1
|
Feiler MO, Kulick ER, Sinclair K, Spiegel N, Habel S, Castello OG. Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172303. [PMID: 38599398 DOI: 10.1016/j.scitotenv.2024.172303] [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: 01/23/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction. METHODS Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection. RESULTS The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation. CONCLUSIONS The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.
Collapse
Affiliation(s)
- Marina Oktapodas Feiler
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, United States of America; Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America.
| | - Erin R Kulick
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Krystin Sinclair
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Nitzana Spiegel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Sonia Habel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Olivia Given Castello
- Charles Library, Temple University Libraries, Temple University, United States of America
| |
Collapse
|
2
|
Shah S, Kim HS, Hong YC, Park H, Ha M, Kim Y, Lee JH, Ha EH. Infantile allergic diseases: a cohort study prenatal fish intake and mercury exposure context. BMC Public Health 2024; 24:568. [PMID: 38388869 PMCID: PMC10885545 DOI: 10.1186/s12889-024-18008-9] [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: 11/10/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Allergic diseases (ADs) have been increasingly reported in infants and children over the last decade. Diet, especially the inclusion of fish intake, may help to lower the risk of ADs. However, fish also, can bioaccumulate environmental contaminants such as mercury. Hence, our study aims to determine what effects the type and frequency of fish intake have on ADs in six-month-old infants, independently and jointly with mercury exposure. METHODS This study is part of the prospective birth cohort: Mothers and Children's Environmental Health (MOCEH) study in South Korea. Data was collected on prenatal fish intake, prenatal mercury concentration and ADs for infants aged six months for 590 eligible mother-infant pairs. Logistic regression analysis was conducted to evaluate the risk of prenatal fish intake and mercury concentration on ADs in infants. Finally, interaction between fish intake and mercury concentration affecting ADs in infants was evaluated. Hazard ratios of prenatal fish intake on ADs in 6 month old infants were calculated by prenatal mercury exposure. RESULTS Logistic regression analysis showed that white fish (OR: 0.53; 95% CI 0.30-0.94; P < 0.05) intake frequency, once a week significantly decreased the risk of ADs in infants. Stratification analysis showed that consuming white fish once a week significantly reduced the hazard of ADs (HR: 0.44; 95% CI 0.21-0.92; P < 0.05) in infants in the high-mercury (≥ 50th percentile) exposure group. CONCLUSION The result indicates that prenatal white fish intake at least once a week reduces the risk of ADs in infants, especially in the group with high prenatal mercury exposure.
Collapse
Affiliation(s)
- Surabhi Shah
- Department of Environmental Medicine, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Ji Hyen Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea.
| | - Eun-Hee Ha
- Department of Environmental Medicine, Ewha Womans University College of Medicine, 808-1, Magok-dong, Gangseo-gu, 07804, Seoul, Republic of Korea.
- System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Lee JY, Choi YH, Choi HI, Moon KW. Association between environmental mercury exposure and allergic disorders in Korean children: Korean National Environmental Health Survey (KoNEHS) cycles 3-4 (2015-2020). Sci Rep 2024; 14:1472. [PMID: 38233475 PMCID: PMC10794242 DOI: 10.1038/s41598-024-51811-3] [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: 07/14/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
Although previous studies have suggested potential adverse effects of mercury on a child's immune system, the associations have been inconsistent. We aimed to determine the association between urinary mercury levels and allergic diseases in Korean children with high mercury exposure. Data from 853 and 710 children aged 6-11 years in the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015-2017) and cycle 4 (2018-2020) were analyzed. We examined the association between mercury exposure and the prevalence of atopic dermatitis (AD), asthma, allergic rhinitis (AR), and allergic multimorbidity. After adjusting for all covariates, the urinary mercury level was positively associated with AD in the 2015-2017 study (OR = 1.34, 95% CI = 1.01, 1.79) and AR in 2018-2020 study (OR = 1.46, 95% CI = 1.01, 2.10). Pooled effects showed OR of 1.34 (95% CI = 1.01, 1.79) for AD and 1.47 (95% CI = 1.01, 2.12) for allergic multimorbidity. The association with allergic multimorbidity was greater in boys (OR = 1.88, 95% CI = 1.01, 3.49) than in girls (OR = 1.25, 95% CI = 0.73, 2.14). These results suggest that environmental mercury exposure may exacerbate symptoms of atopic dermatitis and allergic multimorbidity in children.
Collapse
Affiliation(s)
- Ji-Youn Lee
- School of Health and Environmental Science, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, South Korea
| | - Yun-Hee Choi
- Department of Ophthalmology, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hyeon-Il Choi
- Department of Infection Biology, College of Medicine, Chungnam National University, Munhwa-ro 266, Jung-gu, Daejeon, 35015, South Korea.
| | - Kyong Whan Moon
- School of Health and Environmental Science, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, South Korea
- BK21 FOUR R&E Center for Learning Health System, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, South Korea
| |
Collapse
|
4
|
Miyazaki J, Ikehara S, Tanigawa K, Kimura T, Ueda K, Ozono K, Kimura T, Kobayashi Y, Yamazaki S, Kamijima M, Sobue T, Iso H. Prenatal exposure to selenium, mercury, and manganese during pregnancy and allergic diseases in early childhood: The Japan Environment and Children's study. ENVIRONMENT INTERNATIONAL 2023; 179:108123. [PMID: 37595534 DOI: 10.1016/j.envint.2023.108123] [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: 03/21/2023] [Revised: 07/23/2023] [Accepted: 07/28/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently limited. OBJECTIVES We aimed to examine the associations between prenatal metallic (mercury, selenium, and manganese) exposure and the risk of allergic diseases in early childhood until three years of age. METHODS The data from 94,794 mother-infant pairs, who participated in the Japan Environment and Children's study, were used in this study. Prenatal metallic element exposure was measured in maternal blood collected during mid-pregnancy. The incidence of atopic dermatitis, food allergies, asthma, and allergic rhinitis during the first three years of life was prospectively investigated using self-reports of physician-diagnosed allergies. A multivariable modified Poisson regression model was used to estimate the cumulative incidence ratio and their 95% confidence intervals of allergic diseases associated with prenatal exposure to mercury, selenium, and manganese. We further evaluated the interaction between mercury and selenium exposures in this association. RESULTS We confirmed 26,238 cases of childhood allergic diseases: atopic dermatitis, food allergies, asthma, and allergic rhinitis in 9,715 (10.3%), 10,897 (11.5%), and 9,857 (10.4%), 4,630 (4.9%), respectively. No association was found between prenatal mercury or manganese exposure and the risk of allergic diseases. Prenatal selenium exposure was inversely associated with atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases, but not with asthma. These inverse associations were more pronounced for lower mercury exposures than for higher exposures. CONCLUSIONS Our findings suggest that prenatal exposure to selenium may be beneficial for reducing the risk of atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases in early childhood, especially with lower prenatal mercury exposure.
Collapse
Affiliation(s)
- Junji Miyazaki
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35, Shinano-cho, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Satoyo Ikehara
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Kanami Tanigawa
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, 840, Murodo-cho, Izumi-shi, Osaka 594-1101, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan
| | - Kimiko Ueda
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Faculty of Health and Well-being, Kansai University, 1-11-1 Kaorigaoka-cho, Sakai-ku, Sakai, Osaka, 590-8515, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Yayoi Kobayashi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba-shi, Ibaraki 305-8506, Japan
| | - Shin Yamazaki
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba-shi, Ibaraki 305-8506, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-Cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| |
Collapse
|
5
|
Chamani S, Mobasheri L, Rostami Z, Zare I, Naghizadeh A, Mostafavi E. Heavy metals in contact dermatitis: A review. J Trace Elem Med Biol 2023; 79:127240. [PMID: 37331278 DOI: 10.1016/j.jtemb.2023.127240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
Contact dermatitis is an inflammatory skin reaction caused by direct contact with chemical substances in the environment and can either be irritant or allergic in nature. The clinical symptoms of contact dermatitis, include local skin rash, itching, redness, swelling, and lesions. Nowadays, 15-20% of people have some degree of contact dermatitis, which can be more or less severe. Immune responses in allergic contact dermatitis (ACD) are due to the effects of cytokines and allergen-specific CD4+ and CD8+ T cells on the skin. Acids and alkalis such as drain cleaners, plants such as poinsettias, hair colors, and nail polish remover, are all prominent causes of irritant contact dermatitis (ICDs). Heavy metals are metallic elements with a high atomic weight that are hazardous in low quantities and are known to cause dermatitis after systemic or local exposure. Nickel (Ni), chromium (Cr), lead (Pb), and copper (Cu) are among the most common heavy metals used in various industries. Metal allergies may cause ACD and also systemic contact dermatitis (SCD). Contact dermatitis is detected by laboratory tests such as patch testing, lymphocyte stimulation test (LST), and evaluation of cytokine production by primary cultures of peripheral blood mononuclear cells. This article presents an update on the epidemiological and clinical characteristics of ACD and SCD caused by three heavy metals (Cr, Cu, and Pb). Ni is not discussed due to recent coverage. Furthermore, the effects of contact sensitivity to some other heavy metals, such as gold (Au), cobalt (Co), palladium (Pd), and mercury (Hg) are discussed.
Collapse
Affiliation(s)
- Sajad Chamani
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Leila Mobasheri
- Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zeinab Rostami
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies Co. Ltd., Shiraz 7178795844, Iran
| | - Ali Naghizadeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
| | - Ebrahim Mostafavi
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
| |
Collapse
|
6
|
Zheng K, Zeng Z, Tian Q, Huang J, Zhong Q, Huo X. Epidemiological evidence for the effect of environmental heavy metal exposure on the immune system in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 868:161691. [PMID: 36669659 DOI: 10.1016/j.scitotenv.2023.161691] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/28/2022] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
Heavy metals exist widely in daily life, and exposure to heavy metals caused by environmental pollution has become a serious public health problem worldwide. Due to children's age-specific behavioral characteristics and imperfect physical function, the adverse health effects of heavy metals on children are much higher than in adults. Studies have found that heavy metal exposure is associated with low immune function in children. Although there are reviews describing the evidence for the adverse effects of heavy metal exposure on the immune system in children, the summary of evidence from epidemiological studies involving the level of immune molecules is not comprehensive. Therefore, this review summarizes the current epidemiological study on the effect of heavy metal exposure on childhood immune function from multiple perspectives, emphasizing its risks to the health of children's immune systems. It focuses on the effects of six heavy metals (lead (Pb), cadmium (Cd), arsenic (As), mercury (Hg), nickel (Ni), and manganese (Mn)) on children's innate immune cells, lymphocytes and their subpopulations, cytokines, total and specific immunoglobulins, and explores the immunotoxicological effects of heavy metals. The review finds that exposure to heavy metals, particularly Pb, Cd, As, and Hg, not only reduced lymphocyte numbers and suppressed adaptive immune responses in children, but also altered the innate immune response to impair the body's ability to fight pathogens. Epidemiological evidence suggests that heavy metal exposure alters cytokine levels and is associated with the development of inflammatory responses in children. Pb, As, and Hg exposure was associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Cd, Ni and Mn showed activation effects on the immune response to childhood vaccination. Exposure age, sex, nutritional status, and co-exposure may influence the effects of heavy metals on immune function in children.
Collapse
Affiliation(s)
- Keyang Zheng
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Zhijun Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China
| | - Qianwen Tian
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Jintao Huang
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Qi Zhong
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China.
| |
Collapse
|
7
|
Hyperbaric oxygen therapy in carbon monoxide poisoning in Moroccan patients. Acta Neurol Belg 2023; 123:139-143. [PMID: 34245438 DOI: 10.1007/s13760-021-01688-0] [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: 12/29/2020] [Accepted: 04/23/2021] [Indexed: 10/20/2022]
Abstract
Describe the epidemiological, clinical characteristics of acute carbon monoxide poisoning (COP), and the therapeutic effect of hyperbaric oxygen therapy on patient's clinical outcome. This is the first study in this field in Morocco. It studies retrospectively 309 victims of acute COP with major neurological signs. All patients have been treated with hyperbaric oxygen therapy, and have been admitted by the emergency department of the Mohammed V military training hospital in Rabat, between January 2015 and December 2018. All poisonings were accidental and occurred especially in winter (50%), with a predominance in urban areas (93%). The poisoning was often caused by a non-compliant water heater (91%), multi-causality was in half of the cases, and affected adults and women (mean age: 21 ± 17 years, gender (male:female) 1:1.5. The average admission time to the hyperbaric chamber lasted 9 h 04 min (± 12 h 32 min). Clinical signs were mainly unconsciousness (151 cases), headache (85 cases), vomiting (63 cases), nausea (53 cases), and dizziness (51 cases). All the patients benefitted from hyperbaric oxygen therapy sessions. The clinical outcome was positive in the majority of cases, but 23% of the cases presented minor or major sequelae. Patients with sequelae had a longer length of admission than those who had not. COP is a major public health problem in Morocco. Through this study, we suggest the interest of hyperbaric oxygen therapy, especially when it is administered timely without delay.
Collapse
|
8
|
Wang J, Yin J, Hong X, Liu R. Exposure to Heavy Metals and Allergic Outcomes in Children: a Systematic Review and Meta-analysis. Biol Trace Elem Res 2022; 200:4615-4631. [PMID: 35006554 DOI: 10.1007/s12011-021-03070-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains unclear. This systematic review was conducted to examine whether heavy metal exposure is associated with allergic outcomes during childhood. We performed a systematic search of all relevant articles in Web of Science, EMBASE, and PubMed, from inception through to November 2020. We used odds ratio (OR) and the standard mean differences (SMDs) with 95% confidence intervals (CIs) to present estimates from individual studies. In addition, random-effects meta-analysis was used to pool the data. We also conducted the meta-regression and subgroup analysis to explore potential sources of heterogeneity. After duplicate removal, we finally included 35 articles in the systematic review and meta-analysis from an initial 11,181 articles. The overall results showed that copper (Cu) was associated with asthma (pooled SMD = 1.50, 95% CI = 0.13-2.86); in the subgroup analysis, the results indicated that lead (Pb) was associated with asthma (pooled OR = 6.27, 95% CI = 2.24-17.56), and Cu and Pb were connected with atopic dermatitis (SMD = - 1.05, 95% CI = - 1.45 to - 0.65; SMD = 5.68, 95% CI = 5.05-6.32), respectively. Mercury (Hg) was associated with atopic dermatitis (pooled OR = 1.13, 95% CI = 1.04-1.22) and wheeze (OR = 1.20, 95% CI = 1.05-1.37). The meta-analysis results indicate that Cu might be connected with childhood asthma, but not with other allergic diseases; Hg and Pb may have no association with allergic diseases during childhood. Given some limits observed in the current studies, more prospective cohort studies are still needed to verify our findings. Review registration: PROSPERO CRD42020222167.
Collapse
Affiliation(s)
- Jia Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Jiechen Yin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Xiang Hong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ran Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
| |
Collapse
|
9
|
Tsai TL, Wang SL, Hsieh CJ, Wen HJ, Kuo CC, Liu HJ, Sun CW, Chen ML, Wu MT. Association Between Prenatal Exposure to Metals and Atopic Dermatitis Among Children Aged 4 Years in Taiwan. JAMA Netw Open 2021; 4:e2131327. [PMID: 34705012 PMCID: PMC8552055 DOI: 10.1001/jamanetworkopen.2021.31327] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE The prevalence of atopic dermatitis has substantially increased in recent decades, and atopic dermatitis could lead to allergic airway inflammation later in life. A previous study found that inorganic arsenic exposure was associated with allergic airway inflammation in children aged 8 to 14 years. However, the association between prenatal exposure to arsenic and other metals and the risk of atopic dermatitis among young children remains unknown. OBJECTIVE To assess the association between prenatal exposure to arsenic and other metals and the occurrence of atopic dermatitis in children at age 4 years. DESIGN, SETTING, AND PARTICIPANTS In total, 1152 pregnant women were enrolled in the original Taiwan Maternal and Infant Cohort Study (TMICS), a multicenter birth cohort study conducted at 9 hospitals in northern, central, southern, and eastern Taiwan from October 2012 to May 2015. Of those, 586 mothers and children aged 4 years participated in follow-up questionnaire interviews from August 2016 to January 2019. After excluding 216 participants with missing data, the final statistical analysis of follow-up data included 370 mother and child pairs from the central and eastern regions of Taiwan. Data were analyzed from February 2 to August 12, 2021. EXPOSURES Arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc during pregnancy. MAIN OUTCOMES AND MEASURES The outcome was parent-reported atopic dermatitis history among children aged 4 years. The presence of atopic dermatitis was defined as a positive response to the question, "Has your child ever had atopic dermatitis diagnosed by a physician?" During the initial TMICS study period, concentrations of arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc were measured in maternal urine during the third trimester of pregnancy using an inductively coupled plasma mass spectrometer. Estimated total inorganic arsenic exposure was calculated using a model that included data on both total arsenic and arsenic species (arsenite, arsenate, monomethylarsonate, and dimethylarsenate) obtained from a previous TMICS cohort. RESULTS Among 370 children included in the analysis, the mean (SD) age was 3.94 (0.59) years; 208 children (56.2%) were male, and 267 children (72.2%) were from the central region of Taiwan. A total of 110 children (29.7%) had atopic dermatitis at age 4 years. Maternal estimated total inorganic arsenic exposure during pregnancy was associated with increased odds of atopic dermatitis among children at age 4 years (odds ratio [OR], 2.42 [95% CI, 1.33-4.39] for every doubled increase of total inorganic arsenic) after adjusting for parental allergies, child's sex, geographic area, maternal educational level, and exposure to tobacco smoke. Every increased unit in the weighted quantile sum index of maternal metal exposure was significantly associated with atopic dermatitis (OR, 1.63; 95% CI, 1.28-2.07). Arsenic (40.1%) and cadmium (20.5%) accounted for most of the metal mixture index. CONCLUSIONS AND RELEVANCE This cohort study found that prenatal exposure to inorganic arsenic and coexposure to inorganic arsenic and cadmium were associated with a higher risk of atopic dermatitis in young children. These findings suggest that prevention of exposure to inorganic arsenic and cadmium during pregnancy may be helpful for the control of atopic dermatitis and other potential allergies in children.
Collapse
Affiliation(s)
- Tsung-Lin Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan
| | - Chia-Jung Hsieh
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Hui-Ju Wen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chin-Chi Kuo
- Big Data Center, China Medical University Hospital, Taichung, Taiwan
- Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Huei-Ju Liu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chien-Wen Sun
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Mei-Lien Chen
- Institute of Environmental and Occupational Health Sciences, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Tsang Wu
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
10
|
Chua RXY, Tay MJY, Ooi DSQ, Siah KTH, Tham EH, Shek LPC, Meaney MJ, Broekman BFP, Loo EXL. Understanding the Link Between Allergy and Neurodevelopmental Disorders: A Current Review of Factors and Mechanisms. Front Neurol 2021; 11:603571. [PMID: 33658968 PMCID: PMC7917177 DOI: 10.3389/fneur.2020.603571] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Both allergic diseases and neurodevelopmental disorders are non-communicable diseases (NCDs) that not only impact on the quality of life and but also result in substantial economic burden. Immune dysregulation and inflammation are typical hallmarks in both allergic and neurodevelopmental disorders, suggesting converging pathophysiology. Epidemiological studies provided convincing evidence for the link between allergy and neurodevelopmental diseases such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Possible factors influencing the development of these disorders include maternal depression and anxiety, gestational diabetes mellitus, maternal allergic status, diet, exposure to environmental pollutants, microbiome dysbiosis, and sleep disturbances that occur early in life. Moreover, apart from inflammation, epigenetics, gene expression, and mitochondrial dysfunction have emerged as possible underlying mechanisms in the pathogenesis of these conditions. The exploration and understanding of these shared factors and possible mechanisms may enable us to elucidate the link in the comorbidity.
Collapse
Affiliation(s)
- Regena Xin Yi Chua
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michelle Jia Yu Tay
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology & Hepatology, University Medicine Cluster, National University Hospital, Singapore, Singapore
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J Meaney
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Department of Psychiatry, Onze Lieve Vrouwe Gasthuis and Amsterdam University Medical Centre, VU University Medical Center, Amsterdam, Netherlands
| | - Evelyn Xiu Ling Loo
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| |
Collapse
|
11
|
Shah S, Jeong KS, Park H, Hong YC, Kim Y, Kim B, Chang N, Kim S, Kim Y, Kim BN, Kwon H, Bae S, Kim HC, Leem JH, Park EK, Joo H, Park B, Ha M, Ha E. Environmental pollutants affecting children's growth and development: Collective results from the MOCEH study, a multi-centric prospective birth cohort in Korea. ENVIRONMENT INTERNATIONAL 2020; 137:105547. [PMID: 32088541 DOI: 10.1016/j.envint.2020.105547] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/26/2019] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The Mothers and Children's Environmental Health study (MOCEH) is a multi-centric prospective birth cohort study investigating effects of various environmental pollutants like heavy metals, endocrine disruptors, air pollutants, nutrition and lifestyle on birth outcomes, growth and development, health and disease of children. In this study, we report all the outcomes from the MOCEH study describing the different environmental pollutants affecting children's health and disease. METHODS In MOCEH study, 1,751 pregnant women in their first trimester were recruited at 3 centers from 2006 to 2010 in South Korea. The children were followed from birth up to 6 years. Information on health outcomes of children including birth parameters, demographic characteristics, medical and child-rearing history, and nutritional status, were repeatedly obtained through the follow-ups by questionnaires administration, clinical evaluation, and biological specimen collection and measurements. Prenatal and postnatal measurement in biospecimen, i.e., lead, mercury, cadmium, manganese, 1-hydroxypyrene, 2-naphthol, malonadialdehyde, hippuric acid, bisphenol A and phthalate metabolites, and measurement in air samples, i.e., particulate matter, nitrogen dioxide, and total volatile organic compounds were performed. RESULTS The results show the adverse effect of prenatal exposure to heavy metals like mercury, lead and cadmium on children's physical, cognitive and neurobehavioral development. Exposure to endocrine disruptors, air pollution, second hand smoke, and mother's lifestyle during pregnancy affects children's growth and development. We also identified specific window periods of exposure of pollutants significantly related to children's health outcomes. CONCLUSION The collective results from MOCEH study provide strong scientific evidence that exposures to prenatal and postnatal environmental pollutants have a negative effect on growth and development of children, which will be useful in implementing effective national policy to improve children's environmental health.
Collapse
Affiliation(s)
- Surabhi Shah
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Byungmi Kim
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea
| | - Suejin Kim
- Humidifier Disinfectant Health Center, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea; Department of Psychiatry, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hojang Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Eun-Kyo Park
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyunjoo Joo
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Bohyun Park
- Department of Preventive Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
| |
Collapse
|
12
|
50 Years in Less Than 1000 Words. Epidemiology 2019; 30 Suppl 2:S1-S2. [PMID: 31569146 DOI: 10.1097/ede.0000000000001080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|