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Freire C, Castiello F, Babarro I, Anguita-Ruiz A, Casas M, Vrijheid M, Sarzo B, Beneito A, Kadawathagedara M, Philippat C, Thomsen C, Sakhi AK, Lopez-Espinosa MJ. Association of prenatal exposure to phthalates and synthetic phenols with pubertal development in three European cohorts. Int J Hyg Environ Health 2024; 261:114418. [PMID: 38968838 DOI: 10.1016/j.ijheh.2024.114418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND There is limited epidemiological evidence on the association of prenatal exposure to phthalates and synthetic phenols with altered pubertal timing. OBJECTIVE To examine the association of prenatal exposure to phthalates, bisphenol A (BPA), parabens, benzophenone 3 (BP-3), and triclosan (TCS) with pubertal development in girls and boys from three European cohorts. METHODS Urinary metabolites of six different phthalate diesters (DEP, DiBP, DnBP, BBzP, DEHP, and DiNP), BPA, methyl- (MePB), ethyl- (EtPB), propyl- (PrPB), and butyl-paraben (BuPB), BP-3, and TCS were quantified in one or two (1st and 3rd trimester) urine samples collected during pregnancy (1999-2008) from mothers in three birth cohorts: INMA (Spain), EDEN (France), and MoBa (Norway). Pubertal development of their children was assessed at a single visit at age 7-12 years (579 girls, 644 boys) using the parent-reported Pubertal Development Scale (PDS). Mixed-effect Poisson and g-computation and Bayesian Kernel Machine Regression (BKMR) were employed to examine associations of individual and combined prenatal chemical exposure, respectively, with the probability of overall pubertal onset, adrenarche, and gonadarche (stage 2+) in girls and boys. Effect modification by child body mass index (BMI) was also assessed. RESULTS Maternal concentrations of the molar sum of DEHP and of DiNP metabolites were associated with a slightly higher probability of having started puberty in boys (relative risk, RR [95% CI] = 1.13 [0.98-1.30] and 1.20 [1.06-1.34], respectively, for a two-fold increase in concentrations), with a stronger association for DiNP in boys with overweight or obesity. In contrast, BPA, BuPB, EtPB, and PrPB were associated with a lower probability of pubertal onset, adrenarche, and/or gonadarche in all boys (e.g. overall puberty, BPA: RR [95% CI] = 0.93 [0.85-1.01] and BuPB: 0.95 [0.90-1.00], respectively), and the association with BPA was stronger in boys with underweight/normal weight. In girls, MEHP and BPA were associated with delayed gonadarche in those with underweight/normal weight (RR [95% CI] = 0.86 [0.77-0.95] and 0.90 [0.84-0.97], respectively). Most of these associations were trimester specific. However, the chemical mixture was not associated with any pubertal outcome in boys or girls. CONCLUSIONS Prenatal exposure to certain phthalates and synthetic phenols such as BPA may impact the pubertal development of boys, and weight status may modify this effect. BPA may also alter the pubertal development of girls.
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Affiliation(s)
- Carmen Freire
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Francesca Castiello
- Pediatric Unit, Germans Trias I Pujol University Hospital, 08916, Badalona, Spain
| | - Izaro Babarro
- Faculty of Medicine and Nursing, University of the Basque Country (UPV/EU), 20014, Donostia/San Sebastián, Spain; Biogipuzkoa Health Research Institute, 20014, Donostia/San Sebastián, Spain
| | - Augusto Anguita-Ruiz
- ISGlobal, 08036, Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Maribel Casas
- ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain
| | - Martine Vrijheid
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain; ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain
| | - Blanca Sarzo
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain
| | - Andrea Beneito
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain
| | - Manik Kadawathagedara
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, 75004, Paris, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm, U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, 38000, Grenoble, France
| | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Amrit Kaur Sakhi
- Department of Food Safety, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Maria-Jose Lopez-Espinosa
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain; Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, 46010, Valencia, Spain
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de Paula LCP, Alves C. Food packaging and endocrine disruptors. J Pediatr (Rio J) 2024; 100 Suppl 1:S40-S47. [PMID: 37913820 PMCID: PMC10960186 DOI: 10.1016/j.jped.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES Narrative review evaluating food contamination by endocrine disruptors present in food packaging. DATA SOURCE The terms "endocrine disruptors" and "food packaging" were used in combination in the PubMed, MEDLINE and SciELO databases, evaluating studies, in humans, published in Portuguese, English, French and Spanish between 1990 and 2023. DATA SYNTHESIS Packaging, especially those made from plastic or recycled material, is an important source of food contamination by endocrine disruptors. Bisphenols and phthalates are the endocrine disruptors most frequently associated with food contamination from packaging. However, many unknown substances and even those legally authorized can cause harm to health when exposure is prolonged or when substances with additive effects are mixed. Furthermore, the discarding of packaging can cause contamination to continue into the environment. CONCLUSION Although packaging materials are essential for the transport and storage of food, many of them are associated with chemical contamination. As it is not possible to exclude them from our routine, it is important to develop research aimed at identifying the endocrine disruptors present in them, including the effects of chronic exposure; and that regulatory agencies and industry come together to reduce or prevent this risk. Additionally, consumers must be instructed on how to purchase products, handle them and prepare them to reduce the migration of chemical substances into food.
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Affiliation(s)
- Leila Cristina Pedroso de Paula
- Hospital de Clínicas da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Residência de Endocrinologia e Endocrinologia Pediátrica, Porto Alegre, RS, Brazil
| | - Crésio Alves
- Universidade Federal da Bahia, Faculdade de Medicina, Hospital Universitário Prof. Edgard Santos, Serviço de Endocrinologia Pediátrica, Salvador, BA, Brazil.
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Kim CE, Binder AM, Corvalan C, Pereira A, Shepherd J, Calafat AM, Botelho JC, Hampton JM, Trentham-Dietz A, Michels KB. Time-specific impact of mono-benzyl phthalate (MBzP) and perfluorooctanoic acid (PFOA) on breast density of a Chilean adolescent Cohort. ENVIRONMENT INTERNATIONAL 2023; 181:108241. [PMID: 37857187 DOI: 10.1016/j.envint.2023.108241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION High mammographic density is among the strongest and most established predictors for breast cancer risk. Puberty, the period during which breasts undergo exponential mammary growth, is considered one of the critical stages of breast development for environmental exposures. Benzylbutyl phthalate (BBP) and perfluorooctanoic acid (PFOA) are pervasive endocrine disrupting chemicals that may increase hormone-sensitive cancers. Evaluating the potential impact of BBP and PFOA exposure on pubertal breast density is important to our understanding of early-life environmental influences on breast cancer etiology. OBJECTIVE To prospectively assess the effect of biomarker concentrations of monobenzyl phthalate (MBzP) and PFOA at specific pubertal window of susceptibility (WOS) on adolescent breast density. METHOD This study included 376 Chilean girls from the Growth and Obesity Cohort Study with data collection at four timepoints: Tanner breast stages 1 (B1) and 4 (B4), 1- year post- menarche (1YPM) and 2-years post-menarche (2YPM). Dual-energy X-ray absorptiometry was used to assess the absolute fibroglandular volume (FGV) and percent breast density (%FGV) at 2YPM. We used concentrations of PFOA in serum and MBzP in urine as an index of exposure to PFOA and BBP, respectively. Parametric G-formula was used to estimate the time-specific effects of MBzP and PFOA on breast density. The models included body fat percentage as a time-varying confounder and age, birthweight, age at menarche, and maternal education as fixed covariates. RESULTS A doubling of serum PFOA concentration at B4 resulted in a non-significant increase in absolute FGV (β:11.25, 95% confidence interval (CI): -0.28, 23.49)), while a doubling of PFOA concentration at 1YPM resulted in a decrease in % FGV (β:-4.61, 95% CI: -7.45, -1.78). We observed no associations between urine MBzP and breast density measures. CONCLUSION In this cohort of Latina girls, PFOA serum concentrations corresponded to a decrease in % FGV. No effect was observed between MBzP and breast density measures across pubertal WOS.
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Affiliation(s)
- Claire E Kim
- Department of Epidemiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Alexandra M Binder
- Department of Epidemiology, University of California Los Angeles, Los Angeles, CA, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer, Honolulu, HI, USA
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - John Shepherd
- Population Sciences in the Pacific Program, University of Hawaii Cancer, Honolulu, HI, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne C Botelho
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John M Hampton
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, USA
| | - Karin B Michels
- Department of Epidemiology, University of California Los Angeles, Los Angeles, CA, USA; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
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Taylor KW, Howdeshell KL, Bommarito PA, Sibrizzi CA, Blain RB, Magnuson K, Lemeris C, Tracy W, Baird DD, Jackson CL, Gaston SA, Rider CV, Walker VR, Rooney AA. Systematic evidence mapping informs a class-based approach to assessing personal care products and pubertal timing. ENVIRONMENT INTERNATIONAL 2023; 181:108307. [PMID: 37948866 DOI: 10.1016/j.envint.2023.108307] [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: 03/29/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Personal care products (PCPs) contain many different compounds and are a source of exposure to endocrine disrupting chemicals (EDCs), including phthalates and phenols. Early-life exposure to EDCs commonly found in PCPs has been linked to earlier onset of puberty. OBJECTIVE To characterize the human and animal evidence on the association between puberty-related outcomes and exposure to PCPs and their chemical constituents and, if there is sufficient evidence, identify groups of chemicals and outcomes to support a systematic review for a class-based hazard or risk assessment. METHODS We followed the OHAT systematic review framework to characterize the human and animal evidence on the association between puberty-related health outcomes and exposure to PCPs and their chemical constituents. RESULTS Ninety-eight human and 299 animal studies that evaluated a total of 96 different chemicals were identified and mapped by key concepts including chemical class, data stream, and puberty-related health outcome. Among these studies, phthalates and phenols were the most well-studied chemical classes. Most of the phthalate and phenol studies examined secondary sex characteristics and changes in estradiol and testosterone levels. Studies evaluating PCP use and other chemical classes (e.g., parabens) had less data. CONCLUSIONS This systematic evidence map identified and mapped the published research evaluating the association between exposure to PCPs and their chemical constituents and puberty-related health outcomes. The resulting interactive visualization allows researchers to make evidence-based decisions on the available research by enabling them to search, sort, and filter the literature base of puberty-related studies by key concepts. This map can be used by researchers and regulators to prioritize and target future research and funding to reduce uncertainties and address data gaps. It also provides information to inform a class-based hazard or risk assessment on the association between phthalate and phenol exposures and puberty-related health outcomes.
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Affiliation(s)
- Kyla W Taylor
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
| | - Kembra L Howdeshell
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Paige A Bommarito
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | | | | | | | | | - Donna D Baird
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Chandra L Jackson
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA; National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Symielle A Gaston
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Cynthia V Rider
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Vickie R Walker
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Andrew A Rooney
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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Muzeza C, Ngole-Jeme V, Msagati TAM. The Mechanisms of Plastic Food-Packaging Monomers' Migration into Food Matrix and the Implications on Human Health. Foods 2023; 12:3364. [PMID: 37761073 PMCID: PMC10529129 DOI: 10.3390/foods12183364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
The development of packaging technology has become a crucial part of the food industry in today's modern societies, which are characterized by technological advancements, industrialization, densely populated cities, and scientific advancements that have increased food production over the past 50 years despite the lack of agricultural land. Various types of food-packaging materials are utilized, with plastic being the most versatile. However, there are certain concerns with regards to the usage of plastic packaging because of unreacted monomers' potential migration from the polymer packaging to the food. The magnitude of monomer migration depends on numerous aspects, including the monomer chemistry, type of plastic packaging, physical-chemical parameters such as the temperature and pH, and food chemistry. The major concern for the presence of packaging monomers in food is that some monomers are endocrine-disrupting compounds (EDCs) with a capability to interfere with the functioning of vital hormonal systems in the human body. For this reason, different countries have resolved to enforce guidelines and regulations for packaging monomers in food. Additionally, many countries have introduced migration testing procedures and safe limits for packaging monomer migration into food. However, to date, several research studies have reported levels of monomer migration above the set migration limits due to leaching from the food-packaging materials into the food. This raises concerns regarding possible health effects on consumers. This paper provides a critical review on plastic food-contact materials' monomer migration, including that from biodegradable plastic packaging, the monomer migration mechanisms, the monomer migration chemistry, the key factors that affect the migration process, and the associated potential EDC human health risks linked to monomers' presence in food. The aim is to contribute to the existing knowledge and understanding of plastic food-packaging monomer migration.
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Affiliation(s)
- Celia Muzeza
- Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science, Engineering and Technology, University of South Africa, Science Campus, Roodepoort, Johannesburg 1709, South Africa
- Department of Environmental Science, College of Agriculture and Environmental Sciences, University of South Africa, Science Campus, Roodepoort, Johannesburg 1709, South Africa;
| | - Veronica Ngole-Jeme
- Department of Environmental Science, College of Agriculture and Environmental Sciences, University of South Africa, Science Campus, Roodepoort, Johannesburg 1709, South Africa;
| | - Titus Alfred Makudali Msagati
- Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science, Engineering and Technology, University of South Africa, Science Campus, Roodepoort, Johannesburg 1709, South Africa
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Cox B, Wauters N, Rodríguez-Carrillo A, Portengen L, Gerofke A, Kolossa-Gehring M, Lignell S, Lindroos AK, Fabelova L, Murinova LP, Desalegn A, Iszatt N, Schillemans T, Åkesson A, Colles A, Den Hond E, Koppen G, Van Larebeke N, Schoeters G, Govarts E, Remy S. PFAS and Phthalate/DINCH Exposure in Association with Age at Menarche in Teenagers of the HBM4EU Aligned Studies. TOXICS 2023; 11:711. [PMID: 37624216 PMCID: PMC10459167 DOI: 10.3390/toxics11080711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
Early puberty has been found to be associated with adverse health outcomes such as metabolic and cardiovascular diseases and hormone-dependent cancers. The decrease in age at menarche observed during the past decades has been linked to an increased exposure to endocrine-disrupting compounds (EDCs). Evidence for the association between PFAS and phthalate exposure and menarche onset, however, is inconsistent. We studied the association between PFAS and phthalate/DINCH exposure and age at menarche using data of 514 teenagers (12 to 18 years) from four aligned studies of the Human Biomonitoring for Europe initiative (HBM4EU): Riksmaten Adolescents 2016-2017 (Sweden), PCB cohort (follow-up; Slovakia), GerES V-sub (Germany), and FLEHS IV (Belgium). PFAS concentrations were measured in blood, and phthalate/DINCH concentrations in urine. We assessed the role of each individual pollutant within the context of the others, by using different multi-pollutant approaches, adjusting for age, age- and sex-standardized body mass index z-score and household educational level. Exposure to di(2-ethylhexyl) phthalate (DEHP), especially mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), was associated with an earlier age at menarche, with estimates per interquartile fold change in 5OH-MEHP ranging from -0.34 to -0.12 years in the different models. Findings from this study indicated associations between age at menarche and some specific EDCs at concentrations detected in the general European population, but due to the study design (menarche onset preceded the chemical measurements), caution is needed in the interpretation of causality.
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Affiliation(s)
- Bianca Cox
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Natasha Wauters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
- Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Antje Gerofke
- German Environment Agency, Umweltbundesamt (UBA), 14195 Berlin, Germany; (A.G.); (M.K.-G.)
| | - Marike Kolossa-Gehring
- German Environment Agency, Umweltbundesamt (UBA), 14195 Berlin, Germany; (A.G.); (M.K.-G.)
| | - Sanna Lignell
- Swedish Food Agency, 751 26 Uppsala, Sweden; (S.L.); (A.K.L.)
| | | | - Lucia Fabelova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 01 Bratislava, Slovakia; (L.F.); (L.P.M.)
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 01 Bratislava, Slovakia; (L.F.); (L.P.M.)
| | - Anteneh Desalegn
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.D.); (N.I.)
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.D.); (N.I.)
| | - Tessa Schillemans
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (T.S.); (A.Å.)
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (T.S.); (A.Å.)
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Elly Den Hond
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, 2023 Antwerp, Belgium;
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
- Department of Biomedical Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
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Stroustrup A, Zhang X, Spear E, Bandyopadhyay S, Narasimhan S, Meher AK, Choi J, Qi G, Poindexter BB, Teitelbaum SL, Andra SS, Gennings C, Aschner JL. Phthalate exposure in the neonatal intensive care unit is associated with development of bronchopulmonary dysplasia. ENVIRONMENT INTERNATIONAL 2023; 178:108117. [PMID: 37517179 PMCID: PMC10581357 DOI: 10.1016/j.envint.2023.108117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Bronchopulmonary dysplasia (BPD) is a serious yet common morbidity of preterm birth. Although prior work suggests a possible role for phthalate exposure in the development of BPD, no study has rigorously evaluated this. Our objective was to determine whether hospital-based phthalate exposure is associated with the development of BPD and to identify developmental windows sensitive to exposure. STUDY DESIGN This is a prospective multicenter cohort study of 360 preterm infants born at 23-33 weeks gestation participating in the Developmental Impact of NICU Exposures (DINE) cohort. 939 urine specimens collected during the NICU stay were analyzed for biomarkers of phthalate exposure by liquid chromatography with tandem mass spectrometry. The modified Shennan definition was used to diagnose bronchopulmonary dysplasia. Reverse distributed-lag modeling identified developmental windows sensitive to specific phthalate exposure, controlling for relevant covariates including sex and respiratory support. RESULTS Thirty-five percent of participants were diagnosed with BPD. Exposure to specific phthalate mixtures at susceptible points in preterm infant development are associated with later diagnosis of BPD in models adjusted for use of respiratory support. The weighted influence of specific phthalate metabolites in the mixtures varied by sex. Metabolites of di(2-ethylhexyl) phthalate, a phthalate previously linked to neonatal respiratory support equipment, drove this association, particularly among female infants, at 26- to 30-weeks post-menstrual age. CONCLUSIONS This is the largest and only multi-site study of NICU-based phthalate exposure and clinical impact yet reported. In well-constructed models accounting for infant sex and respiratory support, we found a significant positive association between ultimate diagnosis of BPD and prior exposure to phthalate mixtures with DEHP predominance at 26- to 30-weeks PMA or 34-36-weeks PMA. This information is critically important as it identifies a previously unrecognized and modifiable contributing factor to BPD.
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Affiliation(s)
- Annemarie Stroustrup
- Department of Pediatrics and Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY, United States; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Emily Spear
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Sanjukta Bandyopadhyay
- Clinical and Translational Science Institute, University of Rochester, Rochester, NY, United States
| | - Srinivasan Narasimhan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anil K Meher
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Gao Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Brenda B Poindexter
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Syam S Andra
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Judy L Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, United States; Department of Pediatrics and Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, United States
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8
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Su PH, Huang JY, Wang SLJ, Chang HP. Phthalates exposure and pubertal development in a 15-year follow-up birth cohort study in Taiwan. Front Endocrinol (Lausanne) 2023; 14:1065918. [PMID: 37288299 PMCID: PMC10242106 DOI: 10.3389/fendo.2023.1065918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/10/2023] [Indexed: 06/09/2023] Open
Abstract
Purpose Phthalates are ubiquitous endocrine disruptors that can affect pubertal development in children. The association of fetal and childhood levels of phthalates with pubertal development were explored. Methods We conduct a population-based birth cohort study to investigate the association between prenatal and childhood exposure to phthalates and pubertal development. Initially, a total of 445 children were recruited from 2000 to 2001, of which 90 children were followed for 15 years which measurements of urine and development assessed at 2, 5, 8, 11, and 14 years. We defined higher Tanner stage as the 14-year-old Tanner stage ≥ 4 and 5 for boys and girls, respectively. A logistic regression analysis was conducted to estimate the crude and adjusted odds ratio of a higher Tanner stage at 14 years old. The Pearson correlation coefficient and multiple linear regression were used to estimate the association of testicular volume, uterine volume, ovarian volume, and blood hormones at 14 years of age with the log-transformed concentration of phthalates at 2, 5, 8, 11, and 14 years. Results In boys, a significantly different geometric mean of mono-benzyl phthalate (MBzP) was observed in 11-year-olds; 6.82 and 2.96 in the lower Tanner stage group and higher Tanner stage group. In girls, a significant difference in the geometric mean of mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) in 11-year-olds and mono-ethyl phthalate (MEP) in 2-year-olds was observed; MEHHP was 32.97 and 18.13 in the lower Tanner stage group and higher Tanner stage group, and MEP was 26.54 and 65.74 in the lower Tanner stage group and higher Tanner stage group, respectively. Uterine volume at 14 years old was negatively associated with several phthalate metabolites (MEHP at 8 years old, MnBP at 8 years old, MBzP at 14 years old, MMP prenatally, MMP at 8 years old, and MEP at 8 years old) after adjusting for covariates. However, no significant correlations were found between phthalate metabolites and ovarian or testicular volume. Conclusion Phthalate exposure at certain time points may influence the reproductive development of children during puberty; however, further studies should be conducted to determine the causal nature of this association.
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Affiliation(s)
- Pen-Hua Su
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Li Julie Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Hua-Pin Chang
- Department of Nursing, Asia University, Taichung, Taiwan
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9
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Al-Saleh I, Elkhatib R, Alnuwaysir H, Aldhalaan H, Binmanee A, Hawari A, Alhazzani F, Jabr MB. The cumulative risk assessment of phthalates exposure in preterm neonates. Int J Hyg Environ Health 2023; 248:114112. [PMID: 36657281 DOI: 10.1016/j.ijheh.2023.114112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/11/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023]
Abstract
Phthalates are widely used plasticizers in various consumer products and medical devices, with some reporting as having estrogenic and anti-androgenic endocrine-disrupting effects. Premature neonates may be exposed to high levels of specific phthalates during hospitalization in the neonatal intensive care unit (NICU) because of reliance on multiple medical procedures that pose a possible health risk. The present study utilized seven urinary phthalate metabolites of dibutyl phthalate isomers [(di-n-butyl phthalate (DnBP) and diisobutyl phthalate (DiBP)], butylbenzyl phthalate (BBzP), and di(2-ethylhexyl) phthalate (DEHP) that had been previously measured in 33 preterm neonates sampled at hospital admission (N = 23) and daily during their NICU stay (N = 260). We aimed to perform: (1) cumulative risk assessment (CRA) using the volume and creatinine-adjusted models; (2) examine the temporal variability of CRA from repeated measures and (3) estimate the risk of cumulative exposure to phthalates based on their anti-androgenic and/or estrogenic properties. We multiplied the relative activity of individual phthalates exhibiting estrogenic or anti-androgenic effects by daily intake. For each preterm neonate, CRA was assessed based on the hazard index (HI) metric [the sum of hazard quotients] based on three reference doses for anti-androgenicity: the tolerable daily intake (TDI) from the European Food Safety Authority, the reference dose (RfD-AA) published in 2010 and newly revised published in 2020 (NRfD-AA). The metabolites of BBzP and DEHP were 2-23 fold higher in preterm neonates during their NICU stay. Median HIs increased in the order of HINRfDAA > HIRfDAA > HITDI. In the creatinine-based model, 87% (92%), 87% (96%), and 100% (100%) of preterm neonates at admission (during NICU stay) showed HITDI, HIRfD-AA, and HINRfD-AA exceeding 1, respectively with DEHP the most prevalent. The temporal reproducibility of HI (based on three reference doses) during preterm neonate stay in the NICU was high, with intra-class correlation coefficients ranging between 0.77 and 0.97, suggesting persistent exposure to phthalates. The four phthalates that preterm neonates were exposed to in the NICU exhibited estrogenic binding and anti-androgenic effects with median values (creatinine-based) of 98.7 and 56.9 μg/kg body weight/day, respectively. This was especially true for DEHP. The results indicate that preterm neonates in this NICU setting are probably at high risk of cumulative phthalate exposure with anti-androgenic properties that may have long-term adverse reproductive and developmental effects.
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Affiliation(s)
- Iman Al-Saleh
- Environmental Health Program, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia.
| | - Rola Elkhatib
- Environmental Health Program, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Hissah Alnuwaysir
- Environmental Health Program, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Hesham Aldhalaan
- Center for Autism Research, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Abdulaziz Binmanee
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Amal Hawari
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Fahad Alhazzani
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Mohammad Bin Jabr
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
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10
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Trasande L, Kassotis CD. The Pediatrician's Role in Protecting Children from Environmental Hazards. Pediatr Clin North Am 2023; 70:137-150. [PMID: 36402464 PMCID: PMC10591514 DOI: 10.1016/j.pcl.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Children suffer disproportionately from disease and disability due to environmental hazards, for reasons rooted in their biology. The contribution is substantial and increasingly recognized, particularly due to ever-increasing awareness of endocrine disruption. Regulatory actions can be traced directly to reductions in toxic exposures, with tangible benefits to society. Deep flaws remain in the policy framework in industrialized countries, failing to offer sufficient protection, but are even more limited in industrializing nations where the majority of chemical production and use will occur by 2030. Evidence-based steps for reducing chemical exposures associated with adverse health outcomes exist and should be incorporated into anticipatory guidance.
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Affiliation(s)
- Leonardo Trasande
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU School of Global Public Health, New York, NY, USA.
| | - Christopher D Kassotis
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI, USA
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11
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Castiello F, Suárez B, Beneito A, Lopez-Espinosa MJ, Santa-Marina L, Lertxundi A, Tardón A, Riaño-Galán I, Casas M, Vrijheid M, Olea N, Fernández MF, Freire C. Childhood exposure to non-persistent pesticides and pubertal development in Spanish girls and boys: Evidence from the INMA (Environment and Childhood) cohort. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120571. [PMID: 36356884 DOI: 10.1016/j.envpol.2022.120571] [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: 05/01/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
This study assessed cross-sectional associations between urinary metabolites of non-persistent pesticides and pubertal development in boys and girls from urban and rural areas in Spain and examined effect modification by body mass index (BMI). Four metabolites of insecticides (TCPy, metabolite of chlorpyrifos; IMPy, metabolite of diazinon; DETP, non-specific metabolite of organophosphates; 3-PBA, metabolite of pyrethroids) and the metabolite of ethylene-bis-dithiocarbamate fungicides (ETU) were quantified in urine collected in 2010-2016 from 7 to 11-year-old children (606 girls, 933 boys) participating in the INMA Project. Pubertal development was ascertained by Tanner stages and/or parent-reported Pubertal Development Scale (PDS). Associations between pesticide metabolites and odds of being in stage 2+ for breast development (girls), genital development (boys), pubic hair growth (girls and boys), and/or overall puberty onset, gonadarche, and adrenarche (PDS for girls and boys) were examined by mixed-effect logistic regression. Effect modification by BMI was explored by interaction terms and stratified analysis. In girls, DETP and ETU concentrations>75th percentile (P75) were associated with higher odds of overall puberty development (OR [95%CI] = 1.86 [1.07-3.24] and 1.71 [1.03-2.83], respectively, for > P75 vs. undetected concentrations), while ETU > P75 was also associated with higher odds of breast development (OR [95%CI] = 5.55 [2.83-12.91]), particularly in girls with underweight/normal weight (OR [95%CI] = 10.08 [2.62-38.76]). In boys, detection of TCPy (40%) and 3-PBA (34%) was associated with higher odds of genital development (OR [95%CI] = 1.97 [1.08-3.57] and 2.08 [1.15-3.81], respectively), and the association with 3-PBA was observed in boys with overweight/obesity alone. In addition, ETU > P75 was associated with higher odds of genital development in boys with underweight/normal weight (OR [95%CI] = 2.89 [1.08-7.74]) but higher DETP with lower odds of puberty in boys with overweight/obesity (OR [95%CI] = 0.94 [0.89-0.99] per log-unit increase in concentration). Results suggest an association of childhood exposure to ETU and certain insecticides with earlier puberty in girls and boys that may be modified by child BMI.
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Affiliation(s)
- Francesca Castiello
- Pediatrics Unit, San Cecilio University Hospital, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.granada), 18012, Granada, Spain
| | - Beatriz Suárez
- Instituto de Investigación Biosanitaria de Granada (ibs.granada), 18012, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Biomedical Research Centre (CIBM), University of Granada, 18016, Granada, Spain
| | - Andrea Beneito
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain; Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, 46010, Valencia, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; BIODONOSTIA Health Research Institute, 20014, San Sebastián, Spain; Health Department of Basque Government, Subdirectorate of Public Health of Gipuzkoa, 20013, San Sebastián, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), 48940, Leioa, Bizkaia, Spain; BIODONOSTIA Health Research Institute, 20014, San Sebastián, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Instituto de Investigación Sanitaria Del Principado de Asturias (ISPA), Department of Preventive Medicine and Public Health, School of Medicine, University of Oviedo, 33003, Oviedo, Spain
| | - Isolina Riaño-Galán
- Instituto de Investigación Sanitaria Del Principado de Asturias (ISPA), Department of Preventive Medicine and Public Health, School of Medicine, University of Oviedo, 33003, Oviedo, Spain; Pediatrics Unit, Asturias Central University Hospital, 33011, Oviedo, Asturias, Spain
| | - Maribel Casas
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain
| | - Nicolás Olea
- Instituto de Investigación Biosanitaria de Granada (ibs.granada), 18012, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Biomedical Research Centre (CIBM), University of Granada, 18016, Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016, Granada, Spain
| | - Mariana F Fernández
- Instituto de Investigación Biosanitaria de Granada (ibs.granada), 18012, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Biomedical Research Centre (CIBM), University of Granada, 18016, Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016, Granada, Spain
| | - Carmen Freire
- Instituto de Investigación Biosanitaria de Granada (ibs.granada), 18012, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Biomedical Research Centre (CIBM), University of Granada, 18016, Granada, Spain.
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12
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Rivera-Núñez Z, Kinkade CW, Zhang Y, Rockson A, Bandera EV, Llanos AAM, Barrett ES. Phenols, Parabens, Phthalates and Puberty: a Systematic Review of Synthetic Chemicals Commonly Found in Personal Care Products and Girls' Pubertal Development. Curr Environ Health Rep 2022; 9:517-534. [PMID: 35867279 PMCID: PMC9742306 DOI: 10.1007/s40572-022-00366-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Exposure to endocrine disrupting chemicals through personal care products (PCPs) is widespread and may disrupt hormone-sensitive endpoints, such as timing of puberty. Given the well-documented (and ongoing) decline in age at menarche in many populations, we conducted a systematic review of the epidemiological literature on exposure to chemicals commonly found in PCPs (including certain phthalates, phenols, and parabens) in relation to girls' pubertal development. RECENT FINDINGS The preponderance of research on this topic has examined phthalate exposures with the strongest evidence indicating that prenatal monoethyl phthalate (MEP) concentrations may be associated with slightly earlier timing of puberty, including age at menarche. Findings examining peri-pubertal phthalate exposures and pubertal outcomes were less consistent as were studies of prenatal and peri-pubertal phenol exposures. Very few studies had examined parabens in relation to girls' pubertal development. Common study limitations included potential exposure misclassification related to use of spot samples and/or mistimed biomarker assessment with respect to the outcomes. The role of body size as a mediator in these relationships remains unresolved. Overall, evidence of associations between chemical exposures in PCPs and girls' pubertal development was conflicting. When associations were observed, effect sizes were small. Nevertheless, given the many environmental, social, and behavioral factors in the modern environment that may act synergistically to accelerate timing of puberty, even marginal changes may be cause for concern, with implications for cancer risk, mental health, and cardiometabolic disease in later life.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA. .,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
| | - Carolyn W Kinkade
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Yingting Zhang
- Robert Wood Johnson Library of the Health Sciences, Rutgers University, New Brunswick, NJ, 08901, USA
| | - Amber Rockson
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Elisa V Bandera
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.,Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08903, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Emily S Barrett
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
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13
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Kay JE, Cardona B, Rudel RA, Vandenberg LN, Soto AM, Christiansen S, Birnbaum LS, Fenton SE. Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022; 9:535-562. [PMID: 35984634 PMCID: PMC9729163 DOI: 10.1007/s40572-022-00376-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Population studies show worrisome trends towards earlier breast development, difficulty in breastfeeding, and increasing rates of breast cancer in young women. Multiple epidemiological studies have linked these outcomes with chemical exposures, and experimental studies have shown that many of these chemicals generate similar effects in rodents, often by disrupting hormonal regulation. These endocrine-disrupting chemicals (EDCs) can alter the progression of mammary gland (MG) development, impair the ability to nourish offspring via lactation, increase mammary tissue density, and increase the propensity to develop cancer. However, current toxicological approaches to measuring the effects of chemical exposures on the MG are often inadequate to detect these effects, impairing our ability to identify exposures harmful to the breast and limiting opportunities for prevention. This paper describes key adverse outcomes for the MG, including impaired lactation, altered pubertal development, altered morphology (such as increased mammographic density), and cancer. It also summarizes evidence from humans and rodent models for exposures associated with these effects. We also review current toxicological practices for evaluating MG effects, highlight limitations of current methods, summarize debates related to how effects are interpreted in risk assessment, and make recommendations to strengthen assessment approaches. Increasing the rigor of MG assessment would improve our ability to identify chemicals of concern, regulate those chemicals based on their effects, and prevent exposures and associated adverse health effects.
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Affiliation(s)
| | | | | | - Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Ana M Soto
- Tufts University School of Medicine, Boston, MA, USA
| | - Sofie Christiansen
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Linda S Birnbaum
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Suzanne E Fenton
- Mechanistic Toxicology Branch, Division of the National Toxicology Program, National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA
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14
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Yoon LS, Binder AM, Pereira A, Calafat AM, Shepherd J, Corvalán C, Michels KB. Variability in urinary phthalates, phenols, and parabens across childhood and relation to adolescent breast composition in Chilean girls. ENVIRONMENT INTERNATIONAL 2022; 170:107586. [PMID: 36302292 PMCID: PMC10517447 DOI: 10.1016/j.envint.2022.107586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Epidemiologic evidence suggests that environmental factors acting as endocrine disrupting chemicals (EDCs) are associated with mammographic breast density and the risk of breast cancer. Exposure to EDCs during puberty, a period of rapid breast development, may affect susceptibility to breast carcinogenesis. METHODS In a cohort of 366 Chilean adolescents from the Growth and Obesity Cohort Study, we evaluated the relation between urinary concentrations of 15 suspected EDC biomarkers across three pubertal time points (Tanner breast stage 1 (B1), 4 (B4), and 1-year post-menarche) and breast fibroglandular volume (FGV; percent FGV [%FGV] and absolute FGV [aFGV]) and total breast volume (tBV) at 2-years post-menarche. We used linear mixed models to test differences in creatinine-corrected EDC biomarker concentrations at B4 and 1-year post-menarche compared to B1 and calculated intraclass correlation coefficients (ICC) of EDC concentrations across time points to appraise the consistency of measurements. We fit multivariable generalized estimating equations (GEEs) to evaluate windows of susceptibility for the association between log10-transformed EDCs and log10-transformed breast outcomes. GEEs were adjusted for age, body fat percentage, total caloric intake, and maternal education. RESULTS Urinary EDC biomarker concentrations highly varied across pubertal time points (ICC range 0.01-0.30). For 12 EDCs, biomarker concentrations decreased over time. Triclosan measured at 1-year post-menarche was inversely associated with %FGV at 2-years post-menarche (β = -0.025, 95 % confidence interval = -0.041, -0.008). Mono(2-ethyl-5-carboxypentyl) phthalate and the sum of di(2-ethylhexyl) phthalate metabolite concentrations at B4 were positively associated with aFGV and tBV at 2-years post-menarche. No measured phenols were associated with aFGV and tBV, while no measured parabens were associated with %FGV and aFGV. CONCLUSIONS Our study suggests relatively high variability in EDC biomarker concentrations across the peripubertal time period. We also found evidence to suggest that there may be pubertal windows of susceptibility to select EDCs for the association with adolescent breast density.
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Affiliation(s)
- Lara S Yoon
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90025, USA.
| | - Alexandra M Binder
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90025, USA; Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Macul, Santiago 7830490, Chile.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F17, Atlanta, GA 30341, USA.
| | - John Shepherd
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Macul, Santiago 7830490, Chile.
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90025, USA; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Elsässerstraße 2, 79110 Freiburg, Germany.
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15
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Kim H, Kil M, Han C. Urinary phthalate metabolites and anemia: Findings from the Korean National Environmental Health Survey (2015-2017). ENVIRONMENTAL RESEARCH 2022; 215:114255. [PMID: 36113574 DOI: 10.1016/j.envres.2022.114255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/16/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Several animal studies have suggested an association between phthalate exposure and decreased hemoglobin levels. To address the lack of epidemiological evidence, we evaluated the association between urinary phthalate metabolite concentrations and hematologic indices by using nationally representative data from Korea. METHODS Data from 3722 adults included in the third stage (2015-2017) of the Korean National Environmental Health Survey (KONEHS) were used. The association between various urinary phthalate metabolites and hematologic indices (hemoglobin, hematocrit, mean corpuscular volume [MCV], and red blood cell [RBC], white blood cell [WBC], and platelet counts) was evaluated using linear regression analysis adjusted for potential confounders. Sex-stratified analysis was performed. RESULTS All urinary phthalate metabolites were negatively associated with hemoglobin levels. A two-fold increase in urinary mono-(2-ethyl-5-carboxy-pentyl) phthalate (MECPP), mono-carboxyoctyl phthalate (MCOP), mono-carboxyonyl phthalate (MCNP), and mono-(3-carboxypropyl) phthalate (MCPP) levels was associated with a -0.099 g/dL (95% confidence interval (CI), -0.137 to -0.060), -0.116 g/dL (95% CI, -0.156 to -0.076), -0.111 g/dL (95% CI, -0.154 to -0.068), and -0.144 g/dL (95% CI, -0.198 to -0.089) change in hemoglobin levels, respectively. The RBC count and MCV showed negative and positive associations, respectively, with urinary phthalate metabolite concentrations. WBC counts were positively associated with MECPP, MCOP, MCNP, and MCPP levels, whereas the platelet count showed no association with urinary phthalate metabolites. CONCLUSIONS Urinary phthalate metabolite concentration showed a negative association with hemoglobin level. Since this was a cross-sectional study, further longitudinal and experimental studies are needed to identify a clear causal linkage and the pathological mechanism underlying phthalate exposure and anemia.
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Affiliation(s)
- Hahyeon Kim
- Chungnam National University College of Medicine, Daejeon, South Korea
| | - Minuk Kil
- Chungnam National University College of Medicine, Daejeon, South Korea
| | - Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; KDI School of Public Policy and Management, Sejong, South Korea.
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Freire C, Castiello F, Lopez-Espinosa MJ, Beneito A, Lertxundi A, Jimeno-Romero A, Vrijheid M, Casas M. Association of prenatal phthalate exposure with pubertal development in Spanish boys and girls. ENVIRONMENTAL RESEARCH 2022; 213:113606. [PMID: 35716812 DOI: 10.1016/j.envres.2022.113606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/18/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Phthalates are widespread, anti-androgenic chemicals known to alter early development, with possible impact on puberty timing. AIM To investigate the association of prenatal phthalate exposure with pubertal development in boys and girls. METHODS Urinary metabolites of six different phthalate diesters (DEP, DiBP, DnBP, BBzP, DEHP, and DiNP) and non-phthalate plasticizer DINCH® were quantified in two urine samples collected during pregnancy from mothers participating in the INMA Spanish cohort study. Pubertal assessment of their children at age 7-10 years (409 boys, 379 girls) was conducted using the parent-reported Pubertal Development Scale. Modified Poisson and Weighted Quantile Sum (WQS) regression was employed to examine associations between prenatal phthalates and risk of puberty onset, adrenarche, and gonadarche. Effect modification by child weight status was explored by stratified analysis. RESULTS Prenatal exposure to DEHP was associated with higher risk of puberty onset (relative risk [RR] = 1.32, 95% CI = 1.09-1.59 per each log-unit increase in concentrations) and gonadarche (RR = 1.23, 95% CI = 1.00-1.50) in boys and higher risk of adrenarche (RR = 1.25, 95% CI = 1.03-1.51) in girls at age 7-10 years. In boys, prenatal exposure to DEP, DnBP, and DEHP was also associated with higher risk of adrenarche or gonadarche (RRs = 1.49-1.80) in those with normal weight, and BBzP and DINCH® exposure with lower risk of adrenarche (RR = 0.49, 95% CI = 0.27-0.89 and RR = 0.47, 95% CI = 0.24-0.90, respectively) in those with overweight/obesity. In girls, DiBP, DnBP, and DINCH® were associated with slightly higher risk of gonadarche (RRs = 1.14-1.19) in those with overweight/obesity. In the WQS model, the phthalate mixture was not associated with puberty in boys or girls. CONCLUSION Prenatal exposure to certain phthalates was associated with pubertal development at age 7-10 years, especially earlier puberty in boys with normal weight and girls with overweight/obesity. However, there was no evidence of effect of the phthalate mixture on advancing or delaying puberty in boys or girls.
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Affiliation(s)
- Carmen Freire
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; Biomedical Research Centre, University of Granada, 18016, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Francesca Castiello
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; Pediatrics Unit, San Cecilio University Hospital, 18016, Granada, Spain.
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain; Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, 46010, Valencia, Spain.
| | - Andrea Beneito
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Jaume I University-University of Valencia, 46020, Valencia, Spain.
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), 48940, Leioa, Bizkaia, Spain; BIODONOSTIA Health Research Institute, 20014, San Sebastián, Spain.
| | - Alba Jimeno-Romero
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), 48940, Leioa, Bizkaia, Spain; BIODONOSTIA Health Research Institute, 20014, San Sebastián, Spain.
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain.
| | - Maribel Casas
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, 08036, Barcelona, Spain; Universitat Pompeu Fabra, 08005, Barcelona, Spain.
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Hwa HL, Peng FS, Ting TT, Chen HW, Chan HY, Yang DP, Chen PC, Kuo YN, Chen PS. Monitoring Phthalates in Maternal and Cord Blood: Implications for Prenatal Exposure and Birth Outcomes. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2022; 41:715-725. [PMID: 35199389 DOI: 10.1002/etc.5280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Although many phthalates are endocrine-disrupting chemicals that are associated with adverse birth outcomes, the relationship between maternal phthalate exposure and birth outcomes is not yet conclusive. The objective of the present study was to investigate the association between prenatal exposure to phthalates in human maternal and cord blood and birth outcomes of the infants. Sixty-five mother-infant pairs were recruited in Taipei City and New Taipei City, and birth outcomes of the infants were recorded. Twelve phthalate metabolites were measured in maternal and cord blood samples. The mean of mono-ethyl phthalate, mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), and mono-(2-ethylhexyl) phthalate (MEHP) was relatively higher than that of the other metabolites in both maternal and infant blood. There was a significant difference (p < 0.05) for mono-methyl phthalate (MMP) and MnBP between the maternal blood and cord blood of male infants. Mono-benzyl phthalate (MBzP), MMP, MiBP, and ∑di-2-ethylhexyl phthalate (∑DEHP) in maternal blood were inversely correlated with the anogenital index (AGI) of male infants, with a p value between 0.011 and 0.033. Mono-n-octyl phthalate, MMP, MiBP, MnBP, and MBzP were positively correlated with the AGI of female infants, with a p value between 0.001 and 0.034. Cord blood levels of MnBP, mono-(2-ethyl-5-oxohexyl)-phthalate, MEHP, and ∑DEHP were found to be inversely associated with head circumference in all the infants, adjusted for gestational age. Phthalate monoesters are potentially estrogenic and antiandrogenic chemicals. Longitudinal follow-up of the present study population could help clarify the long-term impact of phthalates on growth and the health effects of background exposure levels. Environ Toxicol Chem 2022;41:715-725. © 2022 SETAC.
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Affiliation(s)
- Hsiao-Lin Hwa
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, Taipei, Taiwan
- Forensic and Clinical Toxicology Center, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fu-Shiang Peng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Te-Tien Ting
- School of Big Data Management, Soochow University, Taipei, Taiwan
| | - Huei-Wen Chen
- Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan
| | - Hsiang-Yu Chan
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, Taipei, Taiwan
| | - Da-Peng Yang
- Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yun-Ning Kuo
- Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan
| | - Pai-Shan Chen
- Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan
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18
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Kuiper JR, Braun JM, Calafat AM, Lanphear BP, Cecil KM, Chen A, Xu Y, Yolton K, Kalkwarf HJ, Buckley JP. Associations of pregnancy phthalate concentrations and their mixture with early adolescent bone mineral content and density: The Health Outcomes and Measures of the Environment (HOME) study. Bone 2022; 154:116251. [PMID: 34740813 PMCID: PMC8671261 DOI: 10.1016/j.bone.2021.116251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The developing fetus may be particularly susceptibility to environmental osteotoxicants, but studies of pregnancy phthalate exposures and childhood bone health are scarce. OBJECTIVES To examine relations of pregnancy phthalate exposure biomarkers with early adolescent bone mineral density (BMD) and bone mineral content (BMC) in a prospective birth cohort. METHODS We used data from 223 pregnant mothers and their children enrolled in a Cincinnati, OH area cohort from 2003 to 2006. We quantified monoethyl phthalate (MEP), monoisobutyl phthalate, monobutyl phthalate, monobenzyl phthalate, mono-(3-carboxypropyl) phthalate (MCPP), and four metabolites of di-2-ethylhexyl phthalate in maternal urine collected at 16 and 26 weeks gestation, and calculated the average of creatinine-standardized concentrations. Using dual x-ray absorptiometry measures at age 12 years, we calculated BMD and BMC Z-scores for six skeletal sites. In overall and sex-stratified models, we estimated covariate-adjusted associations per 2-fold increase in phthalate biomarker concentrations using linear regression, and estimated joint effects of the phthalate biomarkers mixture using Bayesian kernel machine regression (BKMR) and quantile g-computation. RESULTS In single phthalate models, several biomarkers were positively associated with BMC and BMD. For example, each doubling of MEP and MCPP, 1/3rd distal radius BMD Z-score increased by 0.09 (95% CI: 0.01, 0.17) and 0.16 (95% CI: 0.01, 0.31), respectively. For phthalate mixtures, associations were generally U-shaped among males and positive-linear among females, using both statistical methods. Mixture associations were strongest with forearm sites: in BKMR models, increasing all biomarkers from the 50th to 90th percentile was associated with a 0.64 (95% CI: 0.01, 1.28) greater 1/3rd distal radius BMD Z-score in males, and a 0.49 (95% CI: -0.13, 1.10) greater ultradistal radius BMD Z-score in females. DISCUSSION In this study, phthalate exposures during gestation were associated with increased BMD Z-scores in early adolescence, though further research is needed to determine implications for long-term skeletal health.
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Affiliation(s)
- Jordan R Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Kim M Cecil
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Heidi J Kalkwarf
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Uldbjerg CS, Koch T, Lim YH, Gregersen LS, Olesen CS, Andersson AM, Frederiksen H, Coull BA, Hauser R, Juul A, Bräuner EV. OUP accepted manuscript. Hum Reprod Update 2022; 28:687-716. [PMID: 35466359 PMCID: PMC9434240 DOI: 10.1093/humupd/dmac013] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/25/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Globally, the ages at pubertal onset for girls and boys have been decreasing during recent decades, partly attributed to excess body fat accumulation. However, a growing body of literature has recognized that endocrine disrupting chemicals (EDCs) may play an important role in this global trend, but the association has not yet been fully established. OBJECTIVE AND RATIONALE EDCs can interfere with normal hormone function and metabolism and play a role in pubertal onset. We aimed to systematically identify and evaluate the current evidence on the timing of pubertal onset in girls and boys following prenatal or postnatal exposures to xenobiotic EDCs. SEARCH METHODS Following PRISMA guidelines, we performed a systematic literature search of original peer-reviewed publications in the PubMed database through a block search approach using a combination of index MeSH and free text search terms. Publications were considered if they covered biomarkers of prenatal or postnatal exposures to xenobiotic EDCs (European Commission's list of category 1 EDCs) measured in maternal or child biospecimen and pubertal onset defined by the progression of the following milestones (and assessed in terms of the following measures): menarche (age), thelarche (Tanner staging) and pubarche (Tanner staging), in girls, and genital stage (Tanner staging), testicular volume (ml) and pubarche (Tanner staging), in boys. OUTCOMES The literature search resulted in 703 references, of which we identified 52 publications fulfilling the eligibility criteria for the qualitative trend synthesis and 23 publications for the meta-analysis. The qualitative trend synthesis provided data on 103 combinations of associations between prenatal or postnatal exposure to EDC compounds groups and puberty outcomes and the meta-analysis enabled 18 summary risk estimates of meta-associations. WIDER IMPLICATIONS Statistically significant associations in the qualitative trend synthesis suggested that postnatal exposure to phthalates may be associated with earlier thelarche and later pubarche. However, we did not find consistent evidence in the meta-analysis for associations between timing of pubertal onset in girls and boys and exposures to any of the studied xenobiotic EDCs. We were not able to identify specific pre- or postnatal windows of exposure as particularly critical and susceptible for effects of EDCs. Current evidence is subject to several methodological challenges and inconsistencies and evidence on specific exposure-outcome associations remains too scarce to firmly confirm EDC exposure as a risk factor for changes in age of pubertal onset in the general child population. To create a more uniform foundation for future comparison of evidence and to strengthen pooled studies, we recommend the use of more standardized approaches in the choice of statistical analyses, with exposure transformations, and in the definitions and assessments of puberty outcomes. The impact of mixtures of EDC exposures on the association also remains unestablished and would be valuable to elucidate for prenatal and postnatal windows of exposure. Future large, longitudinal epidemiological studies are needed to clarify the overall association.
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Affiliation(s)
| | | | - Y -H Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - L S Gregersen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - C S Olesen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A -M Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - H Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B A Coull
- Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - R Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - A Juul
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
| | - E V Bräuner
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
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20
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Bräuner EV, Uldbjerg CS, Lim YH, Gregersen LS, Krause M, Frederiksen H, Andersson AM. Presence of parabens, phenols and phthalates in paired maternal serum, urine and amniotic fluid. ENVIRONMENT INTERNATIONAL 2022; 158:106987. [PMID: 34991249 PMCID: PMC8739868 DOI: 10.1016/j.envint.2021.106987] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To examine whether selected endocrine disrupting chemicals were present in pregnant women and passed through the placental barrier to amniotic fluid, potentially exposing the developing fetus. METHODS Paired samples of maternal serum, urine and amniotic fluid were concurrently collected (<1 h) from 200 pregnant women (age >18 years) with a singleton pregnancy and undergoing amniocentesis between gestational weeks 12 - 36. The concentration of six different parabens, seven phenols, 31 metabolites from 15 phthalate diesters and the polychlorinated substance triclocarban were analyzed by isotope diluted TurboFlow-liquid chromatography-tandem mass spectrometry. RESULTS Concentrations of all included compounds were highest in maternal urine followed by serum, and lowest in amniotic fluid. Of the six parabens measured in amniotic fluid, methylparaben (MeP) and ethylparaben (EtP) were detectable most often (87% and 33% of the samples, respectively). Of the seven phenols measured, three (2,4-dichlorphenol, 2,5-dichlorphenol, 2-propylphenol) were detectable in the range of 14-21% of the amniotic fluid samples, at low concentrations (<0.12 ng/ml). Two secondary phthalates metabolites, mono-(2-carboxymethyl-hexyl) phthalate and mono-carboxy-iso-octyl phthalate were each present in ≤15% of the amniotic fluid samples at concentrations 2-5 times lower than in maternal serum and 20-100 times lower than in maternal urine. A modest statistically significant correlation between the levels of MeP and EtP was detected in paired maternal urine-amniotic fluid samples was detected (Spearman rMeP: 0.246; rEtP: 0.364). Likewise, the concentration of mono-ethyl phthalate (MEP) in paired maternal urine and amniotic fluid samples indicated a modest statistically significant correlation (Spearman rMEP: 0.264), driven by detectable levels of MEP in only 3% of the amniotic fluid samples. CONCLUSIONS In general, the included parabens, phenols and phthalates were effectively metabolized and excreted via the urine, which was the matrix that reflected the highest detectable levels. The detectable levels of several included parabens and phthalates in human amniotic fluid calls for further investigations of the toxicokinetic and potential endocrine disrupting properties of individual and multiple endocrine disruptors in order to better assess the risk to the developing fetus.
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Affiliation(s)
- Elvira V Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Cecilie S Uldbjerg
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Laura S Gregersen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Marianna Krause
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark.
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21
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Prenatal exposure to a mixture of different phthalates increases the risk of mammary carcinogenesis in F1 female offspring. Food Chem Toxicol 2021; 156:112519. [PMID: 34428494 DOI: 10.1016/j.fct.2021.112519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022]
Abstract
Phthalates metabolites have been detected in the urine of pregnant and breastfeeding women. Thus, this study evaluated the adverse effects of maternal exposure to a mixture of six phthalates (Pth mix) on the mammary gland development and carcinogenesis in F1 female offspring. Pregnant female Sprague-Dawley rats were exposed daily to vehicle or Pth mix (35.22% diethyl-phthalate, 21.03% di-(2-ethylhexyl)-phthalate, 14.91% dibutyl-phthalate, 15.10% diisononyl-phthalate, 8.61% diisobutyl-phthalate, and 5.13% benzylbutyl-phthalate) by gavage at 20 μg/kg, 200 μg/kg or 200 mg/kg during gestational day 10 (GD 10) to postnatal day 21 (PND 21). After weaning (PND 22), some female offspring were euthanized for mammary gland analyses while other females received a single dose of N-methyl-N-nitrosourea (MNU, 50 mg/kg) or vehicle and then tumor incidence and multiplicity were recorded until PND 180. Maternal Pth mix exposure increased the number of Ki-67 and progesterone receptor-positive epithelial cells in the mammary gland from Pth mix 200 at μg/kg and 200 mg/kg groups. In addition, tumor incidence and mean number were higher only in Pth mix at 200 mg/kg when compared to the vehicle-treated group, and percentage of tumor-free animals was lower in Pth mix at 200 μg/kg and 200 mg/kg groups. The findings indicate that perinatal Pth mixture exposure increased susceptibility to MNU-induced mammary carcinogenesis in adult F1 female offspring.
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Endocrine-Disrupting Chemicals and Early Puberty in Girls. CHILDREN-BASEL 2021; 8:children8060492. [PMID: 34200537 PMCID: PMC8226958 DOI: 10.3390/children8060492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022]
Abstract
In recent decades, pubertal onset in girls has been considered to occur at an earlier age than previously. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with alterations in pubertal timing, with several reports suggesting that EDCs may have a role in the secular trend in pubertal maturation, at least in girls. However, relevant studies give inconsistent results. On the other hand, the majority of girls with idiopathic precocious or early puberty present the growth pattern of constitutional advancement of growth (CAG), i.e., growth acceleration soon after birth. Herein, we show that the growth pattern of CAG is unrelated to exposure to endocrine-disrupting chemicals and is the major determinant of precocious or early puberty. Presented data suggest that EDCs, at most, have a minor effect on the timing of pubertal onset in girls.
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McDonald JA, Cherubin S, Goldberg M, Wei Y, Chung WK, Schwartz LA, Knight JA, Schooling CM, Santella RM, Bradbury AR, Buys SS, Andrulis IL, John EM, Daly MB, Terry MB. Common Childhood Viruses and Pubertal Timing: The LEGACY Girls Study. Am J Epidemiol 2021; 190:766-778. [PMID: 33128063 DOI: 10.1093/aje/kwaa240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022] Open
Abstract
Earlier pubertal development is only partially explained by childhood body mass index; the role of other factors, such as childhood infections, is less understood. Using data from the LEGACY Girls Study (North America, 2011-2016), we prospectively examined the associations between childhood viral infections (cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) 1, HSV2) and pubertal timing. We measured exposures based on seropositivity in premenarcheal girls (n = 490). Breast and pubic hair development were classified based on mother-reported Tanner Stage (TS) (TS2+ compared with TS1), adjusting for age, body mass index, and sociodemographic factors. The average age at first blood draw was 9.8 years (standard deviation, 1.9 years). The prevalences were 31% CMV+, 37% EBV+, 14% HSV1+, 0.4% HSV2+, and 16% for both CMV+/EBV+ coinfection. CMV+ infection without coinfection was associated with developing breasts an average of 7 months earlier (hazard ratio (HR) = 2.12, 95% confidence interval (CI): 1.32, 3.40). CMV infection without coinfection and HSV1 and/or HSV2 infection were associated with developing pubic hair 9 months later (HR = 0.41, 95% CI: 0.24, 0.71, and HR = 0.42, 95% CI: 0.22, 0.81, respectively). Infection was not associated with menarche. If replicated in larger cohorts with blood collection prior to any breast development, this study supports the hypothesis that childhood infections might play a role in altering pubertal timing.
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Martínez-Ibarra A, Martínez-Razo LD, MacDonald-Ramos K, Morales-Pacheco M, Vázquez-Martínez ER, López-López M, Rodríguez Dorantes M, Cerbón M. Multisystemic alterations in humans induced by bisphenol A and phthalates: Experimental, epidemiological and clinical studies reveal the need to change health policies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 271:116380. [PMID: 33387779 DOI: 10.1016/j.envpol.2020.116380] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/21/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
A vast amount of evidence indicates that bisphenol A (BPA) and phthalates are widely distributed in the environment since these compounds are mass-produced for the manufacture of plastics and plasticizers. These compounds belong to a large group of substances termed endocrine-disrupting chemicals (EDC). It is well known that humans and living organisms are unavoidably and unintentionally exposed to BPA and phthalates from food packaging materials and many other everyday products. BPA and phthalates exert their effect by interfering with hormone synthesis, bioavailability, and action, thereby altering cellular proliferation and differentiation, tissue development, and the regulation of several physiological processes. In fact, these EDC can alter fetal programming at an epigenetic level, which can be transgenerational transmitted and may be involved in the development of various chronic pathologies later in the adulthood, including metabolic, reproductive and degenerative diseases, and certain types of cancer. In this review, we describe the most recent proposed mechanisms of action of these EDC and offer a compelling selection of experimental, epidemiological and clinical studies, which show evidence of how exposure to these pollutants affects our health during development, and their association with a wide range of reproductive, metabolic and neurological diseases, as well as hormone-related cancers. We stress the importance of concern in the general population and the urgent need for the medical health care system to closely monitor EDC levels in the population due to unavoidable and involuntary exposure to these pollutants and their impact on human health.
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Affiliation(s)
- A Martínez-Ibarra
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Ciudad de México 04960, Mexico; Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico
| | - L D Martínez-Razo
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico
| | - K MacDonald-Ramos
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico
| | - M Morales-Pacheco
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico
| | - E R Vázquez-Martínez
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico
| | - M López-López
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana, Ciudad de México 04960, Mexico
| | | | - M Cerbón
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología "Isidro Espinosa de Los Reyes" - Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 11000, Mexico.
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Kim HJ, Kim SH, Oh YS, Heo SH, Kim KH, Kim DY, Lee SR, Chae HD. Effects of Phthalate Esters on Human Myometrial and Fibroid Cells: Cell Culture and NOD-SCID Mouse Data. Reprod Sci 2021; 28:479-487. [PMID: 33037561 DOI: 10.1007/s43032-020-00341-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/01/2020] [Indexed: 01/22/2023]
Abstract
Evidence is growing that phthalate esters play an important role in the pathogenesis of estrogen-dependent gynecologic diseases, especially uterine fibroids. We aimed to investigate whether in vitro treatment with di-(2-ethylhexyl)-phthalate (DEHP) affects angiogenesis, proliferation, and apoptosis in uterine fibroids. To ascertain this, we evaluated vascular endothelial growth factor (VEGF) expression and AKT/ERT phosphorylation and compared the fibroid volume between nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice fed with and without DEHP. VEGF expression was measured using enzyme-linked immunosorbent assay, and AKT/ERK phosphorylation was analyzed by western blot analysis in human myometrial and fibroid cells. The volume of the fibroid tissues implanted to NOD/SCID mice was measured, and the expression of collagen type I protein, Ki-67, proliferating cell nuclear antigen, and B cell lymphoma 2 were analyzed using immunohistochemistry. We could see significant increases in VEGF expression and AKT phosphorylation in human myometrial and fibroid cells treated with DEHP. The volume of the fibroid tissues was significantly increased in NOD/SCID mice fed with DEHP, which was accompanied by increased expression of collagen type I and AKT phosphorylation. Taken together, these results suggest that exposure to phthalate esters may influence uterine fibroid pathogenesis by increasing VEGF and collagen expression and upregulating AKT phosphorylation.
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Affiliation(s)
- Hyun Jin Kim
- Department of Obstetrics and Gynecology, University of Kyung Hee College of Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Sung Hoon Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Young Sang Oh
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Seung-Ho Heo
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Kang-Hyun Kim
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Do Young Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sa Ra Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Hee Dong Chae
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
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Sears CG, Braun JM. Phthalate Exposure, Adolescent Health, and the Need for Primary Prevention. Endocrinol Metab Clin North Am 2020; 49:759-770. [PMID: 33153678 DOI: 10.1016/j.ecl.2020.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Phthalates, a class of endocrine-disrupting chemicals, are used widely in many consumer products, and exposure can interfere with a range of hormonal functions during early life. These disruptions may alter development during late childhood and adolescence. This article discusses the potential effects of phthalate exposure on adiposity, puberty, and neurodevelopment during late childhood and adolescence. It also highlights studies of behavioral interventions to reduce phthalate exposures and the roles of health care professionals and policy makers in preventing phthalate exposure.
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Affiliation(s)
- Clara G Sears
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, 121 South Main Street, Providence, RI 02912, USA.
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, 121 South Main Street, Providence, RI 02912, USA. https://twitter.com/JosephMBraun1
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Hlisníková H, Petrovičová I, Kolena B, Šidlovská M, Sirotkin A. Effects and Mechanisms of Phthalates' Action on Reproductive Processes and Reproductive Health: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6811. [PMID: 32961939 PMCID: PMC7559247 DOI: 10.3390/ijerph17186811] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
The production of plastic products, which requires phthalate plasticizers, has resulted in the problems for human health, especially that of reproductive health. Phthalate exposure can induce reproductive disorders at various regulatory levels. The aim of this review was to compile the evidence concerning the association between phthalates and reproductive diseases, phthalates-induced reproductive disorders, and their possible endocrine and intracellular mechanisms. Phthalates may induce alterations in puberty, the development of testicular dysgenesis syndrome, cancer, and fertility disorders in both males and females. At the hormonal level, phthalates can modify the release of hypothalamic, pituitary, and peripheral hormones. At the intracellular level, phthalates can interfere with nuclear receptors, membrane receptors, intracellular signaling pathways, and modulate gene expression associated with reproduction. To understand and to treat the adverse effects of phthalates on human health, it is essential to expand the current knowledge concerning their mechanism of action in the organism.
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Affiliation(s)
- Henrieta Hlisníková
- Department of Zoology and Anthropology, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (I.P.); (B.K.); (M.Š.); (A.S.)
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28
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Sexual EDC-ucation: What we Have Learned About Endocrine-Disrupting Chemicals and Reproduction. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00269-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Levine AM, Gerstle DB. Female breast cancer mortality in relation to puberty on Staten Island, New York. AIMS Public Health 2020; 7:344-353. [PMID: 32617361 PMCID: PMC7327401 DOI: 10.3934/publichealth.2020029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/04/2020] [Indexed: 11/18/2022] Open
Abstract
Pursuant to a Congressional act in 2008, the Department of Health and Human Services established the Interagency Breast Cancer and Environmental Research Coordinating Committee to address the burden of breast cancer in the United States. Subsequently, the Committee recommended researchers study the timing of exposure to breast cancer risk factors. Given the high breast cancer mortality rate on Staten Island, this paper presents a case-control study investigating breast cancer risk associated with puberty while living on Staten Island. The dataset combined New York City Department of Health and Mental Hygiene female death certificate information between 1985 and 2006, with life history information from newspaper obituaries. Data analyzed included: age, length of residence on Staten Island, birth on Staten Island, and residence on Staten Island during puberty. Cases were individuals who died of breast cancer and controls were individuals who died of non-malignant causes. Analysis included multivariate logistic regression on the full dataset and multiple replicates of randomized one case to two controls simulations. Results indicated that living on Staten Island during puberty (ages 9-19) was associated with an elevated risk of dying from breast cancer (odds ratio 1.35, p < 0.001, 95% CI = 1.18, 1.55). This paper suggests the importance of studying puberty as a window of susceptibility for breast cancer risk.
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Affiliation(s)
- Alfred M Levine
- Center for Environmental Science, College of Staten Island, Staten Island, New York, USA.,Engineering and Environmental Science, College of Staten Island, Staten Island, New York, USA
| | - Donna B Gerstle
- Center for Environmental Science, College of Staten Island, Staten Island, New York, USA
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30
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Henriksen LS, Mathiesen BK, Assens M, Krause M, Skakkebæk NE, Juul A, Andersson AM, Hart RJ, Newnham JP, Keelan JA, Pennell C, Main KM, Frederiksen H. Use of stored serum in the study of time trends and geographical differences in exposure of pregnant women to phthalates. ENVIRONMENTAL RESEARCH 2020; 184:109231. [PMID: 32087443 DOI: 10.1016/j.envres.2020.109231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Exposure to some phthalate diesters has been associated with adverse reproductive health outcomes in both rodents and humans indicative of anti-androgenic effects. Exposure during sensitive periods of development, such as prenatally, is of particular concern. OBJECTIVES We wished to investigate whether phthalate metabolites measured in maternal serum samples from historical birth cohorts can be used to assess prenatal exposure. Further, we aimed to study temporal and geographical trends in phthalate exposure across three different birth cohorts. METHODS We compared phthalate metabolite levels in maternal serum samples from an Australian (1989-91) and a Danish (1997-2001) birth cohort with levels in serum and urine samples from a recent Danish birth cohort (2012-14). Samples were analysed for 32 phthalate metabolites from 15 phthalate diesters by isotope-diluted liquid chromatography-tandem mass spectrometry (LC-MS/MS). Correlations between metabolites were tested by Spearman rank correlation test, and differences between the cohorts were tested by Mann-Whitney U test. RESULTS Overall, we observed large variations in serum phthalate metabolite levels between individuals. Secondary metabolites of di-(2-ethyl-hexyl) phthalate (DEHP) and di-iso-nonyl phthalate (DiNP) in serum were weakly to moderately and positively correlated to the levels measured in urine, and secondary metabolites of DEHP were also moderately to strongly and significantly correlated in serum. Correlations with mono-(2-ethyl-hexyl) phthalate (MEHP) and mono-iso-nonyl phthalate (MiNP), the two primary metabolites of DEHP and DiNP, were inconsistent, and we found indications of sample contamination. We observed some significant differences in phthalate metabolite levels between the three cohorts with generally higher levels in the older birth cohorts. CONCLUSION Based on comparison across two older birth cohorts and a recent cohort, our results support the concept that historical biobanked serum samples may be used for assessment of prenatal exposure to phthalates when using serum levels of the monoesters of the low-molecular weight (LMW) phthalates and the secondary metabolites of the high-molecular weight (HMW) phthalates. Serum phthalate measurements are, however, not suitable for human biomonitoring and should only be used to exploit historical samples from cohorts, where urine samples were not collected. Our findings suggest that phthalate exposure may have decreased over time from the early 1990s to the 2010s.
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Affiliation(s)
- Louise S Henriksen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
| | - Barbara K Mathiesen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Maria Assens
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Marianna Krause
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Niels Erik Skakkebæk
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Roger J Hart
- Division of Obstetrics & Gynaecology, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, 6008, Australia; Fertility Specialists of Western Australia, Bethesda Hospital, 25 Queenslea Drive, Claremont, WA, 6010, Australia
| | - John P Newnham
- Division of Obstetrics & Gynaecology, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, 6008, Australia
| | - Jeffrey A Keelan
- Division of Obstetrics & Gynaecology, Faculty of Health & Medical Sciences, University of Western Australia, Perth, WA, 6008, Australia
| | - Craig Pennell
- Discipline of Obstetrics and Gynaecology, School of Medicine and Public Health, Faculty of Medicine and Health, The University of Newcastle, New South Wales, Australia
| | - Katharina M Main
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
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Golestanzadeh M, Riahi R, Kelishadi R. Association of phthalate exposure with precocious and delayed pubertal timing in girls and boys: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2020; 22:873-894. [PMID: 32091510 DOI: 10.1039/c9em00512a] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Exposure to phthalate derivatives has adverse effects on the health and development of humans, especially for children. A growing body of evidence supports the idea that exposure to phthalates can change an individual's physiological set point and the time of puberty in both genders. In this systematic review and meta-analysis, recent studies were evaluated to obtain systematic and regulation results in relation to puberty status and phthalate exposure in girls and boys. We searched English-language papers using Scopus, ISI, and PubMed databases as search engines, with no restriction of time, until the end of July 2019. A comprehensive literature search for an association between phthalate exposure and signs of puberty as well as levels of different types of hormones was carefully performed. Of the 67 studies retained for full-text screening, 39 studies were eligible for data management and extraction. For conducting a meta-analysis, four studies had appropriate effect size and metrics for pooling in the meta-analysis. Our findings revealed that low and high exposure to phthalates could alter pubertal development in both genders; the effects were either early or delayed puberty such as changes in the pubarche, thelarche, and menarche time, as well as in testicular volume. We statistically analyzed the association of pubic-hair development, breast development, and menarche time with exposure to phthalates in girls. For example, the pooled odds ratios of mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) in relation to breast development were (OR: 1.48, 95% CI: 1.11-1.85) and (OR: 1.52, 95% CI: 1.15-1.58) (P-value < 0.001), respectively. In addition, we analyzed the correlation between pubic-hair development and testicular volume with exposure to phthalates in boys. To the best of our knowledge, this is the first systematic review and meta-analysis of its kind for girls and boys. In conclusion, we found that a positive association exists between phthalate exposure and pubertal timing in the pediatric age group. Therefore, prevention of exposure to phthalates and reduction of their use should be underscored in the strategies for primordial prevention of pubertal timing and related consequences.
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Affiliation(s)
- Mohsen Golestanzadeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Suh J, Choi HS, Kwon A, Chae HW, Kim HS. Effect of agricultural pesticide on precocious puberty in urban children: an exploratory study. Clin Exp Pediatr 2020; 63:146-150. [PMID: 32024321 PMCID: PMC7170788 DOI: 10.3345/cep.2019.00416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/01/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The incidence of precocious puberty has increased throughout the 20th century. The association between precocious puberty and endocrine disrupting chemicals including agricultural pesticides has been a subject of global study, but human data are lacking. PURPOSE We investigated the relationship between agricultural pesticides and the development of precocious puberty. METHODS We enrolled 60 female subjects at Severance Children's Hospital from December 2015 to January 2017. Of them, 30 were diagnosed with precocious puberty, while the other 30 prepubertal girls were enrolled as normal controls. We investigated their clinical characteristics and analyzed the urinary levels of 320 different agricultural pesticides. RESULTS Agricultural pesticide was detected in one of 30 patients with precocious puberty (3.3%) versus 2 of 30 girls in the normal control group (3.3% vs. 6.7%, P=0.554). Dinotefuran, a neonicotinoid-class insecticide, was detected in the samples of all 3 positive subjects. CONCLUSION Our results showed no relationship between agricultural pesticides and the development of precocious puberty. Larger sample sizes and robustly controlled variables are necessary to further investigate this topic.
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Affiliation(s)
- Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Han Saem Choi
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Cathey A, Watkins DJ, Sánchez BN, Tamayo-Ortiz M, Solano-Gonzalez M, Torres-Olascoaga L, Téllez-Rojo MM, Peterson KE, Meeker JD. Onset and tempo of sexual maturation is differentially associated with gestational phthalate exposure between boys and girls in a Mexico City birth cohort. ENVIRONMENT INTERNATIONAL 2020; 136:105469. [PMID: 31931345 PMCID: PMC7024044 DOI: 10.1016/j.envint.2020.105469] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/12/2019] [Accepted: 01/05/2020] [Indexed: 05/03/2023]
Abstract
Phthalates are endocrine disrupting compounds commonly found in consumer products, exposure to which may influence reproductive maturation. Effects from exposure in utero on the onset and progression of sexual development are understudied. We examined longitudinal associations between gestational phthalate exposure and sexual maturation at two points in adolescence (8-14, 9-18 years). Gestational exposure was quantified using the geometric mean of 3 trimester-specific urinary phthalate metabolite measurements. Sexual maturation was assessed using Tanner stages and menarche onset for girls and Tanner stages and testicular volume for boys. Generalized estimating equations for correlated ordinal multinomial responses were used to model relationships between phthalates and odds of transitioning to the next Tanner stage, while generalized additive (GA) mixed models were used to assess the odds of menarche. All models were adjusted for child age (centered around the mean), BMI z-score, change in BMI between visits, time (years) between visits (ΔT), and interactions between ΔT and mean-centered child age and the natural log of exposure metabolite concentration. Among girls, a doubling of gestational MBzP concentrations was associated with increased odds of being at a higher Tanner stage for breast development at 8-14 years (OR = 4.62; 95% CI: 1.38, 15.5), but with slower progression of breast development over the follow-up period (OR = 0.65 per year; 95% CI: 0.46, 0.92) after adjustment for child age and BMI z-score. Similar results were found for ∑DEHP levels and breast development. In boys, a doubling of gestational MBP concentrations was associated with lower odds of being at a higher Tanner stage for pubic hair growth at 8-14 years (OR = 0.37; 95% CI: 0.14, 0.95) but with faster progression (OR: 1.28; 95% CI: 0.97, 1.69). These results indicate that gestational phthalate exposures may impact the onset and progression of sexual development, and that these relationships differ between boys and girls.
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Affiliation(s)
- Amber Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico; Mexican Council of Science and Technology, Mexico City, Mexico
| | - Maritsa Solano-Gonzalez
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico
| | - Libni Torres-Olascoaga
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MOR, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Akgül S, Sur Ü, Düzçeker Y, Balcı A, Kızılkan MP, Kanbur N, Bozdağ G, Erkekoğlu P, Gümüş E, Kocer-Gumusel B, Derman O. Bisphenol A and phthalate levels in adolescents with polycystic ovary syndrome. Gynecol Endocrinol 2019; 35:1084-1087. [PMID: 31219355 DOI: 10.1080/09513590.2019.1630608] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Endocrine disruptors have been proposed in the etiology of polycystic ovary syndrome (PCOS) as they have the potency to interfere with hormone-sensitivity systems. The aim of this study was to evaluate the levels of bisphenol A (BPA) and phtalates in adolescents with PCOS. Sixty-two girls with PCOS and 33 controls, age 12-18 years were enrolled in the study. The diagnosis of PCOS was made using modified Rotterdam criteria. Urinary BPA levels were measured using high-performance liquid chromatography. Di-(2-ethylhexyl)-phthalate (DEHP), the most commonly used phthalate and mono-(2-ethylhexyl)-phthalate (MEHP), its main metabolite were measured by using high-performance liquid chromatography. Adolescents with PCOS had markedly increased BPA levels (15.89 μg/g creatine ± 1.16) when compared with the control group (7.30 μg/g creatine ± 1.38) (p = .016). In adolescents with PCOS, BPA was significantly correlated with polycystic morphology on ultrasound but not with obesity androgen levels, or other metabolic parameters. Patients with PCOS (DEHP: 0.40 ppm ± 0.24, MEHP: 0.13 ppm ± 0.23) and controls (DEHP: 0.49 ppm ± 0.27, MEHP: 0.14 ppm ± 0.3) had similar serum phtalate concentrations (p = .7 and p = .3, respectively). Exposure to specific endocrine disruptors such as BPA could modify neuroendocrine, reproductive, and metabolic regulation favoring PCOS development in adolescents.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Ünzile Sur
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Aylin Balcı
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | | | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Gürkan Bozdağ
- Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Pınar Erkekoğlu
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Ersin Gümüş
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Belma Kocer-Gumusel
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Windham GC, Soriano JW, Dobraca D, Sosnoff CS, Hiatt RA, Kushi LH. Environmental Tobacco Smoke Exposure in Relation to Family Characteristics, Stressors and Chemical Co-Exposures in California Girls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214208. [PMID: 31671594 PMCID: PMC6862570 DOI: 10.3390/ijerph16214208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 02/07/2023]
Abstract
Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in the CYGNET Study. Data were collected from families of girls aged 6–8 years old in Northern California, through clinic exams, questionnaires and biospecimens (n = 421). Linear regression and factor analysis were conducted to explore predictors of urinary cotinine and co-exposure body burdens, respectively. In unadjusted models, geometric mean cotinine concentrations were higher among Black (0.59 ug/g creatinine) than non-Hispanic white (0.27), Asian (0.32), or Hispanic (0.34) participants. Following adjustment, living in a rented home, lower primary caregiver education, and lack of two biologic parents in the home were associated with higher cotinine concentrations. Girls who experienced parental separation or unemployment in the family had higher unadjusted cotinine concentrations. Higher cotinine was also associated with higher polybrominated diphenyl ether and metals concentrations. Our findings have environmental justice implications as Black and socio-economically disadvantaged young girls experienced higher ETS exposure, also associated with higher exposure to other chemicals. Efforts to reduce ETS and co-exposures should account for other disparity-related factors.
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Affiliation(s)
- Gayle C Windham
- Environmental Health Investigations Branch, CA Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA.
| | - Jasmine W Soriano
- Sequoia Foundation, 2166 Avenida de la Playa, Suite D, La Jolla, San Diego, CA 92037, USA.
| | - Dina Dobraca
- Environmental Health Investigations Branch, CA Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA.
| | - Connie S Sosnoff
- Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, USA.
| | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California, 550 16th Street, 2nd floor, Box #0560, San Francisco, CA 94143, USA.
| | - Lawrence H Kushi
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA.
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Radke EG, Glenn BS, Braun JM, Cooper GS. Phthalate exposure and female reproductive and developmental outcomes: a systematic review of the human epidemiological evidence. ENVIRONMENT INTERNATIONAL 2019; 130:104580. [PMID: 31351310 PMCID: PMC9400136 DOI: 10.1016/j.envint.2019.02.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/23/2018] [Accepted: 02/01/2019] [Indexed: 05/19/2023]
Abstract
OBJECTIVE We performed a systematic review of the epidemiology literature to identify the female reproductive and developmental effects associated with phthalate exposure. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA Six phthalates were included in the review: di(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP). The initial literature search (of PubMed, Web of Science, and Toxline) included all studies of female reproductive and developmental effects in humans, and outcomes were selected for full systematic review based on data availability. STUDY EVALUATION AND SYNTHESIS METHODS For each outcome, studies were evaluated using criteria defined a priori for risk of bias and sensitivity by two reviewers using a domain-based approach. Evidence was synthesized by outcome and phthalate and strength of evidence was summarized using a structured framework. RESULTS The primary outcomes reviewed here are (number of included/excluded studies in parentheses): pubertal development (5/13), time to pregnancy (3/4), preterm birth (8/12), and spontaneous abortion (5/0). Among these outcomes, preterm birth had moderate evidence of a positive association with phthalate exposure (specifically DEHP, DBP, and DEP). Exposure levels for BBP, DIBP, and DINP were generally lower than for the phthalates with an observed effect, which may partially explain the difference due to lower sensitivity. Other phthalate/outcome combinations were considered to have slight or indeterminate evidence of an association. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Overall, these results support that some phthalates may be associated with higher odds of preterm birth in humans, though there is some remaining inconsistency. More evidence is needed on the mechanism and relevant exposure window for this association. The views expressed are those of the authors and do not necessarily represent the views or policies of the U.S. EPA.
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Affiliation(s)
- Elizabeth G Radke
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States.
| | - Barbara S Glenn
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States
| | - Joseph M Braun
- Brown University, School of Public Health, United States
| | - Glinda S Cooper
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States; The Innocence Project, United States
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Terry MB, Michels KB, Brody JG, Byrne C, Chen S, Jerry DJ, Malecki KMC, Martin MB, Miller RL, Neuhausen SL, Silk K, Trentham-Dietz A. Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research. Breast Cancer Res 2019; 21:96. [PMID: 31429809 PMCID: PMC6701090 DOI: 10.1186/s13058-019-1168-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman’s life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention. Main text Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland’s structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals—including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols—and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers. Conclusions An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective.
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Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1611, New York, NY, 10032, USA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Drive South, CHS 71-254, Los Angeles, CA, 90095, USA
| | | | - Celia Byrne
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road A-1039F, Bethesda, MD, 20814, USA
| | - Shiuan Chen
- Department of Cancer Biology, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, Duarte, CA, 91010, USA
| | - D Joseph Jerry
- Pioneer Valley Life Sciences Institute and Department of Veterinary & Animal Sciences, University of Massachusetts Amherst, 661 North Pleasant St., Amherst, MA, 01003, USA
| | - Kristen M C Malecki
- Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 605, Madison, WI, 53726, USA
| | - Mary Beth Martin
- Departments of Oncology and Biochemistry & Molecular Biology, Georgetown University Medical Center, E411 New Research Building, Washington, DC, 20057, USA
| | - Rachel L Miller
- Departments of Medicine, Pediatrics, Environmental Health Sciences; Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, PH8E-101B, 630 W. 168th St, New York, NY, 10032, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Kami Silk
- Department of Communication, University of Delaware, 250 Pearson Hall, 125 Academy St, Newark, DE, 19716, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 307, Madison, WI, 53726, USA.
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Harley KG, Berger KP, Kogut K, Parra K, Lustig RH, Greenspan LC, Calafat AM, Ye X, Eskenazi B. Association of phthalates, parabens and phenols found in personal care products with pubertal timing in girls and boys. Hum Reprod 2019; 34:109-117. [PMID: 30517665 DOI: 10.1093/humrep/dey337] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/24/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Are in-utero or peripubertal exposures to phthalates, parabens and other phenols found in personal care products associated with timing of pubertal onset in boys and girls? SUMMARY ANSWER We found some associations of altered pubertal timing in girls, but little evidence in boys. WHAT IS KNOWN ALREADY Certain chemicals in personal care and consumer products, including low molecular weight phthalates, parabens and phenols, or their precursors, are associated with altered pubertal timing in animal studies. STUDY DESIGN, SIZE, DURATION Data were from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) longitudinal cohort study which followed 338 children in the Salinas Valley, California, from before birth to adolescence. PARTICIPANTS/MATERIALS, SETTING, METHODS Pregnant women were enrolled in 1999-2000. Mothers were mostly Latina, living below the federal poverty threshold and without a high school diploma. We measured concentrations of three phthalate metabolites (monoethyl phthalate [MEP], mono-n-butyl phthalate and mono-isobutyl phthalate), methyl and propyl paraben and four other phenols (triclosan, benzophenone-3 and 2,4- and 2,5-dichlorophenol) in urine collected from mothers during pregnancy and from children at age 9. Pubertal timing was assessed among 179 girls and 159 boys every 9 months between ages 9 and 13 using clinical Tanner staging. Accelerated failure time models were used to obtain mean shifts of pubertal timing associated with concentrations of prenatal and peripubertal biomarkers. MAIN RESULTS AND THE ROLE OF CHANCE In girls, we observed earlier onset of pubic hair development with prenatal urinary MEP concentrations and earlier menarche with prenatal triclosan and 2,4-dichlorophenol concentrations. Regarding peripubertal biomarkers, we observed: earlier breast development, pubic hair development and menarche with methyl paraben; earlier menarche with propyl paraben; and later pubic hair development with 2,5-dichlorophenol. In boys, we observed no associations with prenatal urinary biomarker concentrations and only one association with peripubertal concentrations: earlier genital development with propyl paraben. LIMITATIONS, REASONS FOR CAUTION These chemicals are quickly metabolized and one to two urinary measurements per developmental point may not accurately reflect usual exposure. Associations of peripubertal measurements with parabens may reflect reverse causality: children going through puberty early may be more likely to use personal care products. The study population was limited to Latino children of low socioeconomic status living in a farmworker community and may not be widely generalizable. WIDER IMPLICATIONS OF THE FINDINGS This study contributes to a growing literature that suggests that exposure to certain endocrine disrupting chemicals may impact timing of puberty in children. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the National Institute of Environmental Health Sciences and the US Environmental Protection Agency. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA, USA
| | - Kimberly P Berger
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA, USA
| | - Katherine Kogut
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA, USA
| | - Kimberly Parra
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA, USA
| | - Robert H Lustig
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA
| | - Louise C Greenspan
- Department of Pediatrics, Kaiser Permanente, 2238 Geary Blvd., San Francisco, CA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA, USA
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Baken KA, Lambrechts N, Remy S, Mustieles V, Rodríguez-Carrillo A, Neophytou CM, Olea N, Schoeters G. A strategy to validate a selection of human effect biomarkers using adverse outcome pathways: Proof of concept for phthalates and reproductive effects. ENVIRONMENTAL RESEARCH 2019; 175:235-256. [PMID: 31146096 DOI: 10.1016/j.envres.2019.05.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 05/21/2023]
Abstract
Human biomonitoring measures the concentrations of environmental chemicals or their metabolites in body fluids or tissues. Complementing exposure biomarkers with mechanistically based effect biomarkers may further elucidate causal pathways between chemical exposure and adverse health outcomes. We combined information on effect biomarkers previously implemented in human observational studies with mechanisms of action reported in experimental studies and with information from published Adverse Outcome Pathways (AOPs), focusing on adverse reproductive effects of phthalate exposure. Phthalates constitute a group of chemicals that are ubiquitous in consumer products and have been related to a wide range of adverse health effects. As a result of a comprehensive literature search, we present an overview of effect biomarkers for reproductive toxicity that are substantiated by mechanistic information. The activation of several receptors, such as PPARα, PPARγ, and GR, may initiate events leading to impaired male and female fertility as well as other adverse effects of phthalate exposure. Therefore, these receptors appear as promising targets for the development of novel effect biomarkers. The proposed strategy connects the fields of epidemiology and toxicology and may strengthen the weight of evidence in observational studies that link chemical exposures to health outcomes.
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Affiliation(s)
- Kirsten A Baken
- Unit Health, Flemish Institute for Technological Research (VITO NV), Mol, Belgium.
| | - Nathalie Lambrechts
- Unit Health, Flemish Institute for Technological Research (VITO NV), Mol, Belgium
| | - Sylvie Remy
- Unit Health, Flemish Institute for Technological Research (VITO NV), Mol, Belgium; Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Vicente Mustieles
- Biosanitary Research Institute of Granada (ibs.GRANADA), University Hospitals of Granada, Granada, Spain; Center for Biomedical Research (CIBM), University of Granada, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain
| | | | - Christiana M Neophytou
- Department of Biological Sciences, School of Pure and Applied Sciences, University of Cyprus, Nicosia, Cyprus
| | - Nicolas Olea
- Biosanitary Research Institute of Granada (ibs.GRANADA), University Hospitals of Granada, Granada, Spain; Center for Biomedical Research (CIBM), University of Granada, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain
| | - Greet Schoeters
- Unit Health, Flemish Institute for Technological Research (VITO NV), Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Lee JE, Jung HW, Lee YJ, Lee YA. Early-life exposure to endocrine-disrupting chemicals and pubertal development in girls. Ann Pediatr Endocrinol Metab 2019; 24:78-91. [PMID: 31261471 PMCID: PMC6603611 DOI: 10.6065/apem.2019.24.2.78] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Abstract
Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.
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Affiliation(s)
- Jeong Eun Lee
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea
| | - Yun Jeong Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea,Address for correspondence: Young Ah Lee, MD, PhD Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-2082 Fax: +82-2-2072-3917 E-mail:
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Ahern TP, Broe A, Lash TL, Cronin-Fenton DP, Ulrichsen SP, Christiansen PM, Cole BF, Tamimi RM, Sørensen HT, Damkier P. Phthalate Exposure and Breast Cancer Incidence: A Danish Nationwide Cohort Study. J Clin Oncol 2019; 37:1800-1809. [PMID: 30995175 DOI: 10.1200/jco.18.02202] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Phthalate exposure is ubiquitous and especially high among users of drug products formulated with phthalates. Some phthalates mimic estradiol and may promote breast cancer. Existing epidemiologic studies on this topic are small, mostly not prospective, and have given inconsistent results. We estimated associations between longitudinal phthalate exposures and breast cancer risk in a Danish nationwide cohort, using redeemed prescriptions for phthalate-containing drug products to measure exposure. METHODS We ascertained the phthalate content of drugs marketed in Denmark using an internal Danish Medicines Agency ingredient database. We enrolled a Danish nationwide cohort of 1.12 million women at risk for a first cancer diagnosis on January 1, 2005. By combining drug ingredient data with the Danish National Prescription registry, we characterized annual, cumulative phthalate exposure through redeemed prescriptions. We then fit multivariable Cox regression models to estimate associations between phthalate exposures and incident invasive breast carcinoma according to tumor estrogen receptor status. RESULTS Over 9.99 million woman-years of follow-up, most phthalate exposures were not associated with breast cancer incidence. High-level dibutyl phthalate exposure (≥ 10,000 cumulative mg) was associated with an approximately two-fold increase in the rate of estrogen receptor-positive breast cancer (hazard ratio, 1.9; 95% CI, 1.1 to 3.5), consistent with in vitro evidence for an estrogenic effect of this compound. Lower levels of dibutyl phthalate exposure were not associated with breast cancer incidence. CONCLUSION Our results suggest that women should avoid high-level exposure to dibutyl phthalate, such as through long-term treatment with pharmaceuticals formulated with dibutyl phthalate.
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Affiliation(s)
| | - Anne Broe
- 2 University of Southern Denmark, Odense, Denmark.,3 Odense University Hospital, Odense, Denmark
| | - Timothy L Lash
- 4 Emory University, Atlanta, GA.,5 Aarhus University Hospital/Randers Regional Hospital, Aarhus, Denmark
| | | | | | | | | | - Rulla M Tamimi
- 6 Brigham and Women's Hospital, Boston, MA.,7 Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Per Damkier
- 2 University of Southern Denmark, Odense, Denmark.,3 Odense University Hospital, Odense, Denmark
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Aylwin CF, Toro CA, Shirtcliff E, Lomniczi A. Emerging Genetic and Epigenetic Mechanisms Underlying Pubertal Maturation in Adolescence. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2019; 29:54-79. [PMID: 30869843 DOI: 10.1111/jora.12385] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The adolescent transition begins with the onset of puberty which, upstream in the brain, is initiated by the gonadotropin-releasing hormone (GnRH) pulse generator that activates the release of peripheral sex hormones. Substantial research in human and animal models has revealed a myriad of cellular networks and heritable genes that control the GnRH pulse generator allowing the individual to begin the process of reproductive competence and sexual maturation. Here, we review the latest knowledge in neuroendocrine pubertal research with emphasis on genetic and epigenetic mechanisms underlying the pubertal transition.
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Encarnação T, Pais AACC, Campos MG, Burrows HD. Endocrine disrupting chemicals: Impact on human health, wildlife and the environment. Sci Prog 2019; 102:3-42. [PMID: 31829784 PMCID: PMC10424550 DOI: 10.1177/0036850419826802] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Endocrine disrupting chemicals are a group of pollutants that can affect the endocrine system and lead to diseases and dysfunctions across the lifespan of organisms. They are omnipresent. They are in the air we breathe, in the food we eat and in the water we drink. They can be found in our everyday lives through personal care products, household cleaning products, furniture and in children's toys. Every year, hundreds of new chemicals are produced and released onto the market without being tested, and they reach our bodies through everyday products. Permanent exposure to those chemicals may intensify or even become the main cause for the development of diseases such as type 2 diabetes, obesity, cardiovascular diseases and certain types of cancer. In recent years, legislation and regulations have been implemented, which aim to control the release of potentially adverse endocrine disrupting chemicals, often invoking the precautionary principle. The objective of this review is to provide an overview of research on environmental aspects of endocrine disrupting chemicals and their effects on human health, based on evidence from animal and human studies. Emphasis is given to three ubiquitous and persistent groups of chemicals, polychlorinated biphenyls, polybrominated diphenyl ethers and organochlorine pesticides, and on two non-persistent, but ubiquitous, bisphenol A and phthalates. Some selected historical cases are also presented and successful cases of regulation and legislation described. These led to a decrease in exposure and consequent minimization of the effects of these compounds. Recommendations from experts on this field, World Health Organization, scientific reports and from the Endocrine Society are included.
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Affiliation(s)
- Telma Encarnação
- CQC, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Alberto ACC Pais
- CQC, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Maria G Campos
- CQC, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Hugh D Burrows
- CQC, Department of Chemistry, University of Coimbra, Coimbra, Portugal
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Reeves KW, Díaz Santana M, Manson JE, Hankinson SE, Zoeller RT, Bigelow C, Sturgeon SR, Spiegelman D, Tinker L, Luo J, Chen B, Meliker J, Bonner MR, Cote ML, Cheng TYD, Calafat AM. Urinary Phthalate Biomarker Concentrations and Postmenopausal Breast Cancer Risk. J Natl Cancer Inst 2019; 111:1059-1067. [PMID: 30629220 PMCID: PMC6792088 DOI: 10.1093/jnci/djz002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/28/2018] [Accepted: 01/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Growing laboratory and animal model evidence supports the potentially carcinogenic effects of some phthalates, chemicals used as plasticizers in a wide variety of consumer products, including cosmetics, medications, and vinyl flooring. However, prospective data on whether phthalates are associated with human breast cancer risk are lacking. METHODS We conducted a nested case-control study within the Women's Health Initiative (WHI) prospective cohort (n = 419 invasive case subjects and 838 control subjects). Control subjects were matched 2:1 to case subjects on age, enrollment date, follow-up time, and WHI study group. We quantified 13 phthalate metabolites and creatinine in two or three urine samples per participant over one to three years. Multivariable conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for breast cancer risk associated with each phthalate biomarker up to 19 years of follow-up. RESULTS Overall, we did not observe statistically significant positive associations between phthalate biomarkers and breast cancer risk in multivariable analyses (eg, 4th vs 1st quartile of diethylhexyl phthalate, OR = 1.03, 95% CI = 0.91 to 1.17). Results were generally similar in analyses restricted to disease subtypes, to nonusers of postmenopausal hormone therapy, stratified by body mass index, or to case subjects diagnosed within three, five, or ten years. CONCLUSIONS In the first prospective analysis of phthalates and postmenopausal breast cancer, phthalate biomarker concentrations did not result in an increased risk of developing invasive breast cancer.
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Affiliation(s)
- Katherine W Reeves
- Correspondence to: Katherine W. Reeves, PhD, MPH, Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 (e-mail: )
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Muñoz I, Colacino JA, Lewis RC, Arthur AE, Meeker JD, Ferguson KK. Associations between school lunch consumption and urinary phthalate metabolite concentrations in US children and adolescents: Results from NHANES 2003-2014. ENVIRONMENT INTERNATIONAL 2018; 121:287-295. [PMID: 30223205 PMCID: PMC6221921 DOI: 10.1016/j.envint.2018.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 05/05/2023]
Abstract
Diet is a major route of phthalate exposure in humans due to use in food packaging materials. School lunches may be an important contributor to phthalate exposure in children and adolescents in the US because of the large amount of packaging necessary for mass-produced foods. We used 2003-2014 National Health and Nutrition Examination Survey data to study the association between school lunch consumption and urinary phthalate metabolite concentrations in children (ages 6-11 years, N = 2196) and adolescents (ages 12-19 years, N = 2314). After adjustment for other covariates, children who Always consumed school lunch had significantly elevated urinary concentrations of the following phthalate metabolites compared to levels in children who Never ate school lunch: sum of di(2‑ethylhexyl) phthalate metabolites, (28% higher, 95% confidence interval, CI: 10, 49%); mono‑(carboxy‑octyl) phthalate (MCOP; 43% higher, 95% CI: 17, 76%) and mono‑n‑butyl phthalate (18% higher, 95% CI: 3.5, 34%). We did not find statistically significant associations in adolescents, but the trend for MCOP concentrations was similar to that of children. In sensitivity analyses, associations between 24-hour recall of cafeteria food and urinary phthalate metabolites were not statistically significant, which could indicate that associations observed with Always consuming school lunch are due to residual confounding. Our findings show that children who Always eat school lunch had higher levels of exposure to some phthalates, but the source of differences in exposure need to be evaluated in additional studies.
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Affiliation(s)
- Isabel Muñoz
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Justin A Colacino
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ryan C Lewis
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Carle Cancer Center, Carle Foundation Hospital, Urbana, IL, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Lewis K, Kulkarni S, Adams SA, Brandt HM, Lead JR, Ureda JR, Fedrick D, Mathews C, Friedman DB. "For lack of knowledge, our people will perish": Using focus group methodology to explore African-American communities' perceptions of breast cancer and the environment. ENVIRONMENT INTERNATIONAL 2018; 121:111-118. [PMID: 30195624 PMCID: PMC6221986 DOI: 10.1016/j.envint.2018.08.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 05/27/2023]
Abstract
Among women living in the United States, breast cancer is the second leading cause of cancer death. Disproportionate racial disparities in breast cancer exist, with African American (AA) women consistently having the highest rates of breast cancer related mortality despite lower incidence. This study attends to the Institute of Medicine's (IOM) call to action recommending the identification of effective strategies for communicating accurate and reliable breast cancer risk information to diverse audiences. Using focus group methodology, this study explores how AAs perceive and decipher information related to breast cancer and its relationship to their environment. Six focus groups were conducted. The sample (n = 50) was African American, 98% female, with an average age of 50.1 years. The focus group protocol consisted of open-ended questions designed to elicit information about participants' perceptions of their environment and its link to breast cancer. Focus groups were audio recorded and professionally transcribed. Analysis of the focus group transcripts revealed themes pertaining to these categories: (1) general knowledge and beliefs about breast cancer, (2) perceived environmental risks factors for breast cancer, (3) importance of seeking knowledge about breast cancer and the environment, and (4) recommended communication strategies. The emergent themes reflect the knowledge participants possessed about breast cancer and environmental risk factors, in addition to concerns about the importance of possessing accurate information, and how culturally appropriate health communication strategies can be used to disseminate breast cancer knowledge in the community. Findings from this study can be used for culturally appropriate communication about breast cancer and the environment with AA communities.
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Affiliation(s)
- Kaleea Lewis
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Lewis: ; Kulkarni: ; Brandt: ; Friedman
| | - Shibani Kulkarni
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Lewis: ; Kulkarni: ; Brandt: ; Friedman
| | - Swann Arp Adams
- Department of Epidemiology & Biostatistics, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Adams:
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208
- Statewide Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street Columbia, SC 29208
| | - Heather M. Brandt
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Lewis: ; Kulkarni: ; Brandt: ; Friedman
- Statewide Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street Columbia, SC 29208
| | - Jamie R. Lead
- Department of Environmental Health Sciences, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Lead:
- Center for Environmental Nanoscience and Risk, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208
| | - John R. Ureda
- Insights Consulting, Inc., 1441 St Andrews Rd, Columbia, SC 29210; Ureda:
| | - Delores Fedrick
- Chester County Literacy Council, 109 Ella Street Chester, SC 29706; Fedrick:
| | - Chris Mathews
- Turning Pages Greater Columbia Literacy Council, 4840 Forest Drive, Suite 6B-PMB 267 Columbia, SC 29206; Mathews:
| | - Daniela B. Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208; Lewis: ; Kulkarni: ; Brandt: ; Friedman
- Statewide Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street Columbia, SC 29208
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Berger K, Eskenazi B, Kogut K, Parra K, Lustig RH, Greenspan LC, Holland N, Calafat AM, Ye X, Harley KG. Association of Prenatal Urinary Concentrations of Phthalates and Bisphenol A and Pubertal Timing in Boys and Girls. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:97004. [PMID: 30203993 PMCID: PMC6375461 DOI: 10.1289/ehp3424] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/12/2018] [Accepted: 08/02/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Animal studies suggest that phthalates and bisphenol A (BPA), endocrine-disrupting chemicals found in many consumer products, may impact the timing of puberty. OBJECTIVES We aimed to determine the association of prenatal exposure to high-molecular-weight phthalates and BPA with pubertal timing in boys and girls participating in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) longitudinal cohort study. METHODS We quantified urinary concentrations of eight phthalate metabolites and BPA at two time points during pregnancy among participating mothers ([Formula: see text]) and conducted clinical Tanner staging of puberty on their children every 9 months between 9 and 13 y of age. We conducted accelerated failure time models and examined the role of child overweight/obese status in this association. RESULTS The sum of urinary metabolites of di(2-ethylhexyl) phthalate [Formula: see text], monobenzyl phthalate (MBzP), and BPA were associated with later onset of at least one of the three outcomes assessed in girls (thelarche, pubarche, or menarche) and with earlier onset of at least one of the two outcomes assessed in boys (gondarche and pubarche). We found that monocarboxynonyl phthalate, monocarboxyoctyl phthalate, mono(3-carboxypropyl) phthalate, and BPA were associated with later pubarche and menarche mostly among normal-weight girls but not overweight/obese girls. MBzP was associated with later thelarche in all girls, and [Formula: see text] was associated with later thelarche and menarche in all girls. BPA and all phthalate biomarkers were associated with earlier gonadarche and pubarche in all boys as well as in overweight/obese boys when stratified by weight. Among normal-weight boys, associations with BPA were also inverse, whereas associations with phthalate metabolites were close to the null or positive. CONCLUSIONS Several high-molecular-weight phthalates and BPA were associated with later puberty in girls and earlier puberty in boys included in the CHAMACOS cohort study. Childhood overweight/obesity may modify these associations. https://doi.org/10.1289/EHP3424.
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Affiliation(s)
- Kimberly Berger
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Brenda Eskenazi
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Katherine Kogut
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Kimberly Parra
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Robert H Lustig
- 2 Department of Pediatrics, University of California, San Francisco , San Francisco, California, USA
| | - Louise C Greenspan
- 3 Department of Pediatrics, Kaiser Permanente , San Francisco, California, USA
| | - Nina Holland
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Antonia M Calafat
- 4 Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
| | - Xiaoyun Ye
- 4 Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
| | - Kim G Harley
- 1 Center for Environmental Research and Children's Health (CERCH) , School of Public Health, University of California, Berkeley , Berkeley, California, USA
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Binder AM, Corvalan C, Pereira A, Calafat AM, Ye X, Shepherd J, Michels KB. Prepubertal and Pubertal Endocrine-Disrupting Chemical Exposure and Breast Density among Chilean Adolescents. Cancer Epidemiol Biomarkers Prev 2018; 27:1491-1499. [PMID: 30158279 DOI: 10.1158/1055-9965.epi-17-0813] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/09/2017] [Accepted: 08/23/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND During puberty, mammary tissue undergoes rapid development, which provides a window of heightened susceptibility of breast composition to the influence of endogenous and exogenous hormones. Exposure to endocrine-disrupting chemicals (EDC) may affect breast development and composition and the risk of developing breast cancer in adulthood. METHODS We evaluated the associations between breast density and urinary concentrations of phenols and phthalates collected at Tanner 1 (B1) and Tanner 4 (B4) in 200 Chilean girls. Total breast volume (BV), fibroglandular volume (FGV), and percent dense breast (%FGV) were evaluated at B4 using dual X-ray absorptiometry. Generalized estimating equations were used to analyze the association between concentrations of EDC biomarkers across puberty and breast density. RESULTS The geometric mean %FGV was 7% higher among girls in the highest relative to the lowest tertile of monocarboxyisooctyl phthalate [1.07; 95% confidence interval (CI), 1.01-1.14]. Monoethyl phthalate concentrations at B4 were positively associated with FGV (highest vs. lowest tertile: 1.22; 95% CI, 1.06-1.40). Bisphenol A displayed a U-shaped association with FGV; girls in the middle tertile had at least 10% lower FGV than girls in the lowest or highest tertiles. Monocarboxyisononyl phthalate showed a nonlinear association with BV. No other statistically significant associations were observed. CONCLUSIONS Our results suggest that the developing breast tissue is susceptible to select EDCs during childhood and adolescence. IMPACT This study may spur further investigations into environmental influences on breast development during puberty and how shifts in pubertal breast density track through the life course to modify breast cancer risk.
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Affiliation(s)
- Alexandra M Binder
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Shepherd
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California.
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Zuccarello P, Oliveri Conti G, Cavallaro F, Copat C, Cristaldi A, Fiore M, Ferrante M. Implication of dietary phthalates in breast cancer. A systematic review. Food Chem Toxicol 2018; 118:667-674. [DOI: 10.1016/j.fct.2018.06.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/12/2018] [Accepted: 06/06/2018] [Indexed: 01/08/2023]
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50
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Kulkarni S, Lewis K, Adams SA, Brandt HM, Lead JR, Ureda JR, Fedrick D, Mathews C, Friedman DB. A Comprehensive Analysis of How Environmental Risks of Breast Cancer are Portrayed on the Internet. AMERICAN JOURNAL OF HEALTH EDUCATION 2018; 49:222-233. [PMID: 30079123 PMCID: PMC6075842 DOI: 10.1080/19325037.2018.1473182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Effective online communication about the environmental risk factors of breast cancer is essential because of the multitude of environmental exposures and debate regarding the conclusiveness of scientific evidence. PURPOSE The aim of this study was to assess the content, readability, and cultural sensitivity of online resources focused on the environmental risks factors of breast cancer. METHODS A purposive sample of webpages focused on environmental risk factors of breast cancer was obtained through a Google search using 17 search terms. Using nonparametric statistics, we assessed the content, readability, and cultural appropriateness of 235 webpages. RESULTS Eighty-two percent of webpages referred to research studies in their content. For the majority of sites, readability was at a high-school reading grade level. Webpages were not explicitly intended for specific racial/ethnic groups. DISCUSSION Technical language and non-culturally specific messages may hinder users' attention to and comprehension of online breast cancer information. Additional research is needed to examine in-depth the accuracy of this online content. TRANSLATION TO HEALTH EDUCATION PRACTICE Findings suggest that collaborations between scientists, health educators, website designers/media professionals, and the community will be critical to the delivery of accurate, up-to-date, plain-language, and culturally sensitive information about breast cancer and the environment.
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Affiliation(s)
- Shibani Kulkarni
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC 29208
| | - Kaleea Lewis
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC 29208
| | - Swann Arp Adams
- Department of Epidemiology & Biostatistics, University of South Carolina
- College of Nursing, University of South Carolina
- Statewide Cancer Prevention and Control Program, 915 Greene Street, Room 244, Columbia SC 29208
| | - Heather M Brandt
- Department of Health Promotion, Education, and Behavior, University of South Carolina
- Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC 29208
| | - Jamie R Lead
- Department of Environmental Health Sciences, University of South Carolina
- Center for Environmental Nanoscience and Risk, University of South Carolina, 921 Assembly Street, Public Health Research Center, Suite 511, Columbia, SC 29208
| | - John R Ureda
- Insights Consulting, Inc. 2728 Wilmot Ave., Columbia, SC 29205-254
| | - Delores Fedrick
- Chester County Literacy Council, 109 Ella Street, Chester, SC, 29706
| | - Chris Mathews
- Turning Pages Greater Columbia Literacy Council, 4711 Forest Drive, Suite 3, PMB 267, Columbia SC 29206
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina
- Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 557, Columbia SC, 29208
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