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Liu B, Lu X, Jiang A, Lv Y, Zhang H, Xu B. Influence of maternal endocrine disrupting chemicals exposure on adverse pregnancy outcomes: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115851. [PMID: 38157800 DOI: 10.1016/j.ecoenv.2023.115851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
Maternal endocrine disrupting chemicals (EDCs) exposure, the common environmental pollutants, was capable of involving in adverse pregnancy outcomes. However, the evidence of their connection is not consistent. Our goal was to comprehensively explore the risk of EDCs related to adverse pregnancy outcomes. One hundred and one studies were included from two databases before 2023 to explore the association between EDCs and adverse pregnancy outcomes including miscarriage, small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). We found that maternal PFASs exposure was positively correlated with PTB (OR:1.13, 95% CI:1.04-1.23), SGA (OR:1.10, 95% CI:1.04-1.16) and miscarriage (OR:1.09, 95% CI:1.00-1.19). The pooled estimates also showed maternal PAEs exposure was linked with PTB (OR:1.16, 95% CI:1.11-1.21), SGA (OR:1.20, 95% CI:1.07-1.35) and miscarriage (OR:1.55, 95% CI:1.33-1.81). In addition, maternal exposure to some specific class of EDCs including PFOS, MBP, MEHP, DEHP, and BPA was associated with PTB. Maternal exposure to PFOS, PFOA, PFHpA was associated with SGA. Maternal exposure to BPA was associated with LBW. Maternal exposure to MMP, MEHP, MEHHP, MEOHP, BPA was associated with miscarriage. Maternal PFASs, PAEs and BPA exposure may increase adverse pregnancy outcomes risk according to our study. However, the limited number of studies on dose-response hampered further explanation for causal association.
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Affiliation(s)
- Bin Liu
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Medical Aspects of Specific Environments, School of Basic Medicine, Anhui Medical University, Hefei, China
| | - Xiaoling Lu
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Medical Aspects of Specific Environments, School of Basic Medicine, Anhui Medical University, Hefei, China
| | - Antong Jiang
- Department of Medical Aspects of Specific Environments, School of Basic Medicine, Anhui Medical University, Hefei, China
| | - Yanming Lv
- Department of Toxicology, School of Public Health, Harbin Medical University, Harbin, China
| | - Hongmei Zhang
- Department of Toxicology, School of Public Health, Harbin Medical University, Harbin, China
| | - Bin Xu
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Medical Aspects of Specific Environments, School of Basic Medicine, Anhui Medical University, Hefei, China.
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Lin S, Li J, Yan X, Pei L, Shang X. Maternal pesticide exposure and risk of preterm birth: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2023; 178:108043. [PMID: 37364307 DOI: 10.1016/j.envint.2023.108043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Maternal pesticide exposure might be associated with adverse pregnancy outcomes through triggering inflammation and oxidative stress and disrupting endocrine functions. Yet the association between prenatal pesticide exposure and risk of preterm birth remains inconclusive. OBJECTIVES To conduct a systematic review and meta-analysis of human observational studies using the Office of Health Assessment and Translation (OHAT) framework to explore the association of per ten-fold increase of pesticide concentrations in maternal biological samples during pregnancy with risk of preterm birth and length of gestational age at birth. DATA SOURCE Five English (PubMed, Embase, Cochrane Library, Web of Science and Scopus) and 3 Chinese databases (China national knowledge infrastructure (CNKI), Wanfang Data, and Chinese Biomedical Literature Database (CBM)) were searched till Jan 18th, 2023. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS To be included, pesticide exposure should be measured in maternal biological samples during pregnancy and in log-transformed forms. The primary outcome was preterm birth and the secondary outcome was gestational age at birth. STUDY APPRAISAL, SYNTHESIS METHODS AND CONFIDENCE ASSESSMENT Quality of studies was evaluated using OHAT Risk of Bias Tool. Evidence was quantitatively synthesized with Correlated and Hierarchical Effects (CHE) model. The confidence rating in the body of evidence was done using OHAT. RESULTS A total of 21 studies reported by 18 papers were included, with 7 studies for preterm birth and 19 for gestational age at birth. The meta-analysis found a ten-fold increase of pesticide concentrations was potentially associated with risk of preterm birth (pooled OR = 1.28; 95%CI: 0.93, 1.78) and shortened gestational age at birth (β = -0.10; 95%CI: -0.21, 0.01). Sampling biospecimens in different trimesters was identified as a potential modifier in the association between pesticide exposure and length of gestational age (F = 2.77, P < 0.05). For studies that collected samples at any time during pregnancy, pesticide exposure was found to be associated with shortened length of gestational age (β = -0.43; 95%CI: -0.81, -0.06). The confidence rating in the body of evidence was "moderate" and "very low" for preterm birth and gestational age at birth, respectively. CONCLUSION Our result suggested moderate evidence of an association between pesticide exposure and higher risk of preterm birth. Yet more studies are still needed with larger sample size and careful considerations of confounders and accuracy of outcome measurements. Attention is also required on other pesticide compounds in addition to organochlorine and organophosphorus pesticides, and on windows of susceptibility.
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Affiliation(s)
- Shiqi Lin
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China
| | - Xiaojin Yan
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China
| | - Lijun Pei
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing 100871, China.
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Jiangsu 210002, China
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Long L, Tang X. Exploring the association of organochlorine pesticides exposure and hearing impairment in United States adults. Sci Rep 2022; 12:11887. [PMID: 35831449 PMCID: PMC9279322 DOI: 10.1038/s41598-022-15892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/30/2022] [Indexed: 12/02/2022] Open
Abstract
Hearing loss (HL) is a highly prevalent public health concern. Organochlorine pesticides (OCPs) are widely used environmental pollutants harmful to human health. Studies investigating the effects of OCPs exposure on the auditory system in the general population are rare. To explore the association between OCPs exposure and HL in adults, 366 adults aged 20-69 years who participated in the National Health and Nutrition Examination Survey (NHANES, 2003-2004) were investigated. HL was defined as a pure-tone average (PTA) ≥ 20 dB in the better ear. Multivariate linear and logistic regression analyses were conducted to evaluate the association of four selected serum OCPs with PTAs and the risk of HL. In participants aged < 60 years, hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (p, p'-DDE) exposure was positively associated with low- and speech-frequency PTAs, and with low-frequency HL, respectively. Risk of HL increased in the highest tertile compared with the lowest tertile of serum HCB and p, p'-DDE (odds ratio [OR]: 4.38, 95% confidence interval [CI]: 0.97-19.80; OR: 16.66, 95% CI: 2.64-105.09, respectively). In this study of US adults aged < 60 years, HCB and p, p'-DDE exposure was positively associated with HL. HCB and p, p'-DDE may be potential risk factors for HL.
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Affiliation(s)
- Lili Long
- Department of Otorhinolaryngology, Sichuan University Hospital of Sichuan University, Chengdu, 610065, Sichuan, China
| | - Xinghua Tang
- Department of Otorhinolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, Yihuan Road, Chengdu, 610072, Sichuan, China.
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Qi SY, Xu XL, Ma WZ, Deng SL, Lian ZX, Yu K. Effects of Organochlorine Pesticide Residues in Maternal Body on Infants. Front Endocrinol (Lausanne) 2022; 13:890307. [PMID: 35757428 PMCID: PMC9218079 DOI: 10.3389/fendo.2022.890307] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/22/2022] [Indexed: 01/25/2023] Open
Abstract
There are many organochlorine pollutants in the environment, which can be directly or indirectly exposed to by mothers, and as estrogen endocrine disruptors can cause damage to the lactation capacity of the mammary gland. In addition, because breast milk contains a lot of nutrients, it is the most important food source for new-born babies. If mothers are exposed to organochlorine pesticides (OCPs), the lipophilic organochlorine contaminants can accumulate in breast milk fat and be passed to the infant through breast milk. Therefore, it is necessary to investigate organochlorine contaminants in human milk to estimate the health risks of these contaminants to breastfed infants. In addition, toxic substances in the mother can also be passed to the fetus through the placenta, which is also something we need to pay attention to. This article introduces several types of OCPs, such as dichlorodiphenyltrichloroethane (DDT), methoxychlor (MXC), hexachlorocyclohexane (HCH), endosulfan, chlordane, heptachlorand and hexachlorobenzene (HCB), mainly expounds their effects on women's lactation ability and infant health, and provides reference for maternal and infant health. In addition, some measures and methods for the control of organochlorine pollutants are also described here.
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Affiliation(s)
- Shi-Yu Qi
- College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Xue-Ling Xu
- College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Wen-Zhi Ma
- Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, and Key Laboratory of Reproduction and Genetics of Ningxia Hui Autonomous Region, School of Basic Medical Science, Ningxia Medical University, Yinchuan, China
- *Correspondence: Wen-Zhi Ma, ; Kun Yu, ; Zheng-Xing Lian,
| | - Shou-Long Deng
- National Health Commission of China (NHC) Key Laboratory of Human Disease Comparative Medicine, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing, China
| | - Zheng-Xing Lian
- College of Animal Science and Technology, China Agricultural University, Beijing, China
- *Correspondence: Wen-Zhi Ma, ; Kun Yu, ; Zheng-Xing Lian,
| | - Kun Yu
- College of Animal Science and Technology, China Agricultural University, Beijing, China
- *Correspondence: Wen-Zhi Ma, ; Kun Yu, ; Zheng-Xing Lian,
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Jones KC. Persistent Organic Pollutants (POPs) and Related Chemicals in the Global Environment: Some Personal Reflections. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:9400-9412. [PMID: 33615776 DOI: 10.1021/acs.est.0c08093] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Persistent organic pollutants (POPs) and related chemicals are fascinating because of their combination of physical-chemical properties and complex effects. Most are man-made, but some also have natural origins. They are persistent in the environment, but they can be broken down variously by biodegradation, atmospheric reactions, and abiotic transformations. They can exist in the gas or particle phases, or both, in the atmosphere and in the dissolved or particulate phases, or both, in water. These combinations mean that they may undergo long-range transport in the atmosphere or oceans, or they may stay close to sources. Hence, emissions from one country are frequently a source of contamination to another country. They are also usually lipophilic, so-combined with persistence-this means they can accumulate in organisms and biomagnify through food chains. We all have a baseline of POPs residues in our tissues, even the unborn fetus via placental transfer and the newly born baby via mother's milk. POPs in biological systems occur in mixtures, so confirming effects caused by POPs on humans and other top predators is never straightforward. Depending on which papers you read, POPs may be relatively benign, or they could be responsible for key subchronic and chronic effects on reproductive potential, on immune response, as carcinogens, and on a range of behavioral and cognitive end points. They could be a factor behind diseases and conditions which have been increasingly reported and studied in modern societies. In short, they are endlessly fascinating to scientists and a nightmare to regulators and policy makers.
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Affiliation(s)
- Kevin C Jones
- Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, U.K
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Helou K, Matta J, Harmouche-Karaki M, Sayegh N, Younes H, Mahfouz Y, Mahfouz M, Karake S, Finan R, Abi-Tayeh G, Narbonne JF. Maternal and cord serum levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) among Lebanese pregnant women and predictors of exposure. CHEMOSPHERE 2021; 266:129211. [PMID: 33316473 DOI: 10.1016/j.chemosphere.2020.129211] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/10/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
In this study, the six indicator non-dioxin-like polychlorinated biphenyls NDL-PCBs (PCB28, PCB52, PCB101, PCB138, PCB153, PCB180), as well as four organochlorine pesticides (OCPs), hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichlorethylene (DDE) were measured in 98 maternal and 49 cord sera samples of a group of Lebanese women who gave birth in three hospitals in Greater Beirut, between March and July 2018. Results showed that the levels of these persistent organic pollutants (POPs) in maternal serum were below critical limits as well as those in other countries (Tunisia, France, Portugal, Spain, Poland, Greenland, Canada, Brazil, and China). The ratios of cord serum concentrations to maternal serum concentrations of analyzed POPs were higher than 1. PCB maternal serum concentrations were found to be linked to illegal incineration (OR = 5.78; p = 0.004) as well as eggs (OR = 4.68; p = 0.027) and fruits and vegetables consumption (OR = 3.92; p = 0.016). OCP concentrations were linked to red meat and cold cuts intake (OR = 3.67-4.59; p = 0.001-0.004). While PCB levels were not correlated to newborns anthropometric measurements, OCP levels in cord serum were found to be positively linked to the birth length of newborns (p = 0.014-0.027).
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Affiliation(s)
- Khalil Helou
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Joseph Matta
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon; Industrial Research Institute, Lebanese University Campus, Hadeth Baabda, Lebanon.
| | - Mireille Harmouche-Karaki
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Nicole Sayegh
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Hassan Younes
- UniLaSalle University, 19 Pierre Waguet Street, 60026, Beauvais, France.
| | - Yara Mahfouz
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Maya Mahfouz
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Sara Karake
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, P.O.B. 11-5076, Riad Solh Beirut, 1107 2180, Lebanon.
| | - Ramzi Finan
- Lebanese Society of Obstetrics and Gynecology, Adliye, Beit El- Tabib - 3rd Floor, Beirut, Lebanon; Faculty of Medicine, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, Beirut, Lebanon; Hotel-Dieu de France, Saint-Joseph University of Beirut Hospital, Blvd Alfred Naccache, P.O.B.: 166830, Beirut, Lebanon.
| | - Georges Abi-Tayeh
- Faculty of Medicine, Saint-Joseph University of Beirut, Medical Sciences Campus, Damascus Road, Beirut, Lebanon; Hotel-Dieu de France, Saint-Joseph University of Beirut Hospital, Blvd Alfred Naccache, P.O.B.: 166830, Beirut, Lebanon; Lebanese Fertility Society, Adliye, Beit El- Tabib, Beirut, Lebanon.
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Ouidir M, Buck Louis GM, Kanner J, Grantz KL, Zhang C, Sundaram R, Rahman ML, Lee S, Kannan K, Tekola-Ayele F, Mendola P. Association of Maternal Exposure to Persistent Organic Pollutants in Early Pregnancy With Fetal Growth. JAMA Pediatr 2020; 174:149-161. [PMID: 31886849 PMCID: PMC6990715 DOI: 10.1001/jamapediatrics.2019.5104] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Prenatal exposure to persistent organic pollutants (POPs) has been associated with birth size, but data on fetal growth and among racially/ethnically diverse pregnant women remain scarce. OBJECTIVES To assess the association between maternal plasma POPs in early pregnancy and fetal growth and by infant sex and maternal race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS This cohort study used the National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort, which recruited nonobese, low-risk pregnant women before 14 weeks' gestation between July 1, 2009, and January 31, 2013, in 12 community-based clinics throughout the United States. Participants self-identified their race/ethnicity, self-reported their behavioral risk factors, and were followed up throughout their pregnancy. Data were analyzed from July 31, 2018, to June 3, 2019. EXPOSURES Levels of 76 POPs in early gestation plasma were measured: 11 perfluoroalkyl and polyfluoroalkyl substances, 1 polybrominated biphenyl, 9 polybrominated diphenyl ethers (PBDEs), 44 polychlorinated biphenyls (PCBs), and 11 organochlorine pesticides (OCPs). The bayesian kernel machine regression method was used to examine chemical class mixtures, and generalized additive mixed model was used to analyze individual chemicals. MAIN OUTCOMES AND MEASURES Fourteen fetal biometrics were measured, including head circumference, abdominal circumference, and femur length, within 5 ultrasonography appointments. RESULTS A total of 2284 low-risk pregnant women were included: 606 women (26.5%) self-identified as white with a mean (SD) age of 30.3 (4.4) years, 589 (25.8%) as black with a mean (SD) age of 25.5 (5.5) years, 635 (27.8%) as Hispanic with a mean (SD) age of 27.1 (5.5) years, and 454 (19.9%) as Asian with a mean (SD) age of 30.5 (4.5) years. A comparison between the 75th and 25th percentile of exposure revealed that the OCP mixture was negatively associated with most fetal growth measures, with a reduction of 4.7 mm (95% CI, -6.7 to -2.8 mm) in head circumference, 3.5 mm (95% CI, -4.7 to -2.2 mm) in abdominal circumference, and 0.6 mm (95% CI, -1.1 to -0.2 mm) in femur length. Higher exposure to the PBDE mixture was associated with reduced abdominal circumference (-2.4 mm; 95% CI, -4.0 to -0.5 mm) and femur length (-0.5 mm; 95% CI, -1.0 to -0.1 mm), and the dioxin-like PCB mixture was associated with reduced head circumference (-6.4 mm; 95% CI, -8.4 to -4.3 mm) and abdominal circumference (-2.4 mm; 95% CI, -3.9 to -0.8 mm). Associations with individual chemicals were less consistent. There were some interactions by fetal sex, although most of the results did not vary by maternal race/ethnicity. For example, oxychlordane (-0.98 mm; 95% CI, -1.60 to -0.36 mm; P for interaction <.001), trans-nonachlor (-0.31 mm; 95% CI, -0.54 to -0.08 mm; P for interaction = .005), and p,p'-dichlorodiphenyldichloroethylene (-0.19 mm; 95% CI, -0.22 to -0.09 mm; P for interaction = .006) were associated with shorter femur length among boys only. CONCLUSIONS AND RELEVANCE This study found that, among pregnant women with low POP levels, a mixture of OCPs was negatively associated with most fetal growth measures and that mixtures of PBDEs and dioxin-like PCBs were associated with reduced abdominal circumference. These findings suggested that, although exposures may be low, associations with fetal growth are apparent.
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Affiliation(s)
- Marion Ouidir
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | | | - Jenna Kanner
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | - Katherine L. Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Mohammad L. Rahman
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts
| | - Sunmi Lee
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Albany
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Albany
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
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Casadó L, Arrebola JP, Fontalba A, Muñoz A. Adverse effects of hexaclorobenzene exposure in children and adolescents. ENVIRONMENTAL RESEARCH 2019; 176:108421. [PMID: 31387069 DOI: 10.1016/j.envres.2019.03.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Hexachlorobenzene (HCB: C₆Cl₆) is a persistent, bioaccumulative chemical formerly used worldwide in pesticide mixtures but also produced as a by-product in the chemical and metallurgical industry. Despite current international restrictions in the use and production of HCB, the majority of the general population still show detectable levels of HCB, which raises concerns on the potential health implications of the exposure. OBJECTIVE To compile and synthesize the available scientific evidence regarding the adverse effects of exposure to HCB in children and adolescents. METHODS A review of the literature focused on the adverse effects of HCB exposure in children. Eligible studies were systematically screened from searches in Medline, Scopus and Ebsco-host databases. A total of 62 studies were finally included. RESULTS AND DISCUSSION In our search we found evidences of potential health effects linked to HCB exposure at different levels (e.g. neurotoxic, nephrotoxic, immunotoxic, hepatotoxic and toxicogenomic), although the conclusions are still contradictory. Further prospective research is needed, considering the special vulnerability of children and adolescent population as well as the ubiquity of the exposure.
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Affiliation(s)
- Lina Casadó
- Department of Nursing, Medical Anthropology Research Centre (MARC), University Rovira i Virgili, Tarragona, Spain.
| | - Juan Pedro Arrebola
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain, Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Andrés Fontalba
- Northern Málaga Integrated Healthcare Area, Andalusian Health Service, Antequera, Spain, Department of Nursing, Medicine and Physiotherapy, Almeria University, Almería, Spain
| | - Araceli Muñoz
- School of Social Work, Food Observatory (ODELA), University of Barcelona, Barcelona, Spain, Medical Anthropology Research Centre (MARC), University Rovira i Virgili, Tarragona, Spain
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Govarts E, Iszatt N, Trnovec T, de Cock M, Eggesbø M, Palkovicova Murinova L, van de Bor M, Guxens M, Chevrier C, Koppen G, Lamoree M, Hertz-Picciotto I, Lopez-Espinosa MJ, Lertxundi A, Grimalt JO, Torrent M, Goñi-Irigoyen F, Vermeulen R, Legler J, Schoeters G. Prenatal exposure to endocrine disrupting chemicals and risk of being born small for gestational age: Pooled analysis of seven European birth cohorts. ENVIRONMENT INTERNATIONAL 2018; 115:267-278. [PMID: 29605679 DOI: 10.1016/j.envint.2018.03.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND AIMS There is evidence that endocrine disrupting chemicals (EDCs) have developmental effects at environmental concentrations. We investigated whether some EDCs are associated with the adverse birth outcome Small for Gestational Age (SGA). METHODS We used PCB 153, p,p'-DDE, HCB, PFOS and PFOA measured in maternal, cord blood or breast milk samples of 5446 mother-child pairs (subset of 693 for the perfluorinated compounds) from seven European birth cohorts (1997-2012). SGA infants were those with birth weight below the 10th percentile for the norms defined by gestational age, country and infant's sex. We modelled the association between measured or estimated cord serum EDC concentrations and SGA using multiple logistic regression analyses. We explored effect modification by child's sex and maternal smoking during pregnancy. RESULTS Among the 5446 newborns, 570 (10.5%) were SGA. An interquartile range (IQR) increase in PCB 153 was associated with a modestly increased risk of SGA (odds ratio (OR) of 1.05 [95% CI: 1.04-1.07]) that was stronger in girls (OR of 1.09 [95% CI: 1.04-1.14]) than in boys (OR of 1.03 [95% CI: 1.03-1.04]) (p-interaction = 0.025). For HCB, we found a modestly increased odds of SGA in girls (OR of 1.04 [95% CI: 1.01-1.07] per IQR increase), and an inverse association in boys (OR of 0.90 [95% CI: 0.85-0.95]) (p-interaction = 0.0003). Assessment of the HCB-sex-smoking interaction suggested that the increased odds of SGA associated with HCB exposure was only in girls of smoking mothers (OR of 1.18 [95% CI: 1.11-1.25]) (p-interaction = 0.055). Higher concentrations of PFOA were associated with greater risk of SGA (OR of 1.64 [95% CI: 0.97-2.76]). Elevated PFOS levels were associated with increased odds of SGA in newborns of mothers who smoked during pregnancy (OR of 1.63 [95% CI: 1.02-2.59]), while an inverse association was found in those of non-smoking mothers (OR of 0.66 [95% CI: 0.61-0.72]) (p-interaction = 0.0004). No significant associations were found for p,p'-DDE. CONCLUSIONS Prenatal environmental exposure to organochlorine and perfluorinated compounds with endocrine disrupting properties may contribute to the prevalence of SGA. We found indication of effect modification by child's sex and smoking during pregnancy. The direction of the associations differed by chemical and these effect modifiers, suggesting diverse mechanisms of action and biological pathways.
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Affiliation(s)
- Eva Govarts
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
| | - Nina Iszatt
- Department of Contaminants, Diet and Microbiota, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Tomas Trnovec
- Slovak Medical University, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - Marijke de Cock
- Department of Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Merete Eggesbø
- Department of Contaminants, Diet and Microbiota, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lubica Palkovicova Murinova
- Slovak Medical University, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - Margot van de Bor
- Department of Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Gudrun Koppen
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Marja Lamoree
- Institute for Environmental Studies (IVM), VU University, Amsterdam, The Netherlands
| | - Irva Hertz-Picciotto
- Department of Health Sciences, School of Medicine, University of California, Davis, USA
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Aitana Lertxundi
- Department of Preventive Medicine and Public Health, University of Basque Country (UPV/EHU), Bilbao, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain
| | - Joan O Grimalt
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Servicio de Salud de las Islas Baleares (IB-Salut), Area de Salut de Menorca, Balearic Islands, Spain
| | - Fernando Goñi-Irigoyen
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain; Public Health Laboratory in Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Juliette Legler
- Institute for Environmental Studies (IVM), VU University, Amsterdam, The Netherlands; Division of Toxicology and Veterinary Pharmacology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Greet Schoeters
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; University of Southern Denmark, Institute of Public Health, Department of Environmental Medicine, Odense, Denmark
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Ferguson KK, Chin HB. Environmental chemicals and preterm birth: Biological mechanisms and the state of the science. CURR EPIDEMIOL REP 2017; 4:56-71. [PMID: 28944158 PMCID: PMC5608103 DOI: 10.1007/s40471-017-0099-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE OF REVIEW Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. RECENT FINDINGS Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. SUMMARY Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention.
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Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Helen B. Chin
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
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Environmental pollutants and child health-A review of recent concerns. Int J Hyg Environ Health 2016; 219:331-42. [PMID: 27216159 DOI: 10.1016/j.ijheh.2016.05.001] [Citation(s) in RCA: 214] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 01/09/2023]
Abstract
In recent years, many new studies have evaluated associations between environmental pollutants and child health. This review aims to provide a broad summary of this literature, comparing the state of epidemiological evidence for the effects of a wide range of environmental contaminants (air pollutants, heavy metals, organochlorine compounds, perfluoroalkyl substances, polybrominated diphenyl ethers, pesticides, phthalates and bisphenol A) on child health outcomes. The review addresses effects on foetal growth and prematurity, neurodevelopment, respiratory and immune health, and childhood growth and obesity. Findings of recent prospective studies and meta-analyses have corroborated previous good evidence, often at lower exposure levels, for effects on foetal growth of air pollution and polychlorinated biphenyls (PCBs), for neurotoxic effects of lead, methylmercury, PCBs and organophosphate pesticides, and for respiratory health effects of air pollution. Moderate evidence has emerged for a potential role of environmental pollutants in attention deficit hyperactivity disorder and autism (lead, PCBs, air pollution), respiratory and immune health (dichlorodiphenyldichloroethylene - DDE - and PCBs), and obesity (DDE). In addition, there is now moderate evidence that certain chemicals of relatively recent concern may be associated with adverse child health outcomes, specifically perfluorooctanoate and foetal growth, and polybrominated diphenyl ethers and neurodevelopment. For other chemicals of recent concern, such as phthalates and bisphenol A, the literature is characterised by large inconsistencies preventing strong conclusions. In conclusion, since most of the recent literature evaluates common exposures in the general population, and not particularly high exposure situations, this accumulating body of evidence suggests that the unborn and young child require more protection than is currently provided. Large, coordinated research efforts are needed to improve understanding of long-term effects of complex chemical mixtures.
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Lopez-Espinosa MJ, Murcia M, Iñiguez C, Vizcaino E, Costa O, Fernández-Somoano A, Basterrechea M, Lertxundi A, Guxens M, Gascon M, Goñi-Irigoyen F, Grimalt JO, Tardón A, Ballester F. Organochlorine Compounds and Ultrasound Measurements of Fetal Growth in the INMA Cohort (Spain). ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:157-63. [PMID: 26058084 PMCID: PMC4710595 DOI: 10.1289/ehp.1408907] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 06/05/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have reported decreases in birth size associated with exposure to organochlorine compounds (OCs), but uncertainties remain regarding the critical windows of prenatal exposure and the effects on fetal body segments. OBJECTIVE We examined the relationship between prenatal OC concentrations and fetal anthropometry. METHODS We measured 4,4´-dichlorodiphenyldichloroethylene (4,4´-DDE), hexachlorobenzene (HCB), and polychlorinated biphenyl (PCB) congeners (138, 153, and 180) in 2,369 maternal and 1,140 cord serum samples in four Spanish cohorts (2003-2008). We used linear mixed models to obtain longitudinal growth curves for estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), and femur length (FL) adjusted by parental and fetal characteristics. We calculated standard deviation (SD) scores of growth at 0-12, 12-20, and 20-34 weeks of gestation as well as size at gestational week 34 for the four parameters. We studied the association between OCs and the fetal outcomes by cohort-specific linear models and subsequent meta-analyses. RESULTS PCBs were associated with a reduction in AC up to mid-pregnancy, and BPD and FL from gestational week 20 onward. An inverse association was also found between HCB and AC growth in early pregnancy. The reduction of these parameters ranged from -4% to -2% for a doubling in the OC concentrations. No association between 4,4´-DDE and fetal growth was observed. CONCLUSIONS To our knowledge, this is the first study to report an association between prenatal exposure to some PCBs and HCB and fetal growth: AC during the first two trimesters of pregnancy, and BPD and FL later in pregnancy. CITATION Lopez-Espinosa MJ, Murcia M, Iñiguez C, Vizcaino E, Costa O, Fernández-Somoano A, Basterrechea M, Lertxundi A, Guxens M, Gascon M, Goñi-Irigoyen F, Grimalt JO, Tardón A, Ballester F. 2016. Organochlorine compounds and ultrasound measurements of fetal growth in the INMA cohort (Spain). Environ Health Perspect 124:157-163; http://dx.doi.org/10.1289/ehp.1408907.
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Affiliation(s)
- Maria-Jose Lopez-Espinosa
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Address correspondence to M.-J. Lopez-Espinosa, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO–Public Health, Valencia, Spain. Telephone: (34) 961925941. E-mail:
| | - Mario Murcia
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Carmen Iñiguez
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Nursing Department, School of Nursing, University of Valencia, Valencia, Spain
| | - Esther Vizcaino
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Barcelona, Spain
- Department of Surgery and Cancer, Imperial College London (UK), London, United Kingdom
| | - Olga Costa
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
| | - Mikel Basterrechea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Epidemiology, Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain
- Health Research Institute, Biodonostia, San Sebastian, Spain
| | - Aitana Lertxundi
- Health Research Institute, Biodonostia, San Sebastian, Spain
- Preventive Medicine and Public Health Department, University of the Basque Country, Bilbao, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Pompeu Fabra University, Barcelona, Catalonia, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Mireia Gascon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
- Pompeu Fabra University, Barcelona, Catalonia, Spain
| | - Fernando Goñi-Irigoyen
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Health Research Institute, Biodonostia, San Sebastian, Spain
- Public Health Laboratory, Basque Government, San Sebastian, Spain
| | - Joan O. Grimalt
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Barcelona, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Department of Preventive Medicine and Public Health, University of Oviedo, Spain
| | - Ferran Ballester
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
- Nursing Department, School of Nursing, University of Valencia, Valencia, Spain
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13
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Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, Toppari J, Zoeller RT. EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015; 36:E1-E150. [PMID: 26544531 PMCID: PMC4702494 DOI: 10.1210/er.2015-1010] [Citation(s) in RCA: 1292] [Impact Index Per Article: 143.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/01/2015] [Indexed: 02/06/2023]
Abstract
The Endocrine Society's first Scientific Statement in 2009 provided a wake-up call to the scientific community about how environmental endocrine-disrupting chemicals (EDCs) affect health and disease. Five years later, a substantially larger body of literature has solidified our understanding of plausible mechanisms underlying EDC actions and how exposures in animals and humans-especially during development-may lay the foundations for disease later in life. At this point in history, we have much stronger knowledge about how EDCs alter gene-environment interactions via physiological, cellular, molecular, and epigenetic changes, thereby producing effects in exposed individuals as well as their descendants. Causal links between exposure and manifestation of disease are substantiated by experimental animal models and are consistent with correlative epidemiological data in humans. There are several caveats because differences in how experimental animal work is conducted can lead to difficulties in drawing broad conclusions, and we must continue to be cautious about inferring causality in humans. In this second Scientific Statement, we reviewed the literature on a subset of topics for which the translational evidence is strongest: 1) obesity and diabetes; 2) female reproduction; 3) male reproduction; 4) hormone-sensitive cancers in females; 5) prostate; 6) thyroid; and 7) neurodevelopment and neuroendocrine systems. Our inclusion criteria for studies were those conducted predominantly in the past 5 years deemed to be of high quality based on appropriate negative and positive control groups or populations, adequate sample size and experimental design, and mammalian animal studies with exposure levels in a range that was relevant to humans. We also focused on studies using the developmental origins of health and disease model. No report was excluded based on a positive or negative effect of the EDC exposure. The bulk of the results across the board strengthen the evidence for endocrine health-related actions of EDCs. Based on this much more complete understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability, these findings can be much better translated to human health. Armed with this information, researchers, physicians, and other healthcare providers can guide regulators and policymakers as they make responsible decisions.
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Affiliation(s)
- A C Gore
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - V A Chappell
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - S E Fenton
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - J A Flaws
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - A Nadal
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - G S Prins
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - J Toppari
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
| | - R T Zoeller
- Pharmacology and Toxicology (A.C.G.), College of Pharmacy, The University of Texas at Austin, Austin, Texas 78734; Division of the National Toxicology Program (V.A.C., S.E.F.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Comparative Biosciences (J.A.F.), University of Illinois at Urbana-Champaign, Urbana, Illinois 61802; Institute of Bioengineering and CIBERDEM (A.N.), Miguel Hernandez University of Elche, 03202 Elche, Alicante, Spain; Departments of Urology, Pathology, and Physiology & Biophysics (G.S.P.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612; Departments of Physiology and Pediatrics (J.T.), University of Turku and Turku University Hospital, 20520 Turku, Finland; and Biology Department (R.T.Z.), University of Massachusetts at Amherst, Amherst, Massachusetts 01003
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