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Christensen GM, Terrell ML, Pearce BD, Hood RB, Barton H, Pearson M, Marcus M. Exploring autism spectrum disorder (ASD) and attention deficit disorder (ADD/ADHD) in children exposed to polybrominated biphenyl. Environ Epidemiol 2024; 8:e304. [PMID: 38617420 PMCID: PMC11008633 DOI: 10.1097/ee9.0000000000000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/16/2024] [Indexed: 04/16/2024] Open
Abstract
Background Although the causes of attention-deficit/hyperactivity disorder (ADHD) and autism have not been identified, exposure to endocrine-disrupting chemicals, such as polybrominated biphenyl (PBB), during fetal development and early life has been suspected to impact neurological development. This study aims to investigate the association between prenatal and early life exposure to PBB and the development of ADHD and autism later in life. Methods Data from the Michigan PBB Registry, a cohort of Michigan residents who had been exposed to PBB in a mass contamination event in 1973, was leveraged for this nested case-control analysis among two distinct samples: (1) Those who self-reported ADHD or autism diagnosis, and (2) mothers who reported their child's ADHD or autism diagnosis. PBB exposure was measured in participants of the PBB Registry, and the mother's PBB level was used in mother-reported analyses. Cases were matched with controls by sex and year of birth. Conditional logistic regression models were used to estimate the association between PBB level and case status. Results PBB levels were higher among those who were exposed in early life compared with those exposed in utero (geometric mean: 0.300 ng/ml vs. 0.016 ng/ml). Among women in this cohort, a higher than expected proportion of self-reported ADHD diagnosis (11.11%), compared with population estimates. PBB was not associated with ADHD or autism in either self-reported or mother-reported analyses. Conclusions This study adds to the sparse literature about prenatal and early life exposure to PBB-153 and ADHD and autism. Future studies should examine potential effect modification by sex.
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Affiliation(s)
- Grace M. Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Metrecia L. Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Robert B. Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Hillary Barton
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Melanie Pearson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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2
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Hood RB, Terrell ML, Mardovich S, Somers EC, Pearson M, Barton H, Tomlinson MS, Marder ME, Barr DB, Marcus M. Polybrominated biphenyls (PBBs) and prevalence of autoimmune disorders among members of the Michigan PBB registry. ENVIRONMENTAL RESEARCH 2023; 239:117312. [PMID: 37806482 PMCID: PMC10843028 DOI: 10.1016/j.envres.2023.117312] [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: 05/17/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Polybrominated biphenyls (PBBs), a class of endocrine disrupting chemicals, were the main chemicals present in one of the largest industrial accidents in the United States. We investigated the association between serum PBB-153 levels and autoimmune disorders among members of the Michigan PBB Registry. METHODS Eight hundred and ninety-five members of the registry had both a serum PBB-153 measurement and had completed one or more questionnaires about autoimmune disorders. Autoimmune disorders were examined collectively and within specific organ systems. Sex-stratified unadjusted and adjusted log-binomial models were used to examine the association between tertiles of serum PBB-153 levels and autoimmune disorders. Models were adjusted by lifestage at exposure (in utero, childhood, adulthood), smoking history (never, past, current), and total serum lipid levels (continuous). We utilized cubic spline models to investigate non-linearity between serum PBB-153 levels and the prevalence of autoimmune disorders. RESULTS Approximately 12.9% and 20.7% of male and female participants reported having one or more autoimmune disorders, respectively. After adjustment for potential confounders, we observed no association between PBB-153 tertiles and the composite classification of 'any autoimmune disorder' in either sex. We observed some evidence for an association between serum PBB-153 levels and rheumatoid arthritis in males and females; however, this was not statistically significant in females. We also observed some evidence for an association between serum PBB-153 levels and neurological- and thyroid-related autoimmune disorders in females, but again this was not statistically significant. Additionally, we identified dose-response curves for serum PBB-153 levels and the prevalence of autoimmune disorders that differed by lifestage of exposure and sex. CONCLUSIONS We observed some evidence that increasing serum PBB-153 levels were associated with three specified autoimmune disorders. Studies focusing on these three autoimmune disorders and the potential non-linear trend differences by lifestage of exposure warrant further investigation.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Sarah Mardovich
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Emily C Somers
- Departments of Internal Medicine, Environmental Health Sciences and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Melanie Pearson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Martha Scott Tomlinson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - M Elizabeth Marder
- Department of Environmental Toxicology, University of California, Davis, CA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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3
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Hoffman SS, Liang D, Hood RB, Tan Y, Terrell ML, Marder ME, Barton H, Pearson MA, Walker DI, Barr DB, Jones DP, Marcus M. Assessing Metabolic Differences Associated with Exposure to Polybrominated Biphenyl and Polychlorinated Biphenyls in the Michigan PBB Registry. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:107005. [PMID: 37815925 PMCID: PMC10564108 DOI: 10.1289/ehp12657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Polybrominated biphenyls (PBB) and polychlorinated biphenyls (PCB) are persistent organic pollutants with potential endocrine-disrupting effects linked to adverse health outcomes. OBJECTIVES In this study, we utilize high-resolution metabolomics (HRM) to identify internal exposure and biological responses underlying PCB and multigenerational PBB exposure for participants enrolled in the Michigan PBB Registry. METHODS HRM profiling was conducted on plasma samples collected from 2013 to 2014 from a subset of participants enrolled in the Michigan PBB Registry, including 369 directly exposed individuals (F0) who were alive when PBB mixtures were accidentally introduced into the food chain and 129 participants exposed to PBB in utero or through breastfeeding, if applicable (F1). Metabolome-wide association studies were performed for PBB-153 separately for each generation and Σ PCB (PCB-118, PCB-138, PCB-153, and PCB-180) in the two generations combined, as both had direct PCB exposure. Metabolite and metabolic pathway alterations were evaluated following a well-established untargeted HRM workflow. RESULTS Mean levels were 1.75 ng / mL [standard deviation (SD): 13.9] for PBB-153 and 1.04 ng / mL (SD: 0.788) for Σ PCB . Sixty-two and 26 metabolic features were significantly associated with PBB-153 in F0 and F1 [false discovery rate (FDR) p < 0.2 ], respectively. There were 2,861 features associated with Σ PCB (FDR p < 0.2 ). Metabolic pathway enrichment analysis using a bioinformatics tool revealed perturbations associated with Σ PCB in numerous oxidative stress and inflammation pathways (e.g., carnitine shuttle, glycosphingolipid, and vitamin B9 metabolism). Metabolic perturbations associated with PBB-153 in F0 were related to oxidative stress (e.g., pentose phosphate and vitamin C metabolism) and in F1 were related to energy production (e.g., pyrimidine, amino sugars, and lysine metabolism). Using authentic chemical standards, we confirmed the chemical identity of 29 metabolites associated with Σ PCB levels (level 1 evidence). CONCLUSIONS Our results demonstrate that serum PBB-153 is associated with alterations in inflammation and oxidative stress-related pathways, which differed when stratified by generation. We also found that Σ PCB was associated with the downregulation of important neurotransmitters, serotonin, and 4-aminobutanoate. These findings provide novel insights for future investigations of molecular mechanisms underlying PBB and PCB exposure on health. https://doi.org/10.1289/EHP12657.
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Affiliation(s)
- Susan S. Hoffman
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Donghai Liang
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Robert B. Hood
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | | | - M. Elizabeth Marder
- Department of Environmental Toxicology, University of California, Davis, Davis, California, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Melanie A. Pearson
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Douglas I. Walker
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Dean P. Jones
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
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4
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Hood RB, Terrell ML, Smith AK, Curtis S, Conneely K, Pearson M, Barton H, Barr DB, Marder EM, Marcus M. Elimination of PBB-153; findings from a cohort of Michigan adults. ENVIRONMENTAL RESEARCH 2023; 220:115146. [PMID: 36566966 PMCID: PMC9898188 DOI: 10.1016/j.envres.2022.115146] [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: 11/15/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An industrial accident led to the widespread contamination of polybrominated biphenyl (PBB), a flame retardant, into the food system in Michigan in the 1970's. PBB continues to be detected in Michiganders' blood some forty years later. It is necessary to understand the elimination rate and half-life of PBB because it may provide clues on how to hasten the elimination of it from the human body. METHODS Serum samples were taken from young adult and adult participants of the Michigan PBB registry from 1974 to 2019. A single compartment model was assumed for the elimination rate for PBB-153 in young adults and adults (≥16 years). Generalized linear mixed models were used to estimate the average elimination rate of PBB-153 and allowed for a random intercept and slope for the time between measurements. Models were adjusted for age at exposure, body mass index (BMI) at initial measurement, and smoking. Models were also stratified by demographic characteristics. RESULTS In total, 1974 participants contributed 4768 samples over a forty-year span. The median initial PBB-153 level was 1.542 parts per billion (ppb) (Range: 0.001-1442.48 ppb). The adjusted median participant-specific half-life for PBB-153 was 12.23 years. The half-life of PBB-153 was lengthened by higher initial PBB level (∼1.5 years), younger age at exposure (∼5.4 years), higher BMI (∼1.0 years), and increased gravidity (∼7.3 years). Additionally, the half-life of PBB-153 was shortened by smoking status (∼-2.8 years) and breastfeeding (∼-3.5 years). CONCLUSIONS Consistent with previous studies, PBB-153 has been demonstrated to have a long half-life in the human body and may be modified by some demographic characteristics. These updated estimates of half-life will further support evaluation of health effects associated with PBB exposure. Investigations into mechanisms to accelerate elimination and reduce body burdens of PBB-153, especially those related to body weight, are needed.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Curtis
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Karen Conneely
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Melanie Pearson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Elizabeth M Marder
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Eick SM, Tan Y, Taibl KR, Barry Ryan P, Barr DB, Hüls A, Eatman JA, Panuwet P, D'Souza PE, Yakimavets V, Lee GE, Brennan PA, Corwin EJ, Dunlop AL, Liang D. Prenatal exposure to persistent and non-persistent chemical mixtures and associations with adverse birth outcomes in the Atlanta African American Maternal-Child Cohort. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023:10.1038/s41370-023-00530-4. [PMID: 36841843 PMCID: PMC10450095 DOI: 10.1038/s41370-023-00530-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND African Americans (AAs) experience higher rates of preterm birth and fetal growth restriction relative to other pregnant populations. Differential in utero exposure to environmental chemicals may partially explain these health disparities, as AAs are disproportionately exposed to environmental hazards. OBJECTIVE We examined the individual and mixture effects of non-persistent chemicals and persistent organic pollutants (POPs) on gestational age at birth and birthweight for gestational age z-scores within a prospective cohort of pregnant AAs. METHODS First-trimester serum and urine samples obtained from participants within the Atlanta African American Maternal-Child cohort were analyzed for 43 environmental chemicals, including per-and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), organochlorine pesticides, pyrethroid insecticides, phthalates, bisphenol A, nicotine, and the primary metabolite of delta-9-tetrahydrocannabinol. Linear regression was used to estimate individual associations between chemicals and gestational age and birthweight z-scores (N ranging from 107 to 523). Mixture associations were estimated using quantile g-computation, principal component (PC) analyses, and hierarchical Bayesian kernel machine regression among complete cases (N = 86). RESULTS Using quantile g-computation, increasing all chemical exposures by one quantile was modestly associated with a reduction in gestational age (mean change per quartile increase = -0.47, 95% CI = -1.56, 0.61) and birthweight z-scores (mean change per quartile increase = -0.49, 95% CI = -1.14, 0.15). All PCs were associated with a reduction in birthweight z-scores; associations were greatest in magnitude for the two PCs reflecting exposure to combined tobacco, insecticides, PBDEs, and phthalates. In single pollutant models, we observed inconsistent and largely non-significant associations. SIGNIFANCE We conducted multiple targeted exposure assessment methods to quantify levels of environmental chemicals and leveraged mixture methods to quantify their joint effects on gestational age and birthweight z-scores. Our findings suggest that prenatal exposure to multiple classes of persistent and non-persistent chemicals is associated with reduced gestational age and birthweight z-scores in AAs. IMPACT African Americans (AAs) experience higher rates of preterm birth and fetal growth restriction relative to other pregnant populations. Differential in utero exposure to environmental chemicals may partially explain these health disparities, as AAs are disproportionately exposed to environmental hazards. In the present study, we analyzed serum and urine samples for levels of 43 environmental chemicals. We used quantile g-computation, principal component analysis, and BKMR to assess associations between chemical exposure mixtures and adverse birth outcomes. Our findings suggest that prenatal exposure to multiple classes of chemicals is associated with reduced birthweight z-scores, a proxy for fetal growth, in AAs.
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Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Youran Tan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anke Hüls
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Epidemiology. Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jasmin A Eatman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Priya E D'Souza
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Volha Yakimavets
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Grace E Lee
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | - Anne L Dunlop
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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6
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Wang S, Jin J, Guo C, Li Z, Wang Y, Wei Y, Jin J. Previously identified and unidentified polybrominated biphenyl congeners in serum from people living in an electronic waste dismantling area in China. CHEMOSPHERE 2021; 279:130478. [PMID: 33857646 DOI: 10.1016/j.chemosphere.2021.130478] [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: 01/26/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
The effects of polybrominated biphenyls (PBBs) on human health have previously attracted much attention, but recent studies of PBBs have been focused on BB-153 and a few other congeners. PBB concentrations in serum samples from residents of an area containing an electronic waste dismantling site were determined in this study. The total PBB concentrations (i.e., the sums of the concentrations of the 35 PBB congeners) were 229-1360 ng/g lipid. The BB-153 concentrations were markedly higher in the samples from people living in the electronic waste dismantling area than in samples from people living in a nearby control area. BB-153 was found in all of the samples from the study exposure area but the concentrations were relatively low (0.07-4.70 ng/g lipid). High BB-1 concentrations were found for the first time in serum from people living in both the electronic waste dismantling and control areas. The BB-1 concentrations were 211-1280 ng/g lipid. The retention times of the 35 PBB standards and PCBs (polychlorinated biphenyls) with similar structures were used to predict the retention times of unidentified PBB congeners to allow the PBB distributions in the serum samples to be identified. A total of 26 previously unidentified PBB congeners were identified in the human serum samples. BB-5, BB-35, BB-79, and BB-109 were found in >50% of the samples. The PBB patterns in the serum samples were different from the patterns previously found in serum after a PBB contamination incident in 1973, so the health risks currently posed by PBBs are worth studying.
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Affiliation(s)
- Shijie Wang
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China
| | - Jingxi Jin
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China
| | - Chen Guo
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhigang Li
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Ying Wang
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China; Engineering Research Center of Food Environment and Public Health, Beijing, 100081, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China; Center for Global Health, School of Public Health, Nanjing Medical University, China.
| | - Jun Jin
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China; Engineering Research Center of Food Environment and Public Health, Beijing, 100081, China.
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Curtis SW, Cobb DO, Kilaru V, Terrell ML, Marder ME, Barr DB, Marsit CJ, Marcus M, Conneely KN, Smith AK. Genome-wide DNA methylation differences and polychlorinated biphenyl (PCB) exposure in a US population. Epigenetics 2020; 16:338-352. [PMID: 32660331 DOI: 10.1080/15592294.2020.1795605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Exposure to polychlorinated biphenyls (PCBs), an endocrine-disrupting compound, is ubiquitous despite decades-old bans on the manufacture and use of PCBs. Increased exposure to PCBs is associated with adverse health consequences throughout life, including type 2 diabetes and cancer. PCB exposure is also associated with alterations in epigenetic marks and gene transcription, which could lead to adverse health outcomes, but many of these are population-specific. To further investigate the association between PCB and epigenetic marks, DNA methylation was measured at 787,684 CpG sites in 641 peripheral blood samples from the Michigan Polybrominated Biphenyl (PBB) Registry. 1345 CpGs were associated with increased total PCB level after controlling for age, sex, and 24 surrogate variables (FDR < 0.05). These CpGs were enriched in active promoter and transcription associated regions (p < 0.05), and in regions around the binding sites for transcription factors involved in xenobiotic metabolism and immune function (FDR < 0.05). PCB exposure also associated with proportions of CD4T, NK, and granulocyte cell types, and with the neutrophil to lymphocyte ratio (NLR) (p < 0.05), and the estimated effect sizes of PCB on the epigenome were correlated with the effect sizes previously reported in an epigenome-wide study of C-reactive protein (r = 0.29; p = 2.22e-5), supporting previous studies on the association between PCB and immune dysfunction. These results indicate that PCB exposure is associated with differences in epigenetic marks in active regions of the genome, and future work should investigate whether these may mediate the association between PCB and health consequences.
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Affiliation(s)
- Sarah W Curtis
- Genetics and Molecular Biology Program, Laney Graduate School, Emory University School of Medicine , Atlanta, GA, USA
| | - Dawayland O Cobb
- Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta, GA, USA
| | - Varun Kilaru
- Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta, GA, USA
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health , Atlanta, GA, USA
| | - M Elizabeth Marder
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta, GA, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta, GA, USA
| | - Michele Marcus
- Departments of Epidemiology and Department of Pediatrics Emory University School of Medicine, Environmental Health, Emory University Rollins School of Public Health , Atlanta, GA, USA
| | - Karen N Conneely
- Department of Human Genetics, Emory University School of Medicine , Atlanta, GA, USA
| | - Alicia K Smith
- Departments of Gynecology and Obstetrics & Psychiatry and Behavioral Science, Emory University School of Medicine , Atlanta, GA, USA
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8
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Curtis SW, Gerkowicz SA, Cobb DO, Kilaru V, Terrell ML, Marder ME, Barr DB, Marsit CJ, Marcus M, Conneely KN, Smith AK. Sex-specific DNA methylation differences in people exposed to polybrominated biphenyl. Epigenomics 2020; 12:757-770. [PMID: 32496131 DOI: 10.2217/epi-2019-0179] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Michigan residents were exposed to polybrominated biphenyls (PBBs) when it was accidentally added to the food supply. Highly exposed individuals report sex-specific health problems, but the underlying biological mechanism behind these different health risks is not known. Materials and methods: DNA methylation in blood from 381 women and 277 men with PBB exposure was analyzed with the MethylationEPIC BeadChip. Results: 675 CpGs were associated with PBBs levels in males, while only 17 CpGs were associated in females (false discovery rate <0.05). No CpGs were associated in both sexes. These CpGs were enriched in different functional regions and transcription factor binding sites in each sex. Conclusion: Exposure to PBBs may have sex-specific effects on the epigenome that may underlie sex-specific adverse health outcomes.
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Affiliation(s)
- Sarah W Curtis
- Genetics & Molecular Biology Program, Laney Graduate School, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA
| | - Sabrina A Gerkowicz
- Department of Gynecology & Obstetrics, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA
| | - Dawayland O Cobb
- Department of Gynecology & Obstetrics, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA
| | - Varun Kilaru
- Department of Gynecology & Obstetrics, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA
| | - M Elizabeth Marder
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA
| | - Carmen J Marsit
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA.,Department of Pediatrics Emory University School of Medicine, 1518 Clifton Rd, Atlanta, GA 30322, USA
| | - Karen N Conneely
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St, Atlanta, GA 30322, USA
| | - Alicia K Smith
- Department of Gynecology & Obstetrics, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA.,Department of Psychiatry & Behavioral Science, Emory University School of Medicine, 101 Woodruff Circle NE, Ste 4217, Atlanta, GA 30322, USA
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9
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Greeson KW, Fowler KL, Estave PM, Kate Thompson S, Wagner C, Clayton Edenfield R, Symosko KM, Steves AN, Marder EM, Terrell ML, Barton H, Koval M, Marcus M, Easley CA. Detrimental effects of flame retardant, PBB153, exposure on sperm and future generations. Sci Rep 2020; 10:8567. [PMID: 32444626 PMCID: PMC7244482 DOI: 10.1038/s41598-020-65593-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/06/2020] [Indexed: 02/07/2023] Open
Abstract
In 1973, the Velsicol Chemical Company, which manufactured FireMaster, a brominated flame retardant, and NutriMaster, a nutritional supplement, mistakenly shipped hundreds of pounds of FireMaster to grain mills around Michigan where it was incorporated into animal feed and then into the food chain across the state. An estimated 6.5 million Michigan residents consumed polybrominated biphenyl (PBB)-laced animal products leading to one of the largest agricultural accidents in U.S. history. To date, there have been no studies investigating the effects of PBB on epigenetic regulation in sperm, which could explain some of the endocrine-related health effects observed among children of PBB-exposed parents. Fusing epidemiological approaches with a novel in vitro model of human spermatogenesis, we demonstrate that exposure to PBB153, the primary component of FireMaster, alters the epigenome in human spermatogenic cells. Using our novel stem cell-based spermatogenesis model, we show that PBB153 exposure decreases DNA methylation at regulatory elements controlling imprinted genes. Furthermore, PBB153 affects DNA methylation by reducing de novo DNA methyltransferase activity at increasing PBB153 concentrations as well as reducing maintenance DNA methyltransferase activity at the lowest tested PBB153 concentration. Additionally, PBB153 exposure alters the expression of genes critical to proper human development. Taken together, these results suggest that PBB153 exposure alters the epigenome by disrupting methyltransferase activity leading to defects in imprint establishment causing altered gene expression, which could contribute to health concerns in the children of men exposed to PBB153. While this chemical is toxic to those directly exposed, the results from this study indicate that the epigenetic repercussions may be detrimental to future generations. Above all, this model may be expanded to model a multitude of environmental exposures to elucidate the effect of various chemicals on germline epigenetics and how paternal exposure may impact the health of future generations.
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Affiliation(s)
- Katherine Watkins Greeson
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Kristen L Fowler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Cell Biology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paige M Estave
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - S Kate Thompson
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Chelsea Wagner
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R Clayton Edenfield
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Krista M Symosko
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Alyse N Steves
- Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Elizabeth M Marder
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Metrecia L Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hillary Barton
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael Koval
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Cell Biology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Charles A Easley
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA.
- Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA.
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Chang CJ, Terrell ML, Marcus M, Marder ME, Panuwet P, Ryan PB, Pearson M, Barton H, Barr DB. Serum concentrations of polybrominated biphenyls (PBBs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) in the Michigan PBB Registry 40 years after the PBB contamination incident. ENVIRONMENT INTERNATIONAL 2020; 137:105526. [PMID: 32062441 PMCID: PMC7201813 DOI: 10.1016/j.envint.2020.105526] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/15/2019] [Accepted: 01/24/2020] [Indexed: 05/10/2023]
Abstract
Widespread polybrominated biphenyls (PBBs) contamination occurred in Michigan from 1973 to 1974, when PBBs were accidentally substituted for a nutritional supplement in livestock feed. People who lived in the state were exposed to PBBs via several routes including ingestion, inhalation and skin absorption. PBBs sequestered in lipid-rich matrices such as adipose tissue, are slowly eliminated after entering the human body, and can also be transferred from a mother to her offspring through the placenta and breastfeeding. Due to the long biological half-lives of PBBs, as well as concerns from the exposed community, biomonitoring measurements were conducted from 2012 to 2015. Because of their similar structures, serum PBBs, polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) were all measured 40 years after the PBB contamination incident (N = 862). The serum PBB-153 levels among the original highly-exposed groups (i.e., chemical workers, the family of chemical workers, and individuals who lived on or received food from the contaminated farms) remains significantly higher than other Michigan residents. Several predictors such as sampling age, sex, and smoking status were significantly associated with the serum levels of some persistent organic pollutants (POPs). Higher average values and also wider ranges of serum POP levels were found in this study compared to the National Health and Nutrition Examination Survey (NHANES), with the most substantial difference in serum PBB-153. This was true for all groups of Michigan residents including those who were not part of the above-described highly-exposed groups. Moreover, the people born after the contamination incident began also have higher serum PBB-153 levels when compared with more recent NHANES data (2010-2014), which suggests potential intergenerational exposure and/or continued environmental exposure following the contamination period.
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Affiliation(s)
- Che-Jung Chang
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA.
| | - Metrecia L Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - M Elizabeth Marder
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Parinya Panuwet
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - P Barry Ryan
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Melanie Pearson
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Hillary Barton
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
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11
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Examining Reproductive Health Outcomes in Females Exposed to Polychlorinated Biphenyl and Polybrominated Biphenyl. Sci Rep 2020; 10:3314. [PMID: 32094419 PMCID: PMC7039953 DOI: 10.1038/s41598-020-60234-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/25/2019] [Indexed: 12/02/2022] Open
Abstract
In 1973, accidental contamination of Michigan livestock with polybrominated biphenyls (PBBs) led to the establishment of a registry of exposed individuals that have been followed for > 40 years. Besides being exposed to PBBs, this cohort has also been exposed to polychlorinated biphenyls (PCBs), a structurally similar class of environmental pollutants, at levels similar to average US exposure. In this study, we examined the association between current serum PCB and PBB levels and various female reproductive health outcomes to build upon previous work and inconsistencies. Participation in this cross-sectional study required a blood draw and completion of a detailed health questionnaire. Analysis included only female participants who had participated between 2012 and 2015 (N = 254). Multivariate linear and logistic regression models were used to identify associations between serum PCB and PBB levels with each gynecological and infertility outcome. Additionally, a generalized estimating equation (GEE) model was used to evaluate each pregnancy and birth outcome in order to account for multiple pregnancies per woman. We controlled for age, body mass index, and total lipid levels in all analyses. A p-value of <0.05 was used for statistical significance. Among the women who reported ever being pregnant, there was a significant negative association with higher total PCB levels associating with fewer lifetime pregnancies ( β = −0.11, 95% CI = −0.21 to −0.005, p = 0.04). There were no correlations between serum PCB levels and the self-reported gynecological outcomes (pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, or uterine fibroids). No associations were identified between serum PCB levels and the prevalence of female infertility in women reporting ever having sexual intercourse with a male partner. There were no associations identified between serum PCB levels and pregnancy outcomes (singleton live births or miscarriages) or birth outcomes (preterm birth, birth weight, birth defects, hypertensive disorders of pregnancy, or gestational diabetes). PBB was not associated with any outcome. Further research is needed to determine if and how PCB may reduce pregnancy number.
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12
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Gerkowicz SA, Curtis SW, Knight AK, Cobb DO, Spencer JB, Conneely KN, Terrell ML, Marcus M, Smith AK. Endometriosis, endocrine disrupters, and epigenetics: an investigation into the complex interplay in women with polybrominated biphenyl exposure and endometriosis. J Assist Reprod Genet 2020; 37:427-436. [PMID: 32026200 PMCID: PMC7056781 DOI: 10.1007/s10815-020-01695-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/10/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Endocrine disrupting compounds (EDCs) have been shown to affect multiple biologic processes especially steroid-hormone processes. We sought to determine differences in DNA methylation exists between women with and without endometriosis following exposure to polybrominated biphenyl (PBB). METHODS Cross-sectional study of 305 females in the Michigan PBB Registry. DNA was extracted, and DNA methylation was interrogated using the MethylationEPIC BeadChip (Illumina, San Diego, California). Demographic data was analyzed using Chi-squared and T tests. Linear regressions were performed for each cytosine-guanine dinucleotide (CpG) site, modeling the logit transformation of the β value as a linear function of the presence of endometriosis. Sensitivity analyses were conducted controlling for estradiol levels and menopausal status. Replication study performed evaluating for any association between CpGs reported in the literature and our findings. RESULTS In total, 39,877 CpGs nominally associated with endometriosis (p < 0.05) after adjusting for age and cellular heterogeneity, although none remained significant after correction for multiple comparisons (FDR < 0.05). Pathway analysis of these CpGs showed enrichment in 68 biologic pathways involved in various endocrine, immunologic, oncologic, and cell regulation processes as well as embryologic reproductive tract development and function (FoxO, Wnt, and Hedgehog signaling). We identified 42,261 CpG sites in the literature reported to be associated with endometriosis; 2012 of these CpG sites were also significant in our cohort. CONCLUSION We found 39,877 CpG sites that nominally associated with endometriosis (p < 0.05) after adjusting for age and cellular heterogeneity; however, none remained significant after correction for multiple comparisons (FDR < 0.05).
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Affiliation(s)
- Sabrina A Gerkowicz
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Emory University, Atlanta, GA, USA
| | - Sarah W Curtis
- Genetics and Molecular Biology Program, Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Anna K Knight
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA
| | - Dawayland O Cobb
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Emory University, Atlanta, GA, USA
| | - Karen N Conneely
- Genetics and Molecular Biology Program, Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Metrecia L Terrell
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michele Marcus
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Alica K Smith
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA.
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA.
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13
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Jaacks LM, Yadav S, Panuwet P, Kumar S, Rajacharya GH, Johnson C, Rawal I, Mohan D, Mohan V, Tandon N, Barr DB, Narayan KMV, Prabhakaran D. Metabolite of the pesticide DDT and incident type 2 diabetes in urban India. ENVIRONMENT INTERNATIONAL 2019; 133:105089. [PMID: 31654984 PMCID: PMC6860016 DOI: 10.1016/j.envint.2019.105089] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Previous epidemiological studies, largely conducted in high-income countries and cross-sectional, have suggested a relatively strong association between exposure to dichlorodiphenyldichloroethylene (DDE), a metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), and type 2 diabetes. DDT is widely used in India and the prevalence of type 2 diabetes there is increasing, but the association between these factors has not been explored to date. OBJECTIVE The objective was to estimate the association of the p,p' isomer of DDE with incident type 2 diabetes in India. METHODS A nested case-control study was conducted in a representative prospective cohort of adults from two cities in India. Participants were enrolled in 2010-11 (n = 12,271) and followed for annual assessment of chronic diseases including type 2 diabetes. Baseline plasma samples from incident cases of diabetes (n = 193) and sex-city-matched controls (n = 323) were selected for analysis of p,p-DDE. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. RESULTS At baseline, cases had higher p,p-DDE concentrations: geometric mean (95% CI) 330 (273-399) ng/g lipid compared to 223 (189-262) ng/g lipid among controls. Delhi participants had higher p,p-DDE concentrations: 579 (521-643) ng/g lipid compared to 122 (102-145) ng/g lipid in Chennai. In unadjusted models, being in the highest versus lowest quartile of p,p-DDE was associated with a more than doubling of the odds of diabetes: unadjusted OR (95% CI), 2.30 (1.19, 4.43). However, this effect was no longer significant after adjustment for age: adjusted (95% CI), 0.97 (0.46, 2.06). DISCUSSION Results suggest that levels of p,p'-DDE in Delhi are exceptionally high, but we did not observe a significant association between p,p-DDE and incident type 2 diabetes. As this is the first study to evaluate this association in India, more studies are needed to inform our understanding of the association in this context, including potential routes of exposure.
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Affiliation(s)
- Lindsay M Jaacks
- Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Public Health Foundation of India, Gurgaon, India.
| | - Sudesh Yadav
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Parinya Panuwet
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Sushil Kumar
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Girish H Rajacharya
- International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Cierra Johnson
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Ishita Rawal
- Centre for Chronic Disease Control, New Delhi, India
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | - Dana Boyd Barr
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - K M Venkat Narayan
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, Gurgaon, India; Centre for Chronic Disease Control, New Delhi, India
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14
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Curtis SW, Terrell ML, Jacobson MH, Cobb DO, Jiang VS, Neblett MF, Gerkowicz SA, Spencer JB, Marder ME, Barr DB, Conneely KN, Smith AK, Marcus M. Thyroid hormone levels associate with exposure to polychlorinated biphenyls and polybrominated biphenyls in adults exposed as children. Environ Health 2019; 18:75. [PMID: 31443693 PMCID: PMC6708149 DOI: 10.1186/s12940-019-0509-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 07/30/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Michigan residents were directly exposed to endocrine-disrupting compounds, polybrominated biphenyl (PBB) and polychlorinated biphenyl (PCB). A growing body of evidence suggests that exposure to certain endocrine-disrupting compounds may affect thyroid function, especially in people exposed as children, but there are conflicting observations. In this study, we extend previous work by examining age of exposure's effect on the relationship between PBB exposure and thyroid function in a large group of individuals exposed to PBB. METHODS Linear regression models were used to test the association between serum measures of thyroid function (total thyroxine (T4), total triiodothyronine (T3), free T4, free T3, thyroid stimulating hormone (TSH), and free T3: free T4 ratio) and serum PBB and PCB levels in a cross-sectional analysis of 715 participants in the Michigan PBB Registry. RESULTS Higher PBB levels were associated with many thyroid hormones measures, including higher free T3 (p = 0.002), lower free T4 (p = 0.01), and higher free T3: free T4 ratio (p = 0.0001). Higher PCB levels were associated with higher free T4 (p = 0.0002), and higher free T3: free T4 ratio (p = 0.002). Importantly, the association between PBB and thyroid hormones was dependent on age at exposure. Among people exposed before age 16 (N = 446), higher PBB exposure was associated with higher total T3 (p = 0.01) and free T3 (p = 0.0003), lower free T4 (p = 0.04), and higher free T3: free T4 ratio (p = 0.0001). No significant associations were found among participants who were exposed after age 16. No significant associations were found between TSH and PBB or PCB in any of the analyses conducted. CONCLUSIONS This suggests that both PBB and PCB are associated with thyroid function, particularly among those who were exposed as children or prenatally.
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Affiliation(s)
- Sarah W. Curtis
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Metrecia L. Terrell
- Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Melanie H. Jacobson
- Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Dawayland O. Cobb
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Victoria S. Jiang
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Michael F. Neblett
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Sabrina A. Gerkowicz
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Jessica B. Spencer
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - M. Elizabeth Marder
- Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Dana Boyd Barr
- Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Karen N. Conneely
- Emory University School of Medicine, 615 Michael St, Atlanta, GA 30322 USA
| | - Alicia K. Smith
- Emory University School of Medicine, 101 Woodruff Circle NE, Ste 2205A, Atlanta, GA 30322 USA
| | - Michele Marcus
- Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322 USA
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15
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Curtis SW, Cobb DO, Kilaru V, Terrell ML, Marder ME, Barr DB, Marsit CJ, Marcus M, Conneely KN, Smith AK. Environmental exposure to polybrominated biphenyl (PBB) associates with an increased rate of biological aging. Aging (Albany NY) 2019; 11:5498-5517. [PMID: 31375641 PMCID: PMC6710070 DOI: 10.18632/aging.102134] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/26/2019] [Indexed: 12/13/2022]
Abstract
Advanced age increases risk for cancer, cardiovascular disease, and all-cause mortality. However, people do not age at the same rate, and biological age (frequently measured through DNA methylation) can be older than chronological age. Environmental factors have been associated with the rate of biological aging, but it is not known whether persistent endocrine-disrupting compounds (EDCs) like polybrominated biphenyl (PBB) would associate with age acceleration. Three different epigenetic age acceleration measures (intrinsic, extrinsic, and phenotypic) were calculated from existing epigenetic data in whole blood from a population highly exposed to PBB (N=658). Association between serum PBB concentration and these measures was tested, controlling for sex, lipid levels, and estimated cell type proportions. Higher PBB levels associated with increased age acceleration (intrinsic: β=0.24, 95%CI=0.01-0.46, p = 0.03; extrinsic: β=0.39, 95%CI=0.12-0.65, p = 0.004; and phenotypic: β=0.30, 95%CI=0.05-0.54, p = 0.01). Neither age when exposed to PBB nor sex statistically interacted with PBB to predict age acceleration, but, in stratified analyses, the association between PBB and age acceleration was only in people exposed before finishing puberty and in men. This suggests that EDCs can associate with the biological aging process, and further studies are warranted to investigate other environmental pollutants' effect on aging.
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Affiliation(s)
- Sarah W. Curtis
- Genetics and Molecular Biology Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
| | - Dawayland O. Cobb
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Varun Kilaru
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Metrecia L. Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - M. Elizabeth Marder
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Carmen J. Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Karen N. Conneely
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Alicia K. Smith
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA 30322, USA
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16
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Curtis SW, Cobb DO, Kilaru V, Terrell ML, Marder ME, Barr DB, Marsit CJ, Marcus M, Conneely KN, Smith AK. Exposure to polybrominated biphenyl and stochastic epigenetic mutations: application of a novel epigenetic approach to environmental exposure in the Michigan polybrominated biphenyl registry. Epigenetics 2019; 14:1003-1018. [PMID: 31200609 DOI: 10.1080/15592294.2019.1629232] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Endocrine-disrupting compounds are associated with altered epigenetic regulation and adverse health outcomes, although inconsistent results suggest that people have varied responses to the same exposure. Interpersonal variation in response to environmental exposures is not identified using standard, population-based methods. However, methods that capture an individual's response, such as analyzing stochastic epigenetic mutations (SEMs), may capture currently missed effects of environmental exposure. To test whether polybrominated biphenyl (PBB) was associated with SEMs, DNA methylation was measured using Illumina's MethylationEPIC array in PBB-exposed individuals, and SEMs were identified. Association was tested using a linear regression with robust sandwich variance estimators, controlling for age, sex, lipids, and cell types. The number of SEMs was variable (range: 119-18,309), and positively associated with age (p = 1.23e-17), but not with sex (p = 0.97). PBBs and SEMs were only positively associated in people who were older when they were exposed (p = 0.02 vs. p = 0.91). Many subjects had SEMs enriched in biological pathways, particularly in pathways involved with xenobiotic metabolism and endocrine function. Higher number of SEMs was also associated with higher age acceleration (intrinsic: p = 1.70e-3; extrinsic: p = 3.59e-11), indicating that SEMs may be associated with age-related health problems. Finding an association between environmental contaminants and higher SEMs may provide insight into individual differences in response to environmental contaminants, as well as into the biological mechanism behind SEM formation. Furthermore, these results suggest that people may be particularly vulnerable to epigenetic dysregulation from environmental exposures as they age.
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Affiliation(s)
- Sarah W Curtis
- a Genetics and Molecular Biology Program, Laney Graduate School, Emory University School of Medicine , Atlanta , GA , USA
| | - Dawayland O Cobb
- b Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta , GA , USA
| | - Varun Kilaru
- b Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta , GA , USA
| | - Metrecia L Terrell
- c Department of Epidemiology, Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - M Elizabeth Marder
- d Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Dana Boyd Barr
- d Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Carmen J Marsit
- d Department of Environmental Health, Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Michele Marcus
- e Departments of Epidemiology, Environmental Health, Emory University Rollins School of Public Health, and Department of Pediatrics Emory University School of Medicine , Atlanta , GA , USA
| | - Karen N Conneely
- f Department of Human Genetics, Emory University School of Medicine , Atlanta , GA , USA
| | - Alicia K Smith
- g Departments of Gynecology and Obstetrics & Psychiatry and Behavioral Science, Emory University School of Medicine , Atlanta , GA , USA
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Walker DI, Marder ME, Yano Y, Terrell M, Liang Y, Barr DB, Miller GW, Jones DP, Marcus M, Pennell KD. Multigenerational metabolic profiling in the Michigan PBB registry. ENVIRONMENTAL RESEARCH 2019; 172:182-193. [PMID: 30782538 PMCID: PMC6534816 DOI: 10.1016/j.envres.2019.02.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/12/2019] [Accepted: 02/12/2019] [Indexed: 05/17/2023]
Abstract
Although polychlorinated biphenyls and polybrominated biphenyls are no longer manufactured the United States, biomonitoring in human populations show that exposure to these pollutants persist in human tissues. The objective of this study was to identify metabolic variations associated with exposure to 2,2'4,4',5,5'-hexabromobiphenyl (PBB-153) and 2,2'4,4',5,5'-hexachlorobiphenyl (PCB-153) in two generations of participants enrolled in the Michigan PBB Registry (http://pbbregistry.emory.edu/). Untargeted, high-resolution metabolomic profiling of plasma collected from 156 individuals was completed using liquid chromatography with high-resolution mass spectrometry. PBB-153 and PCB-153 levels were measured in the same individuals using targeted gas chromatography-tandem mass spectrometry and tested for dose-dependent correlation with the metabolome. Biological response to these exposures were evaluated using identified endogenous metabolites and pathway enrichment. When compared to lipid-adjusted concentrations for adults in the National Health and Nutrition Examination Survey (NHANES) for years 2003-2004, PCB-153 levels were consistent with similarly aged individuals, whereas PBB-153 concentrations were elevated (p<0.0001) in participants enrolled in the Michigan PBB Registry. Metabolic alterations were correlated with PBB-153 and PCB-153 in both generations of participants, and included changes in pathways related to catecholamine metabolism, cellular respiration, essential fatty acids, lipids and polyamine metabolism. These pathways were consistent with pathophysiological changes observed in neurodegenerative disease and included previously identified metabolomic markers of Parkinson's disease. To determine if the metabolic alterations detected in this study are replicated other cohorts, we evaluated correlation of PBB-153 and PCB-153 with plasma fatty acids measured in NHANES. Both pollutants showed similar associations with fatty acids previously linked to PCB exposure. Thus, the results from this study show metabolic alterations correlated with PBB-153 and PCB-153 exposure can be detected in human populations and are consistent with health outcomes previously reported in epidemiological and mechanistic studies.
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Affiliation(s)
- Douglas I Walker
- Department of Civil and Environmental Engineering, Tufts University, 200 College Ave, Medford MA 02155, United States; Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University School of Medicine, 615 Michael St, Atlanta GA 30322, United States.
| | - M Elizabeth Marder
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta GA 30322, United States.
| | - Yukiko Yano
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Ave Hall #7360, Berkeley CA 94720, United States.
| | - Metrecia Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta GA 30322, United States.
| | - Yongliang Liang
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University School of Medicine, 615 Michael St, Atlanta GA 30322, United States.
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta GA 30322, United States.
| | - Gary W Miller
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta GA 30322, United States.
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University School of Medicine, 615 Michael St, Atlanta GA 30322, United States.
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta GA 30322, United States.
| | - Kurt D Pennell
- Department of Civil and Environmental Engineering, Tufts University, 200 College Ave, Medford MA 02155, United States.
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Curtis SW, Cobb DO, Kilaru V, Terrell ML, Kennedy EM, Marder ME, Barr DB, Marsit CJ, Marcus M, Conneely KN, Smith AK. Exposure to polybrominated biphenyl (PBB) associates with genome-wide DNA methylation differences in peripheral blood. Epigenetics 2019; 14:52-66. [PMID: 30676242 DOI: 10.1080/15592294.2019.1565590] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In 1973, Michigan residents were exposed to polybrominated biphenyl (PBB) when it was accidentally added to farm animal feed. Highly exposed individuals and their children have experienced endocrine-related health problems, though the underlying mechanism behind these remains unknown. We investigated whether PBB exposure is associated with variation in DNA methylation in peripheral blood samples from 658 participants of the Michigan PBB registry using the MethylationEPIC BeadChip, as well as investigated what the potential function of the affected regions are and whether these epigenetic marks are known to associate with endocrine system pathways. After multiple test correction (FDR <0.05), 1890 CpG sites associated with total PBB levels. These CpGs were not enriched in any particular biological pathway, but were enriched in enhancer and insulator regions, and depleted in regions near the transcription start site or in CpG islands (p < 0.05). They were also more likely to be in ARNT and ESR2 transcription factor binding sites (p = 3.27e-23 and p = 1.62e-6, respectively), and there was significant overlap between CpGs associated with PBB and CpGs associated with estrogen (p < 2.2e-16). PBB-associated CpGs were also enriched for CpGs known to be associated with gene expression in blood (eQTMs) (p < 0.05). These eQTMs were enriched for pathways related to immune function and endocrine-related autoimmune disease (FDR <0.05). These results indicate that exposure to PBB is associated with differences in epigenetic marks that suggest that it is acting similarly to estrogen and is associated with dysregulated immune system pathways.
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Affiliation(s)
- Sarah W Curtis
- a Genetics and Molecular Biology Program, Laney Graduate SchoolLaney Graduate School , Emory University School of Medicine , Atlanta , GA , USA
| | - Dawayland O Cobb
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , GA , USA
| | - Varun Kilaru
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , GA , USA
| | - Metrecia L Terrell
- c Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Elizabeth M Kennedy
- d Department of Environmental Health , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - M Elizabeth Marder
- d Department of Environmental Health , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Dana Boyd Barr
- d Department of Environmental Health , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Carmen J Marsit
- d Department of Environmental Health , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Michele Marcus
- e Departments of Epidemiology, Environmental Health , Emory University Rollins School of Public Health , Atlanta , GA , USA.,f Department of Pediatrics , Emory University School of Medicine , Atlanta , GA , USA
| | - Karen N Conneely
- g Department of Human Genetics , Emory University School of Medicine , Atlanta , GA , USA
| | - Alicia K Smith
- a Genetics and Molecular Biology Program, Laney Graduate SchoolLaney Graduate School , Emory University School of Medicine , Atlanta , GA , USA.,b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , GA , USA.,h Department of Psychiatry and Behavioral Science , Emory University School of Medicine , Atlanta , GA , USA
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Abstract
BACKGROUND Environmental contaminants ranging from legacy chemicals like p,p'-dichlorodiphenyltrichloroethane (DDT) to emerging chemicals like phthalates are ubiquitous. Research aims/questions: This research aims to examine the presence and co-occurrence of contaminants in human milk and effects of pasteurization on human milk chemical contaminants. METHODS We analyzed human milk donated by 21 women to a milk bank for 23 chemicals, including the persistent organic pollutants (POPs) polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) isomers that are known to sequester in adipose tissue, along with the current-use and nonpersistent pesticides chlorpyrifos and permethrin, phthalates, and bisphenol A (BPA). Human milk was analyzed raw and pasteurized for these chemicals using gas chromatography-tandem mass spectrometry for the POPs and high-performance liquid chromatography-tandem mass spectrometry for non-POPs. RESULTS Within the different chemical classes, PBDE47, PCB153, ppDDE, and MEHHP (phthalate metabolite) had the highest median concentrations and were observed in all samples. We also observed chlorpyrifos and BPA in all samples and permethrin in 90% of the samples tested. Only two chemicals, chlorpyrifos and permethrin, were susceptible to substantial degradation from pasteurization, a standard method for processing donated human milk. CONCLUSION We detected 19 of 23 chemicals in all of our prepasteurized milk and 18 of 23 chemicals in all of our pasteurized milk. Pasteurization did not affect the presence of most of the chemicals. Future research should continue to explore human milk for potential chemical contamination and as a means to surveil exposures among women and children.
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Affiliation(s)
| | - Ronald S. Cohen
- Stanford University, Stanford, CA, USA
- Mother’s Milk Bank, San José, CA, USA
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Jacobson MH, Darrow LA, Barr DB, Howards PP, Lyles RH, Terrell ML, Smith AK, Conneely KN, Marder ME, Marcus M. Serum Polybrominated Biphenyls (PBBs) and Polychlorinated Biphenyls (PCBs) and Thyroid Function among Michigan Adults Several Decades after the 1973-1974 PBB Contamination of Livestock Feed. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:097020. [PMID: 28953452 PMCID: PMC5915188 DOI: 10.1289/ehp1302] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND In 1973-1974, Michigan residents were exposed to polybrominated biphenyls (PBBs) through an accidental contamination of the food supply. Residents were enrolled in a registry assembled after the incident, and they and their children participated in follow-up studies to assess subsequent health outcomes. OBJECTIVES We evaluated associations between serum PBBs and polychlorinated biphenyls (PCBs) and markers of thyroid function among Michigan adults. METHODS Serum concentrations of four PBB and four PCB congeners were measured at least once in 753 adults, including 79 women who participated in a 2004-2006 study and 683 women and men with follow-up during 2012-2015. Participants completed questionnaires on health conditions (including physician-diagnosed thyroid disease), behaviors, and demographics. Thyroid hormones were measured in a subset without thyroid disease (n=551). In multivariable linear regression models, PBB and PCB congener concentrations, on both the volume (nanogram/milliliter) and lipid (nanogram/gram lipid) basis, were assessed in relation to thyroid hormones. Logistic regression models were used to estimate associations between serum PBBs and PCBs and thyroid disease. RESULTS Thyroid disease was common (18% overall; 25% among women). Among women, all odds ratios (ORs) for PBB-153 and thyroid disease were positive for quintiles above the reference level, but estimates were imprecise and were without a monotonic increase. For an interquartile range (IQR) increase in PBB-153 (0.43 ng/mL), the OR (any thyroid disease)=1.12; (95% CI: 0.83, 1.52) (n=105 cases); for hypothyroidism, OR=1.35 (95% CI: 0.86, 2.13) (n=49 cases). There were 21 cases of thyroid disease in men [OR=0.69 (95% CI: 0.33); 1.44 for an IQR increase (0.75 ng/mL) in serum PBB-153]. PCB congeners were statistically significantly associated with greater total and free thyroxine and total triiodothyronine among women and with total and free triiodothyronine among men in lipid-standardized models. CONCLUSIONS We found some evidence to support associations of PBBs and PCBs with thyroid disease and thyroid hormone levels. https://doi.org/10.1289/EHP1302.
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Affiliation(s)
- Melanie H Jacobson
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University , Atlanta, Georgia, USA
| | - Lyndsey A Darrow
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University , Atlanta, Georgia, USA
- Department of Environmental Health, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
- School of Community Health Sciences, University of Nevada , Reno, Nevada, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University , Atlanta, Georgia, USA
| | - Robert H Lyles
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
| | - Metrecia L Terrell
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University , Atlanta, Georgia, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta, Georgia, USA
| | - Karen N Conneely
- Department of Human Genetics, Emory University School of Medicine , Atlanta, Georgia, USA
| | - M Elizabeth Marder
- Department of Environmental Health, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University , Atlanta, Georgia, USA
- Department of Environmental Health, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
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