting MMR potentially limiting individual- and country-level development. The preventable burden of disease produced by these sites highlights the need for toxic waste sites to be systematically identified, evaluated, and remediated.
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Affiliation(s)
- Kevin Chatham-Stephens
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
| | - Jack Caravanos
- School of Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA
| | - Bret Ericson
- Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA
| | - Philip Landrigan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Richard Fuller
- Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA
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Ginsberg G, Sonawane B, Nath R, Lewandowski P. Methylmercury-induced inhibition of paraoxonase-1 (PON1)-implications for cardiovascular risk. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:1004-1023. [PMID: 25072822 DOI: 10.1080/15287394.2014.919837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Methylmercury (MeHg) has been associated with increased risk for cardiovascular disease in some but not all epidemiology studies. These inconsistent results may stem from the fact that exposure typically occurs in the context of fish consumption, which is also associated with cardioprotective factors such as omega-3 fatty acids. Mechanistic information may help to understand whether MeHg represents a risk to cardiovascular health. MeHg is a pro-oxidant that inactivates protein sulfhydryls. These biochemical effects may diminish critical antioxidant defense mechanism(s) involved in protecting against atherosclerosis. One such defense mechanism is paraoxonase-1 (PON1), an enzyme present on high-density lipoproteins and that prevents the oxidation of blood lipids and their deposition in vascular endothelium. PON1 is potentially useful as a clinical biomarker of cardiovascular risk, as well as a critical enzyme in the detoxification of certain organophosphate oxons. MeHg and other metals are known to inhibit PON1 activity in vitro. MeHg is associated with lowered serum PON1 activity in a fish-eating population. The implications of lowering PON1 are evaluated by predicting the shift in PON1 population distribution induced by various doses of MeHg. An MeHg dose of 0.3 μg/kg/d is estimated to decrease the population average PON1 level by 6.1% and to increase population risk of acute cardiovascular events by 9.7%. This evaluation provides a plausible mechanism for MeHg-induced cardiovascular risk and suggests means to quantify the risk. This case study exemplifies the use of upstream disease biomarkers to evaluate the additive effect of chemical toxicity with background disease processes in assessing human risk.
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Affiliation(s)
- G Ginsberg
- a Connecticut Department of Public Health , Hartford , Connecticut , USA
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Park RM. Neurobehavioral deficits and parkinsonism in occupations with manganese exposure: a review of methodological issues in the epidemiological literature. Saf Health Work 2013; 4:123-35. [PMID: 24106642 PMCID: PMC3791085 DOI: 10.1016/j.shaw.2013.07.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/19/2013] [Accepted: 07/24/2013] [Indexed: 11/15/2022] Open
Abstract
Exposure to manganese (Mn) is associated with neurobehavioral effects. There is disagreement on whether commonly occurring exposures in welding, ferroalloy, and other industrial processes produce neurologically significant neurobehavioral changes representing parkinsonism. A review of methodological issues in the human epidemiological literature on Mn identified: (1) studies focused on idiopathic Parkinson disease without considering manganism, a parkinsonian syndrome; (2) studies with healthy worker effect bias; (3) studies with problematic statistical modeling; and (4) studies arising from case series derived from litigation. Investigations with adequate study design and exposure assessment revealed consistent neurobehavioral effects and attributable subclinical and clinical signs and symptoms of impairment. Twenty-eight studies show an exposure-response relationship between Mn and neurobehavioral effects, including 11 with continuous exposure metrics and six with three or four levels of contrasted exposure. The effects of sustained low-concentration exposures to Mn are consistent with the manifestations of early manganism, i.e., consistent with parkinsonism. This is compelling evidence that Mn is a neurotoxic chemical and there is good evidence that Mn exposures far below the current US standard of 5.0 mg/m3 are causing impairment.
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Affiliation(s)
- Robert M Park
- National Institute for Occupational Safety and Health, Education and Information Division, Cincinnati, OH, USA
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Choi AL, Grandjean P, Sun G, Zhang Y. Developmental fluoride neurotoxicity: Choi et al. Respond. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:A70. [PMID: 23454355 PMCID: PMC3621205 DOI: 10.1289/ehp.1206192r] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Anna L. Choi
- Harvard School of Public Health, Boston, Massachusetts, E-mail:
| | | | - Guifan Sun
- China Medical University, Shenyang, China
| | - Ying Zhang
- China Medical University, Shenyang, China
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Ciesielski T, Bellinger DC, Schwartz J, Hauser R, Wright RO. Associations between cadmium exposure and neurocognitive test scores in a cross-sectional study of US adults. Environ Health 2013; 12:13. [PMID: 23379984 PMCID: PMC3599125 DOI: 10.1186/1476-069x-12-13] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 01/29/2013] [Indexed: 05/03/2023]
Abstract
BACKGROUND Low-level environmental cadmium exposure and neurotoxicity has not been well studied in adults. Our goal was to evaluate associations between neurocognitive exam scores and a biomarker of cumulative cadmium exposure among adults in the Third National Health and Nutrition Examination Survey (NHANES III). METHODS NHANES III is a nationally representative cross-sectional survey of the U.S. population conducted between 1988 and 1994. We analyzed data from a subset of participants, age 20-59, who participated in a computer-based neurocognitive evaluation. There were four outcome measures: the Simple Reaction Time Test (SRTT: visual motor speed), the Symbol Digit Substitution Test (SDST: attention/perception), the Serial Digit Learning Test (SDLT) trials-to-criterion, and the SDLT total-error-score (SDLT-tests: learning recall/short-term memory). We fit multivariable-adjusted models to estimate associations between urinary cadmium concentrations and test scores. RESULTS 5662 participants underwent neurocognitive screening, and 5572 (98%) of these had a urinary cadmium level available. Prior to multivariable-adjustment, higher urinary cadmium concentration was associated with worse performance in each of the 4 outcomes. After multivariable-adjustment most of these relationships were not significant, and age was the most influential variable in reducing the association magnitudes. However among never-smokers with no known occupational cadmium exposure the relationship between urinary cadmium and SDST score (attention/perception) was significant: a 1 μg/L increase in urinary cadmium corresponded to a 1.93% (95%CI: 0.05, 3.81) decrement in performance. CONCLUSIONS These results suggest that higher cumulative cadmium exposure in adults may be related to subtly decreased performance in tasks requiring attention and perception, particularly among those adults whose cadmium exposure is primarily though diet (no smoking or work based cadmium exposure). This association was observed among exposure levels that have been considered to be without adverse effects and these levels are common in U.S. adults. Thus further research into the potential neurocognitive effects of cadmium exposure is warranted. Because cumulative cadmium exposure may mediate some of the effects of age and smoking on cognition, adjusting for these variables may result in the underestimation of associations with cumulative cadmium exposure. Prospective studies that include never-smokers and non-occupationally exposed individuals are needed to clarify these issues.
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Affiliation(s)
- Timothy Ciesielski
- Institute for Quantitative Biomedical Sciences, Dartmouth College, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - David C Bellinger
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Neurology, Children’s Hospital, Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA
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Hinkle SN, Schieve LA, Stein AD, Swan DW, Ramakrishnan U, Sharma AJ. Associations between maternal prepregnancy body mass index and child neurodevelopment at 2 years of age. Int J Obes (Lond) 2012; 36:1312-9. [PMID: 22964791 PMCID: PMC4583192 DOI: 10.1038/ijo.2012.143] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Both underweight and obese mothers have an increased risk for adverse offspring outcomes. Few studies have examined the association between prepregnancy body mass index (BMI) and children's neurodevelopment. SUBJECTS We used data from the nationally representative Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; n=6850). Children were classified according to their mother's prepregnancy BMI (kg m(-2)) status: underweight (BMI <18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obese class I (BMI 30.0-34.9), and obese class II and III (BMI ≥35.0). Children's age-adjusted mental development index (MDI) and psychomotor development index (PDI) T-scores (mean 50, s.d. 10) were obtained using a validated shortened version of the Bayley Scales of Infant Development-II at approximately 2 years of age. While adjusting for sociodemographics, we estimated the average MDI and PDI scores or the risk of delayed (<-1 s.d. vs >1 s.d.) mental or motor development, relative to children of normal weight mothers. RESULTS Compared with children of normal weight mothers, MDI scores were lower among children of mothers of all other prepregnancy BMI categories, with the greatest adjusted difference among children of class II and III obese mothers (-2.13 (95% CI -3.32, -0.93)). The adjusted risk of delayed mental development was increased among children of underweight (risk ratio (RR) 1.36 (95% CI 1.04, 1.78)) and class II and III obese (RR 1.38 (95% CI 1.03, 1.84)) mothers. Children's PDI scores or motor delay did not differ by maternal prepregnancy BMI. CONCLUSION In this nationally representative sample of 2-year-old US children, low and very-high maternal prepregnancy BMI were associated with increased risk of delayed mental development but not motor development.
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Affiliation(s)
- S N Hinkle
- Nutrition and Health Sciences, Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
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Choi AL, Sun G, Zhang Y, Grandjean P. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1362-8. [PMID: 22820538 PMCID: PMC3491930 DOI: 10.1289/ehp.1104912] [Citation(s) in RCA: 243] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 07/20/2012] [Indexed: 05/20/2023]
Abstract
BACKGROUND Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on children's neurodevelopment. OBJECTIVE We performed a systematic review and meta-analysis of published studies to investigate the effects of increased fluoride exposure and delayed neurobehavioral development. METHODS We searched the MEDLINE, EMBASE, Water Resources Abstracts, and TOXNET databases through 2011 for eligible studies. We also searched the China National Knowledge Infrastructure (CNKI) database, because many studies on fluoride neurotoxicity have been published in Chinese journals only. In total, we identified 27 eligible epidemiological studies with high and reference exposures, end points of IQ scores, or related cognitive function measures with means and variances for the two exposure groups. Using random-effects models, we estimated the standardized mean difference between exposed and reference groups across all studies. We conducted sensitivity analyses restricted to studies using the same outcome assessment and having drinking-water fluoride as the only exposure. We performed the Cochran test for heterogeneity between studies, Begg's funnel plot, and Egger test to assess publication bias, and conducted meta-regressions to explore sources of variation in mean differences among the studies. RESULTS The standardized weighted mean difference in IQ score between exposed and reference populations was -0.45 (95% confidence interval: -0.56, -0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. Subgroup and sensitivity analyses also indicated inverse associations, although the substantial heterogeneity did not appear to decrease. CONCLUSIONS The results support the possibility of an adverse effect of high fluoride exposure on children's neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.
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Affiliation(s)
- Anna L Choi
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
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Maserejian NN, Trachtenberg FL, Hauser R, McKinlay S, Shrader P, Tavares M, Bellinger DC. Dental composite restorations and psychosocial function in children. Pediatrics 2012; 130:e328-38. [PMID: 22802599 PMCID: PMC3408688 DOI: 10.1542/peds.2011-3374] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Resin-based dental materials may intraorally release their chemical components and bisphenol A. The New England Children's Amalgam Trial found that children randomized to amalgam had better psychosocial outcomes than those assigned to composites for posterior tooth restorations. The objective of this study was to examine whether greater exposure to dental composites is associated with psychosocial problems in children. METHODS Analysis of treatment-level data from the New England Children's Amalgam Trial, a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate-based polyacid-modified composite (compomer), among 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (n = 434) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL). RESULTS Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (β = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (β = 0.7, SE = 0.3, P = .02), and Personal Adjustment (β = -0.8, SE = 0.2, P = .002). Associations were stronger with posterior-occlusal (chewing) surfaces, where degradation of composite was more likely. For CBCL change, associations were not statistically significant. At-risk or clinically significant scores were more common among children with greater exposure for CBCL Total Problem Behaviors (16.3% vs 11.2%, P-trend = .01) and numerous BASC-SR syndromes (eg, ≥ 13 vs 0 surface-years, Interpersonal Relations 13.7% vs 4.8%, P-trend = .01). No associations were found with compomer, nor with amalgam exposure levels among children randomized to amalgam. CONCLUSIONS Greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children, whereas no adverse psychosocial outcomes were observed with greater urethane dimethacrylate-based compomer or amalgam treatment levels.
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Affiliation(s)
- Nancy N. Maserejian
- Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts
| | | | - Russ Hauser
- Departments of Environmental Health and,Epidemiology, Harvard School of Public Health, Boston, Massachusetts;,Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sonja McKinlay
- Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts
| | - Peter Shrader
- Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts
| | | | - David C. Bellinger
- Departments of Environmental Health and,Department of Neurology, Children’s Hospital Boston, Boston, Massachusetts; and,Harvard Medical School, Boston, Massachusetts
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Zerbo O, Iosif AM, Delwiche L, Walker C, Hertz-Picciotto I. Month of conception and risk of autism. Epidemiology 2011; 22:469-75. [PMID: 21543984 DOI: 10.1097/ede.0b013e31821d0b53] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studies of season of birth or season of conception can provide clues about etiology. We investigated whether certain months or seasons of conception are associated with increased risk of autism spectrum disorders, for which etiology is particularly obscure. METHODS The study population comprises 6,604,975 children born from 1990 to 2002 in California. Autism cases (n = 19,238) were identified from 1990 through 2008 in databases of the California Department of Developmental Services, which coordinates services for people with developmental disorders. The outcome in this analysis was autism diagnosed before the child's sixth birth date. The main independent variables were month of conception and season of conception (winter, spring, summer, and fall). Multivariate logistic regression models were used to estimate odds ratios (ORs) with their 95% confidence intervals (CIs) for autism by month of conception. RESULTS Children conceived in December (OR = 1.09 [95% CI = 1.02-1.17]), January (1.08 [1.00-1.17]), February (1.12 [1.04-1.20]), or March (1.16 [1.08-1.24]) had higher risk of developing autism compared with those conceived in July. Conception in the winter season (December, January, and February) was associated with a 6% (OR = 1.06, 95% CI = 1.02-1.10) increased risk compared with summer. CONCLUSIONS Higher risks for autism among those conceived in winter months suggest the presence of environmental causes of autism that vary by season.
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Affiliation(s)
- Ousseny Zerbo
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA 95616, USA.
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Miodovnik A, Engel SM, Zhu C, Ye X, Soorya LV, Silva MJ, Calafat AM, Wolff MS. Endocrine disruptors and childhood social impairment. Neurotoxicology 2010; 32:261-7. [PMID: 21182865 DOI: 10.1016/j.neuro.2010.12.009] [Citation(s) in RCA: 269] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 12/13/2010] [Accepted: 12/13/2010] [Indexed: 11/19/2022]
Abstract
Prenatal exposure to endocrine disruptors has the potential to impact early brain development. Neurodevelopmental toxicity in utero may manifest as psychosocial deficits later in childhood. This study investigates prenatal exposure to two ubiquitous endocrine disruptors, the phthalate esters and bisphenol A (BPA), and social behavior in a sample of adolescent inner-city children. Third trimester urines of women enrolled in the Mount Sinai Children's Environmental Health Study between 1998 and 2002 (n=404) were analyzed for phthalate metabolites and BPA. Mother-child pairs were asked to return for a follow-up assessment when the child was between the ages of 7 and 9 years. At this visit, mothers completed the Social Responsiveness Scale (SRS) (n=137), a quantitative scale for measuring the severity of social impairment related to Autistic Spectrum Disorders (ASD) in the general population. In adjusted general linear models increasing log-transformed low molecular weight (LMW) phthalate metabolite concentrations were associated with greater social deficits (β=1.53, 95% CI 0.25-2.8). Among the subscales, LMWP were also associated with poorer Social Cognition (β=1.40, 95% CI 0.1-2.7); Social Communication (β=1.86, 95% CI 0.5-3.2); and Social Awareness (β=1.25, 95% CI 0.1-2.4), but not for Autistic Mannerisms or Social Motivation. No significant association with BPA was found (β=1.18, 95% CI -0.75, 3.11). Prenatal phthalate exposure was associated with childhood social impairment in a multiethnic urban population. Even mild degrees of impaired social functioning in otherwise healthy individuals can have very important adverse effects over a child's lifetime. These results extend our previous finding of atypical neonatal and early childhood behaviors in relation to prenatal phthalate exposure.
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Affiliation(s)
- Amir Miodovnik
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Park HY, Hertz-Picciotto I, Sovcikova E, Kocan A, Drobna B, Trnovec T. Neurodevelopmental toxicity of prenatal polychlorinated biphenyls (PCBs) by chemical structure and activity: a birth cohort study. Environ Health 2010; 9:51. [PMID: 20731829 PMCID: PMC2939589 DOI: 10.1186/1476-069x-9-51] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 08/23/2010] [Indexed: 05/13/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) are ubiquitous environmental toxins. Although there is growing evidence to support an association between PCBs and deficits of neurodevelopment, the specific mechanisms are not well understood. The potentially different roles of specific PCB groups defined by chemical structures or hormonal activities e.g., dioxin-like, non-dioxin like, or anti-estrogenic PCBs, remain unclear. Our objective was to examine the association between prenatal exposure to defined subsets of PCBs and neurodevelopment in a cohort of infants in eastern Slovakia enrolled at birth in 2002-2004. METHODS Maternal and cord serum samples were collected at delivery, and analyzed for PCBs using high-resolution gas chromatography. The Bayley Scales of Infant Development -II (BSID) were administered at 16 months of age to over 750 children who also had prenatal PCB measurements. RESULTS Based on final multivariate-adjusted linear regression model, maternal mono-ortho-substituted PCBs were significantly associated with lower scores on both the psychomotor (PDI) and mental development indices (MDI). Also a significant association between cord mono-ortho-substituted PCBs and reduced PDI was observed, but the association with MDI was marginal (p = 0.05). Anti-estrogenic and di-ortho-substituted PCBs did not show any statistically significant association with cognitive scores, but a suggestive association between di-ortho-substituted PCBs measured in cord serum and poorer PDI was observed. CONCLUSION Children with higher prenatal mono-ortho-substituted PCB exposures performed more poorly on the Bayley Scales. Evidence from this and other studies suggests that prenatal dioxin-like PCB exposure, including mono-ortho congeners, may interfere with brain development in utero. Non-dioxin-like di-ortho-substituted PCBs require further investigation.
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Affiliation(s)
- Hye-Youn Park
- Divisions of Epidemiology, and of Environmental and Occupational Health, Department of Public Health Sciences, School of Medicine, University of California, Davis, 95616, USA
| | - Irva Hertz-Picciotto
- Divisions of Epidemiology, and of Environmental and Occupational Health, Department of Public Health Sciences, School of Medicine, University of California, Davis, 95616, USA
| | - Eva Sovcikova
- Department of Toxic Organic Pollutants, Slovak Medical University, Bratislava, Slovakia
| | - Anton Kocan
- Department of Toxic Organic Pollutants, Slovak Medical University, Bratislava, Slovakia
| | - Beata Drobna
- Department of Toxic Organic Pollutants, Slovak Medical University, Bratislava, Slovakia
| | - Tomas Trnovec
- Department of Toxic Organic Pollutants, Slovak Medical University, Bratislava, Slovakia
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Williams PL, Sergeyev O, Lee MM, Korrick SA, Burns JS, Humblet O, DelPrato J, Revich B, Hauser R. Blood lead levels and delayed onset of puberty in a longitudinal study of Russian boys. Pediatrics 2010; 125:e1088-96. [PMID: 20368318 PMCID: PMC3111933 DOI: 10.1542/peds.2009-2575] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We evaluated the association of blood lead levels (BLLs) with pubertal onset in a longitudinal cohort of Russian boys. METHODS A total of 489 Russian boys were enrolled in 2003-2005, at 8 to 9 years of age, and were monitored annually through May 2008. Cox proportional-hazards models were used to evaluate the association of BLLs at enrollment with time to pubertal onset during follow-up monitoring. RESULTS A total of 481 boys had BLLs, with a median of 3 microg/dL and 28% with values of > or =5 microg/dL. The proportion of pubertal boys increased with age, from 12% at age 8 to 83% at age 12 for testicular volume of >3 mL, from 22% to 90% for genitalia stage 2 or higher, and from 4% to 40% for pubic hair stage 2 or higher. After adjustment for potential confounders including BMI and height, boys with high BLLs (> or =5 microg/dL) had 24% to 31% reduced risk of pubertal onset, on the basis of testicular volume of >3 mL (hazard ratio [HR]: 0.73 [95% confidence interval [CI]: 0.55-0.97]; P = .03), genitalia staging (HR: 0.76 [95% CI: 0.59-0.98]; P = .04), and pubic hair staging (HR: 0.69 [95% CI: 0.44-1.07]; P = .10), compared with those with lower BLLs. Pubertal onset occurred 6 to 8 months later, on average, for boys with high BLLs, compared with those with BLLs of <5 microg/dL. CONCLUSION Higher BLLs were associated with later pubertal onset in this prospective study of peripubertal Russian boys.
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Affiliation(s)
- Paige L. Williams
- Department of Biostatistics, Harvard School of Public Health, 665 Huntington Avenue, I-415, Boston, MA 02115, USA,Corresponding Author: Paige L, Williams, PhD, Department of Biostatistics, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, PH: (617) 432-3872, Fax: (617) 432-2832,
| | - Oleg Sergeyev
- Samara State Medical University, Department of Physical Education and Health, Chapaevskaya Street 89, Samara 443099, Russia,Chapaevsk Medical Association, Meditsinskaya Street 3A, Chapaevsk, Samara region, 446100 Russia
| | - Mary M. Lee
- Pediatric Endocrine Division, Departments of Pediatrics and Cell Biology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Susan A. Korrick
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115, USA,Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
| | - Jane S. Burns
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
| | - Olivier Humblet
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
| | - Julie DelPrato
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
| | - Boris Revich
- Center for Demography and Human Ecology of Institute for Forecasting, Russian Academy of Sciences, RAS. 47 Nahimowski Avenue, Moscow 117418, Russia
| | - Russ Hauser
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
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Bellinger DC. Interpreting epidemiologic studies of developmental neurotoxicity: conceptual and analytic issues. Neurotoxicol Teratol 2009; 31:267-74. [PMID: 19595760 DOI: 10.1016/j.ntt.2009.06.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 06/20/2009] [Accepted: 06/25/2009] [Indexed: 11/25/2022]
Abstract
This paper discusses issues pertaining to the validity, precision, and interpretation of epidemiologic studies of neurotoxicity. With regard to validity, the critical issues pertain to the appropriate strategy for confounder adjustment, particularly when confounders are complex, multi-faceted constructs, and to the need for greater clarity and transparency in articulating the causal relationships implicit in the analytic approach applied. With regard to precision, the critical issue is a need to identify the contributors to the substantial variability observed in the effect estimates that describe dose-response and dose-effect relationships. In addition to methodological sources, such as imprecision in estimating dose at the critical organ site(s), true inter-individual differences in susceptibility to a neurotoxicant could also contribute to the variability. Variability might be reduced by taking full account of factors such as co-exposures or health co-morbidities, genetic polymorphisms, and the social ecology of exposure. With regard to interpretation, we need to do a better job as a field conveying to risk assessors and others the ecological significance of the types of performance deficits observed following neurotoxicant exposure, emphasizing the distinction between individual and population risk. A final issue discussed is the need to define standards for the conduct, analysis, and reporting of epidemiologic studies of neurotoxicity, similar to those developed for other fields.
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Affiliation(s)
- David C Bellinger
- Children's Hospital Boston, Harvard Medical School, Harvard School of Public Health, Farley Basement Box 127, Children's Hospital, Boston, MA 02115, USA.
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Lilienthal H, Slob W, van der Ven LT, Piersma AH. Measurement and evaluation of neurobehavioral effects induced by tetrabromobisphenol A (TBBPA)—Response to Strain et al. (2009). Toxicology 2009. [DOI: 10.1016/j.tox.2009.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hauser R, Sergeyev O, Korrick S, Lee MM, Revich B, Gitin E, Burns JS, Williams PL. Association of blood lead levels with onset of puberty in Russian boys. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:976-80. [PMID: 18629324 PMCID: PMC2453170 DOI: 10.1289/ehp.10516] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Accepted: 03/19/2008] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiologic studies suggest a temporal trend of earlier onset and longer duration of puberty, raising concerns regarding the potential impact of environmental factors on pubertal development. Lead exposure has been associated with delayed pubertal onset in girls; however, epidemiologic data in boys are limited. METHODS We used multivariable logistic regression models to explore the cross-sectional association of blood lead levels with growth and pubertal onset based on physician-assessed testicular volume (TV) and pubertal staging in 489 boys 8-9 years of age from Chapaevsk, Russia. We used multivariable linear regression models to assess associations of blood lead levels with somatic growth at the study entry visit. RESULTS The median (25th-75th percentile) blood lead level was 3 microg/dL (2-5 microg/dL). Height, weight, body mass index, birth weight, and gestational age were predictive of the onset of puberty as assessed either by TV (> 3 mL), genitalia stage (G2), or both. Blood lead level was inversely associated with height (p < 0.001) and weight (p = 0.06) after adjustment for birth weight, gestational age, and age at examination. In multivariable adjusted analyses, boys with blood lead levels > or = 5 microg/dL had 43% reduced odds of having entered G2 compared with those with lower levels (odds ratio = 0.57; 95% confidence interval, 0.34-0.95, p = 0.03). CONCLUSIONS Relatively low environmental blood lead levels were associated with decreased growth and differences in pubertal onset in periadolescent Russian boys. Future analyses of this prospective cohort will address pubertal onset and progression in relation to lead and other environmental chemicals.
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Affiliation(s)
- Russ Hauser
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
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Rohlman DS, Lucchini R, Anger WK, Bellinger DC, van Thriel C. Neurobehavioral testing in human risk assessment. Neurotoxicology 2008; 29:556-67. [PMID: 18539229 DOI: 10.1016/j.neuro.2008.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 04/09/2008] [Accepted: 04/10/2008] [Indexed: 02/06/2023]
Abstract
Neurobehavioral tests are being increasingly used in human risk assessment and there is a strong need for guidance. The field of neurobehavioral toxicology has evolved from research which initially focused on using traditional neuropsychological tests to identify "abnormal cases" to include methods used to detect sub-clinical deficits, to further incorporate the use of neurosensory assessment, and to expand testing from occupational populations to vulnerable populations including older adults and children. Even as exposures in the workplace are reduced, they have been increasing in the environment and research on exposure has now expanded to cross the entire lifetime. These neurobehavioral methods are applied in research and the findings used for regulatory purposes to develop preventative action for exposed populations. This paper reflects a summary of the talks presented at the Neurobehavioral Testing in Human Risk Assessment symposium presented at the 11th meeting of the International Neurotoxicology Association.
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Affiliation(s)
- Diane S Rohlman
- Center for Research on Occupational and Environmental Toxicology, L606, Oregon Health & Science University, Portland, OR 97239, USA.
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Abstract
PURPOSE OF REVIEW Although environmental levels of polychlorinated biphenyls and certain organochlorine pesticides--hexachlorobenzene, dichlorodiphenyl trichloroethane and its primary metabolite, dichlorodiphenyl dichloroethene--are generally on the decline, early-life exposures to these prevalent contaminants continue. The review will describe current understanding of the potential neurodevelopmental consequences of low-level exposures to these contaminants. RECENT FINDINGS Animal models suggest that early-life exposures to polychlorinated biphenyls, dichlorodiphenyl trichloroethane/dichlorodiphenyl dichloroethene or hexachlorobenzene are associated with decreased cognitive or behavioral function in later development. Despite almost 30 years of research, however, results of human studies are inconsistent regarding the nature of the observed effects and their persistence over time. Overall, epidemiologic studies support modest associations of primarily prenatal polychlorinated biphenyl exposures with differences in neuromotor development, decrements in cognition and behavioral deficits, particularly regarding attention and impulse control. There are limited published human data regarding potential neurodevelopmental toxicities of early-life exposures to dichlorodiphenyl trichloroethane/dichlorodiphenyl dichloroethene and hexachlorobenzene. SUMMARY Exposures to polychlorinated biphenyls, dichlorodiphenyl trichloroethane/dichlorodiphenyl dichloroethene and hexachlorobenzene are likely detrimental to neurodevelopment. Effective control of exposure is complicated by variable exposure sources and variable contaminant levels in food, particularly fish, for which it is important to balance the risk of contaminants with nutritional benefits.
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Korrick SA, Bellinger DC. Invited commentary: persistent organic pollutants and childhood learning and behavioural disorders. J Epidemiol Community Health 2007; 61:564-5. [PMID: 17568044 PMCID: PMC2465742 DOI: 10.1136/jech.2006.058073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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