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Margiana R, Hamoud Alshahrani S, Kayumova D, Hussien Radie Alawadi A, Hjazi A, Alsalamy A, Qasim QA, Juyal A, Garousi N. Association between maternal exposure to arsenic by drinking water during pregnancy and risk of preterm birth: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2947-2956. [PMID: 37967266 DOI: 10.1080/09603123.2023.2280155] [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: 08/05/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
The relation of exposure to arsenic in drinking water during pregnancy to the risk of preterm birth (PTB) was contradictory. This meta-analysis aimed to examine the association between drinking water arsenic and PTB. A systematic search in PubMed and Scopus was performed to achieve all relevant studies. Odds ratios (OR) and 95% confidence intervals (CI) were used to pool data using the random-effect models. Overall, 11 studies with a total sample size of 3,404,189 participants were included in the meta-analysis. Arsenic exposure through drinking water during pregnancy was related to an increased risk of PTB (OR = 1.06; 95%CI = 1.01-1.10 for highest versus lowest category of arsenic), with significant heterogeneity across the studies (I2 = 84.8%, P = 0.001). This finding was supported by cohort studies (OR = 1.05; 95%CI = 1.01-1.10). This meta-analysis proposes that higher arsenic exposure in drinking water may be a risk factor for PTB.
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Affiliation(s)
- Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Andrology Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | - Dilrabo Kayumova
- Department of Obstetrics and Gynecology, Tashkent Medical Academy, Tashkent, Uzbekistan
| | - Ahmed Hussien Radie Alawadi
- College of technical engineering, the Islamic University, Najaf, Iraq
- College of technical engineering, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
| | - Ahmed Hjazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ali Alsalamy
- College of technical engineering, Imam Ja'afar Al-Sadiq University, Al-Muthanna, Iraq
| | | | - Ashima Juyal
- Electronics & Communication engineering, Uttaranchal Institute of Technology, Uttaranchal University, Dehradun, India
| | - Nazila Garousi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Shaw GM, Gonzalez DJX, Goin DE, Weber KA, Padula AM. Ambient Environment and the Epidemiology of Preterm Birth. Clin Perinatol 2024; 51:361-377. [PMID: 38705646 DOI: 10.1016/j.clp.2024.02.004] [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] [Indexed: 05/07/2024]
Abstract
Preterm birth (PTB) is associated with substantial mortality and morbidity. We describe environmental factors that may influence PTB risks. We focus on exposures associated with an individual's ambient environment, such as air pollutants, water contaminants, extreme heat, and proximities to point sources (oil/gas development or waste sites) and greenspace. These exposures may further vary by other PTB risk factors such as social constructs and stress. Future examinations of risks associated with ambient environment exposures would benefit from consideration toward multiple exposures - the exposome - and factors that modify risk including variations associated with the structural genome, epigenome, social stressors, and diet.
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Affiliation(s)
- Gary M Shaw
- Epidemiology and Population Health, Obstetrics & Gynecology - Maternal Fetal Medicine, Department of Pediatrics, Stanford University School of Medicine, Center for Academic Medicine (CAM), 453 Quarry Road, Stanford, CA 94304, USA.
| | - David J X Gonzalez
- Division of Environmental Health Sciences, School of Public Health, University of California, 2121 Berkeley Way, CA 94720, USA
| | - Dana E Goin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA
| | - Kari A Weber
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, RAHN 6219, Rock, AR 72205, USA
| | - Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 490 Illinois Street, #103N, San Francisco, CA 94158, USA
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de Souza Freitas G, Rodrigues NG, Lastre-Acosta AM, Feirreira-Pinto L, Teixeira ACSC, Parizi MPS. Attenuation photochemical potential of Pontal of Paranapanema river waters (Brazil) from agrochemicals: geographical and temporal assessment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-33358-y. [PMID: 38632196 DOI: 10.1007/s11356-024-33358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 04/12/2024] [Indexed: 04/19/2024]
Abstract
Knowledge of the environmental photochemical fate of pesticides is essential to assess their potential impacts. However, there are few studies in the literature focused on the photochemical attenuation of micropollutants in Brazilian rivers. In this context, this study characterized the surface waters of the Pontal of Paranapanema region (region which concentrates more than 80% of Brazilian sugarcane cultivations), in order to determine its photochemical attenuation potential against micropollutants in different seasons. Thus, the steady-state concentrations of the photochemically produced reactive intermediates (PPRIs) (hydroxyl radical, HO•; singlet oxygen, 1O2, and triplet-excited state chromophoric dissolved organic matter, 3CDOM*), formed in the rivers, were simulated by using the APEX model (Aquatic Photochemistry of Environmentally-occurring Xenobiotics), considering the sunlight irradiance, water chemistry, and depth. Based on our simulations, these concentrations vary between 0.35 × 10-15 and 4.52 × 10-14 mol L-1 for HO•, 1.3 × 10-15 and 1.2 × 10--14 mol L-1 for 3CDOM*, and 2.5 × 10-15 and 2.5 × 10-14 mol L-1 for 1O2. Finally, mathematical simulations were used for predicting persistence of pesticides atrazine (ATZ) and diuron (DIR) in Pontal of Paranapanema surface waters and the half-life times (t1/2) of the pollutants ranged from a few hours to one week.
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Affiliation(s)
| | | | - Arlen Mabel Lastre-Acosta
- Vale Do Paraíba Environmental Agency, São José Dos Campos, SP, Brazil
- Research Group in Advanced Oxidation Processes (AdOx), Chemical Systems Engineering Center, Department of Chemical Engineering, University of São Paulo, São Paulo, SP, Brazil
| | | | - Antonio Carlos Silva Costa Teixeira
- Research Group in Advanced Oxidation Processes (AdOx), Chemical Systems Engineering Center, Department of Chemical Engineering, University of São Paulo, São Paulo, SP, Brazil
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Yue Y, Sun X, Tian S, Yan S, Sun W, Miao J, Huang S, Diao J, Zhou Z, Zhu W. Multi-omics and gut microbiome: Unveiling the pathogenic mechanisms of early-life pesticide exposure. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2024; 199:105770. [PMID: 38458664 DOI: 10.1016/j.pestbp.2024.105770] [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: 10/10/2023] [Revised: 12/31/2023] [Accepted: 01/08/2024] [Indexed: 03/10/2024]
Abstract
The extensive application of pesticides in agricultural production has raised significant concerns about its impact on human health. Different pesticides, including fungicides, insecticides, and herbicides, cause environmental pollution and health problems for non-target organisms. Infants and young children are so vulnerable to the harmful effects of pesticide exposure that early-life exposure to pesticides deserves focused attention. Recent research lays emphasis on understanding the mechanism between negative health impacts and early-life exposure to various pesticides. Studies have explored the impacts of exposure to these pesticides on model organisms (zebrafish, rats, and mice), as well as the mechanism of negative health effects, based on advanced methodologies like gut microbiota and multi-omics. These methodologies help comprehend the pathogenic mechanisms associated with early-life pesticide exposure. In addition to presenting health problems stemming from early-life exposure to pesticides and their pathogenic mechanisms, this review proposes expectations for future research. These proposals include focusing on identifying biomarkers that indicate early-life pesticide exposure, investigating transgenerational effects, and seeking effective treatments for diseases arising from such exposure. This review emphasizes how to understand the pathogenic mechanisms of early-life pesticide exposure through gut microbiota and multi-omics, as well as the adverse health effects of such exposure.
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Affiliation(s)
- Yifan Yue
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Xiaoxuan Sun
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Sinuo Tian
- Institute of Quality Standard and Testing Technology, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, China
| | - Sen Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Wei Sun
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Jiyan Miao
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Shiran Huang
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Jinling Diao
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Zhiqiang Zhou
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China
| | - Wentao Zhu
- Innovation Center of Pesticide Research, Department of Applied Chemistry, College of Science, China Agricultural University, Beijing 100193, China.
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Issah I, Duah MS, Arko-Mensah J, Bawua SA, Agyekum TP, Fobil JN. Exposure to metal mixtures and adverse pregnancy and birth outcomes: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168380. [PMID: 37963536 DOI: 10.1016/j.scitotenv.2023.168380] [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: 08/30/2023] [Revised: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Prenatal exposure to metal mixtures is associated with adverse pregnancy and birth outcomes like low birth weight, preterm birth, and small for gestational age. However, prior studies have used individual metal analysis, lacking real-life exposure scenarios. OBJECTIVES This systematic review aims to evaluate the strength and consistency of the association between metal mixtures and pregnancy and birth outcomes, identify research gaps, and inform future studies and policies in this area. METHODS The review adhered to the updated Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist, along with the guidelines for conducting systematic reviews and meta-analyses of observational studies of etiology (COSMOS-E). Our data collection involved searching the PubMed, MEDLINE, and SCOPUS databases. We utilized inclusion criteria to identify relevant studies. These chosen studies underwent thorough screening and data extraction procedures. Methodological quality evaluations were conducted using the NOS framework for cohort and case-control studies, and the AXIS tool for cross-sectional studies. RESULTS The review included 34 epidemiological studies, half of which focused on birth weight, and the others investigated neonate size, preterm birth, small for gestational age, miscarriage, and placental characteristics. The findings revealed significant associations between metal mixtures (including mercury (Hg), nickel (Ni), arsenic (As), cadmium (Cd), manganese (Mn), cobalt (Co), lead (Pb), zinc (Zn), barium (Ba), cesium (Cs), copper (Cu), selenium (Se), and chromium (Cr)) and adverse pregnancy and birth outcomes, demonstrating diverse effects and potential interactions. CONCLUSION In conclusion, this review consistently establishes connections between metal exposure during pregnancy and adverse consequences for birth weight, gestational age, and other vital birth-related metrics. This review further demonstrates the need to apply mixture methods with caution but also shows that they can be superior to traditional approaches. Further research is warranted to deeper understand the underlying mechanisms and to develop effective strategies for mitigating the potential risks associated with metal mixture exposure during pregnancy.
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Affiliation(s)
- Ibrahim Issah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana.
| | - Mabel S Duah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - John Arko-Mensah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Serwaa A Bawua
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Thomas P Agyekum
- Department of Occupational and Environmental Health and Safety, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Julius N Fobil
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Contini T, Béranger R, Multigner L, Klánová J, Price EJ, David A. A Critical Review on the Opportunity to Use Placenta and Innovative Biomonitoring Methods to Characterize the Prenatal Chemical Exposome. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:15301-15313. [PMID: 37796725 DOI: 10.1021/acs.est.3c04845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Adverse effects associated with chemical exposures during pregnancy include several developmental and reproductive disorders. However, considering the tens of thousands of chemicals present on the market, the effects of chemical mixtures on the developing fetus is still likely underestimated. In this critical review, we discuss the potential to apply innovative biomonitoring methods using high-resolution mass spectrometry (HRMS) on placenta to improve the monitoring of chemical exposure during pregnancy. The physiology of the placenta and its relevance as a matrix for monitoring chemical exposures and their effects on fetal health is first outlined. We then identify several key parameters that require further investigations before placenta can be used for large-scale monitoring in a robust manner. Most critical is the need for standardization of placental sampling. Placenta is a highly heterogeneous organ, and knowledge of the intraplacenta variability of chemical composition is required to ensure unbiased and robust interindividual comparisons. Other important variables include the time of collection, the sex of the fetus, and mode of delivery. Finally, we discuss the first applications of HRMS methods on the placenta to decipher the chemical exposome and describe how the use of placenta can complement biofluids collected on the mother or the fetus.
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Affiliation(s)
- Thomas Contini
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
- RECETOX, Faculty of Science, Masaryk University, Kotlářská 2, 602 00 Brno, Czech Republic
| | - Rémi Béranger
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
| | - Luc Multigner
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
| | - Jana Klánová
- RECETOX, Faculty of Science, Masaryk University, Kotlářská 2, 602 00 Brno, Czech Republic
| | - Elliott J Price
- RECETOX, Faculty of Science, Masaryk University, Kotlářská 2, 602 00 Brno, Czech Republic
| | - Arthur David
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
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Huang W, Pan XF, Tang S, Sun F, Wu P, Yuan J, Sun W, Pan A, Chen D. Target Exposome for Characterizing Early Gestational Exposure to Contaminants of Emerging Concern and Association with Gestational Diabetes Mellitus. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:13408-13418. [PMID: 37651547 DOI: 10.1021/acs.est.3c04492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Characterization of gestational exposure to complex contaminants of emerging concern (CECs) is critical to the identification of environmental risk factors for pregnancy complications. However, determination of various CECs with diverse physicochemical properties in biological fluids is technically challenging. In the present study, we developed a target exposome protocol, consisting of simple liquid-liquid extraction-based sample preparation and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis, to determine 325 CECs covering 11 subclasses, including poly- and perfluoroalkyl substances, organophosphate esters, ultraviolet (UV) stabilizers, synthetic antioxidants, phthalate esters, and several others. The protocol exhibits exceptional advantages over traditional approaches in the coverage of chemicals, sample volume demand, and time and financial cost. The protocol was applied in a prospective nested gestational diabetes mellitus (GDM) study including 120 cases and 240 matched healthy controls. Thirty-three CECs were detected in >70% of the samples, with a combined concentration of 17.0-484.7 ng/mL. Bayesian kernel machine regression analysis showed that exposure to the CEC mixture was significantly associated with a higher GDM risk. For example, when increasing all CECs in the mixture from 50th percentile to 75th percentile, the estimated probit of GDM incidence had an increase of 92% (95% CI: 56%, 127%). Meanwhile, perfluorohexanesulfonic acid, 1,3-diphenylguanidine, and dibutyl fumarate were identified as the key CECs driving the joint effect. This work demonstrates great potential of our target exposome protocol for environmental risk factor identification in large-scale epidemiology or biomonitoring studies.
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Affiliation(s)
- Wei Huang
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University; Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan 610041, China
| | - Shuqin Tang
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Fengjiang Sun
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
| | - Ping Wu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Jiaying Yuan
- Department of Science and Education, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan 610200, China
| | - Wenwen Sun
- Shanghai AB Sciex Analytical Instrument Trading Co., Ltd, Shanghai 200335, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Da Chen
- School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China
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Clemmensen PJ, Schullehner J, Brix N, Sigsgaard T, Stayner LT, Kolstad HA, Ramlau-Hansen CH. Prenatal Exposure to Nitrate in Drinking Water and Adverse Health Outcomes in the Offspring: a Review of Current Epidemiological Research. Curr Environ Health Rep 2023; 10:250-263. [PMID: 37453984 PMCID: PMC10504112 DOI: 10.1007/s40572-023-00404-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE OF REVIEW Recently, several epidemiological studies have investigated whether prenatal exposure to nitrate from drinking water may be harmful to the fetus, even at nitrate levels below the current World Health Organization drinking water standard. The purpose of this review was to give an overview of the newest knowledge on potential health effects of prenatal exposure to nitrate. RECENT FINDINGS We included 13 epidemiological studies conducted since 2017. Nine studies investigated outcomes appearing around birth, and four studies investigated health outcomes appearing in childhood and young adulthood. The reviewed studies showed some indications of higher risk of preterm delivery, lower birth weight, birth defects, and childhood cancer related to prenatal exposure to nitrate. However, the numbers of studies for each outcome were sparse, and some of the results were conflicting. We suggest that there is a need for additional studies and particularly for studies that include information on water consumption patterns, intake of nitrate from diet, and intake of nitrosatable drugs.
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Affiliation(s)
| | - Jörg Schullehner
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
| | - Nis Brix
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
- Cirrau - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Leslie Thomas Stayner
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL, USA
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Tadevosyan NS, Guloyan HA, Wallis AB, Tadevosyan AE. Maternal exposure to organochlorine pesticides and anthropometrics of newborns - a hospital-based cross-sectional study in rural and urban settings in Armenia. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2023; 58:895-902. [PMID: 37651265 DOI: 10.1080/10934529.2023.2253108] [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: 01/27/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
The study objective was to determine a possible association between maternal exposure to organochlorine pesticides (OCPs) and anthropometric measures at birth in group of postpartum women in urban and rural areas of Armenia. The anthropometric measures of infants were obtained from birth records and gamma-hexachlorocyclohexane (γ-HCH), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene, and dichlorodiphenyldichloroethane were measured in breast milk. Gas-liquid chromatography with electron capture detection was used to identify OCPs. Total OCPs and DDTs were calculated, and the anthropometrics were analyzed for sex and areas, and group differences were compared (Student's t-test). Both individual OCPs and total OCPs and DDTs were significantly higher in rural samples than in urban ones (P < 0.01-0.000), with lower and upper quartiles differing by 2.6-fold and 3.1-fold, respectively (P < 0.000). There was no association between the anthropometrics and OCPs levels in rural or urban areas. However, this does not rule out the possibility of OCPs impact on health later in life. To our knowledge, this was the first study addressing these issues in Armenia. The results obtained will provide data on the current situation regarding birth outcomes in terms of prenatal exposure to OCPs in Armenia and will contribute to the available results from previous studies.
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Affiliation(s)
- Natalya S Tadevosyan
- Laboratory of Environmental Hygiene and Toxicology, Scientific-Research Center of Yerevan State Medical University named after M. Heratsi, Yerevan, Republic of Armenia
| | - Hasmik A Guloyan
- Laboratory of Environmental Hygiene and Toxicology, Scientific-Research Center of Yerevan State Medical University named after M. Heratsi, Yerevan, Republic of Armenia
| | - Anne B Wallis
- Department of Epidemiology & Population Health, School of Public Health & Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Artashes E Tadevosyan
- Department of Public Health and Healthcare Organization, Yerevan State Medical University named after M. Heratsi, Yerevan, Republic of Armenia
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Simões M, Vermeulen R, Portengen L, Janssen N, Huss A. Exploring associations between residential exposure to pesticides and birth outcomes using the Dutch birth registry. ENVIRONMENT INTERNATIONAL 2023; 178:108085. [PMID: 37421898 DOI: 10.1016/j.envint.2023.108085] [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: 01/09/2023] [Revised: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Maternal occupational exposure to pesticides has been linked to adverse birth outcomes but associations with residential pesticide exposures are inconclusive. OBJECTIVES To explore associations between residential exposure to specific pesticides and birth outcomes using individual level exposure and pregnancy/birth data. METHODS From all 2009-2013 singleton births in the Dutch birth registry, we selected mothers > 16 years old living in non-urban areas, who had complete address history and changed addresses at most once during pregnancy (N = 339,947). We estimated amount (kg) of 139 active ingredients (AI) used within buffers of 50, 100, 250 and 500 m around each mother's home during pregnancy. We used generalized linear models to investigate associations between 12 AIs with evidence of reproductive toxicity and gestational age (GA), birth weight (BW), perinatal mortality, child́s sex, prematurity, low birth weight (LBW), small for gestational age (SGA) and large for gestational age (LGA), adjusting for individual and area-level confounders. For the remainder 127 AIs, we used minimax concave penalty with a stability selection step to identify those that could be related to birth outcomes. RESULTS Regression analyses showed that maternal residential exposure to fluroxypyr-meptyl was associated with longer GA, glufosinate-ammonium with higher risk of LBW, linuron with higher BW and higher odds of LGA, thiacloprid with lower odds of perinatal mortality and vinclozolin with longer GA. Variable selection analysis revealed that picoxystrobin was associated with higher odds of LGA. We found no evidence of associations with other AIs. Sensitivity and additional analysis supported these results except for thiacloprid. DISCUSSION In this exploratory study, pregnant women residing near crops where fluroxypyr-meptyl, glufosinate-ammonium, linuron, vinclozolin and picoxystrobin were applied had higher risk for certain potentially adverse birth outcomes. Our findings provide leads for confirmatory investigations on these compounds and/or compounds with similar modes of action.
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Affiliation(s)
- Mariana Simões
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Lützen Portengen
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Nicole Janssen
- Centre for Sustainability, Environment and Health (DMG), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Anke Huss
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
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Chen H, Williams KE, Kwan EY, Kapidzic M, Puckett KA, San A, Fisher SJ, Robinson JF. Proteomic analyses of primary human villous trophoblasts exposed to flame retardant BDE-47 using SWATH-MS. Toxicology 2023; 494:153583. [PMID: 37385330 PMCID: PMC10864010 DOI: 10.1016/j.tox.2023.153583] [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: 04/24/2023] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are a class of brominated flame retardants and recognized developmental toxicants that are detectable in placental tissues. Higher levels of in utero PBDE exposure have been associated with an increased risk of adverse birth outcomes. During pregnancy, cytotrophoblasts (CTBs) from the placenta play critical roles in the formation of the maternal-fetal interface via uterine invasion and vascular remodeling. The differentiation of these cells towards an invasive phenotype is crucial for proper placental development. We previously have shown that BDE-47 can impact CTB viability and hinder the ability of these cells to migrate and invade. To expand on potential toxicological mechanisms, we utilized quantitative proteomic approaches to identify changes in the global proteome of mid-gestation primary human CTBs after exposure to BDE-47. Using sequential window acquisition of all theoretical fragment-ion spectra (SWATH), we identified 3024 proteins in our CTB model of differentiation/invasion. Over 200 proteins were impacted as a function of BDE-47 exposure (1 μM and 5 μM) across the treatment period (15, 24, and 39 h). The differentially expressed molecules displayed time- and concentration-dependent changes in expression and were enriched in pathways associated with aggregatory and adhesive processes. Network analysis identified CYFIP1, a molecule previously unexplored in a placental context, to be dysregulated at BDE-47 concentrations previously seen to impact CTB migration/invasion. Our SWATH-MS dataset thus demonstrates BDE-47 impacts the global proteome of differentiating CTBs and serves as a valuable resource for further understanding of the relationship between environmental chemical exposures and placental development and function. AVAILABILITY OF DATA AND MATERIAL: Raw chromatograms are deposited on the MassIVE proteomic database (https://massive.ucsd.edu) under accession number MSV000087870. Normalized relative abundances are also available as Table S1.
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Affiliation(s)
- Hao Chen
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Katherine E Williams
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Elaine Y Kwan
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Mirhan Kapidzic
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Kenisha A Puckett
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Ali San
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Susan J Fisher
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Joshua F Robinson
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
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12
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Eichenauer H, Huss M, Brander M, Bernauer T, Ehlert U. Effects of improved on-farm crop storage on perceived stress and perceived coping in pregnant women-Evidence from a cluster-randomized controlled trial in Kenya. PLoS One 2023; 18:e0288446. [PMID: 37440562 DOI: 10.1371/journal.pone.0288446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Food insecurity can be harmful to pregnant women, as pregnancy is a challenging period with increased maternal nutritional requirements to ensure optimal fetal development and health of the mother. Whether food insecurity negatively affects maternal health may depend on how stressful pregnant women perceive this food insecurity to be and how strongly they believe they can cope with it. In Sub-Saharan Africa (SSA), pregnant women from smallholder households suffer from food insecurity due to post-harvest losses (PHL), i.e., loss of crops because of inadequate storage. An agricultural intervention that improves crop storage has been shown to reduce food insecurity. However, it remains to be determined whether this agricultural intervention (treatment) has an additional positive effect on pregnant women's perceived stress levels and coping abilities. This study examines whether pregnant women from treatment households experience lower perceived stress levels and higher perceived coping abilities compared to pregnant women from control housholds. METHODS AND FINDINGS In a randomized controlled trial (RCT), short message service (SMS)-based mobile phone surveys were conducted to assess the causal effect of a food security intervention (improved on-farm storage of maize) on perceived stress and coping in pregnant women from smallholder households. Pregnant women were identified through these monthly surveys by asking whether someone in their household was currently pregnant. The significant results revealed that pregnant women from treatment households experienced more perceived stress but better perceived coping abilities compared to pregnant women from control households. Uncertainty due to lack of experience, this might have contributed to the higher perceived stress, as the women could not easily judge the benefits and risks of the new storage technology. However, the technology itself is a tangible resource which might have empowered the pregnant women to counteract the effects of PHL and thus food insecurity. CONCLUSION Our findings indicate that pregnant women from treatment households had higher perceived coping abilities but experienced more perceived stress. More research is needed on how this technology impacts maternal mental health in a broader sense and whether biological mechanisms, such as epigenetics, may underlie this association.
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Affiliation(s)
- Heike Eichenauer
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Matthias Huss
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
- Zurich Knowledge Center for Sustainable Development & Informatics and Sustainability Research Group, University of Zurich, Zurich, Switzerland
| | - Michael Brander
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
- Zurich Knowledge Center for Sustainable Development & Informatics and Sustainability Research Group, University of Zurich, Zurich, Switzerland
| | - Thomas Bernauer
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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13
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Cheslack-Postava K, Rantakokko P, Surcel HM, Hinkka-Yli-Salomäki S, Laitinen J, Upadhyaya S, McKeague IW, Sourander A, Brown AS. Prenatal organochlorine pollutant exposure and risk of schizophrenia in a national birth cohort. Neurotoxicology 2023; 97:47-52. [PMID: 37201646 PMCID: PMC10525014 DOI: 10.1016/j.neuro.2023.05.010] [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: 01/11/2023] [Revised: 03/04/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023]
Abstract
Non-genetic prenatal exposures have been associated with schizophrenia risk. However, the role of prenatal exposure to environmental neurotoxicants in offspring schizophrenia risk has been studied in only limited instances. Polychlorinated biphenyls (PCBs) and the pesticide metabolite p,p'-dichlorodiphenyl dichloroethylene (DDE) have been linked to neurodevelopmental outcomes, including impairments implicated in schizophrenia. To determine whether prenatal maternal levels of organochlorine pollutants including PCBs or DDE are associated with schizophrenia in the offspring, an investigation was conducted in the Finnish Prenatal Study of Schizophrenia (FIPS-S), a case-control study nested in a national birth cohort. Cases were born in 1987-1991 and had at least two diagnoses of schizophrenia (ICD-10 F20; ICD-9 295) or schizoaffective disorder (ICD-10 F25; ICD-9 295.7) recorded in the national Care Register for Health Care. Each case was individually matched to a control on sex, date of birth, and residence in Finland on the date of case diagnosis. In 500 case-control pairs, PCB congeners 74, 99, 118, 138, 153, 156, 170, 180, 183, 187, and some widespread organochlorine pesticides or their metabolites including DDE were measured in archived prenatal maternal sera using gas chromatography - high triple quadrupole mass spectrometry. Maternal total PCBs were quantified as the sum of concentrations of the measured congeners. Associations with schizophrenia were examined using conditional logistic regression. Maternal PCB or DDE levels greater than the 75th percentiles of the control distributions showed no evidence of association with offspring schizophrenia (PCBs: adjusted odds ratio (aOR) = 1.13, 95 % CI = 0.85-1.50), p = 0.41; DDE: aOR = 1.08, 95 % CI = 0.80-1.45; p = 0.63). Maternal levels of either pollutant dichotomized at the 90th percentile or considered as a continuous variable also did not show evidence for association with offspring schizophrenia. This study found a lack of evidence that prenatal maternal levels of the organochlorine pollutants DDE and PCBs are associated with offspring risk of schizophrenia.
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Affiliation(s)
- Keely Cheslack-Postava
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA.
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Heljä-Marja Surcel
- Faculty of Medicine, University of Oulu, Oulu, Finland; Biobank Borealis of Northern Finland, Oulu, Finland
| | - Susanna Hinkka-Yli-Salomäki
- Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Joonas Laitinen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Subina Upadhyaya
- Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Ian W McKeague
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Andre Sourander
- Department of Child Psychiatry, Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland; INVEST Research Flagship, University of Turku, Turku, Finland
| | - Alan S Brown
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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14
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Liang D, Walker DI. Invited Perspective: Application of Nontargeted Analysis in Characterizing the Maternal and Child Exposome. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:71303. [PMID: 37466316 DOI: 10.1289/ehp13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Douglas I Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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15
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Yang J, Chen X, Yamamoto Y. The final 28 Days:Prenatal exposure to air pollution and child anthropometric outcomes. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 342:118289. [PMID: 37279606 DOI: 10.1016/j.jenvman.2023.118289] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/20/2023] [Accepted: 05/26/2023] [Indexed: 06/08/2023]
Abstract
This study examines the health consequences of prenatal exposure to air pollution by combining child health data from an original survey with the Air Pollution Index (API) from official Chinese statistics. Our results show that exposure to air pollution in late trimester (four-week windows before delivery) is negatively associated with health outcomes in children in the short and long terms. One standard deviation increase in the API in the final 28 days before delivery decreased birth weight and length by 0.388 and 0.458, respectively, in z-scores and lowered the weight-for-age and height-for-age by 0.370 and 0.441, respectively, in z-scores at 13-15 years post-exposure. Although the timing of exposure and its consequences have been the subject of debate in existing literature, our results focus on four-week windows and demonstrate that exposure during the late pregnancy period may have adverse health effects on children. We conducted analyses that accounted for potential covariates and omitted variables, and our results remain robust and statistically significant. We also found gender heterogeneous effects that girls are more vulnerable to fetal air pollution exposure than boys. Our findings uncover fetal and child health risks regarding air pollution and reinforce the importance of policies for mitigating air pollution in developing countries.
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Affiliation(s)
- Jie Yang
- Global Research Centre for Advanced Sustainability Science, University of Toyama, Japan
| | - Xintong Chen
- Graduate School of Fisheries and Environmental Sciences, Nagasaki University, Japan
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16
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Yang X, Liu Y, Liu S, Zheng P, Bai X, Ma LQ, Liu W. Prenatal exposure to 209 PCBs in mother-infant pairs from two cities in China: Levels, congener profiles, and transplacental transfer. CHEMOSPHERE 2023; 326:138483. [PMID: 36958503 DOI: 10.1016/j.chemosphere.2023.138483] [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: 01/18/2023] [Revised: 03/09/2023] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
Prenatal exposure to polychlorinated biphenyls (PCBs) has been well researched, but studies covering all 209 congeners are limited. Recent literature suggests a shift in the dominant congeners and increasing levels of unintentionally-produced PCBs (UP-PCBs) in environmental samples in China. To investigate the exposure levels and profiles of PCBs in pregnant women and newborns, as well as the characteristics of transplacental transfer, we measured 209 PCBs in 80 pairs of maternal serum (MS) and cord serum (CS) from Hangzhou and Mianyang, China. The levels of ∑PCBs of participants in this study were lower than those in developed countries and followed the order of (ng/g lw): Hangzhou-MS (148) > Hangzhou-CS (107) > Mianyang-MS (63.8) > Mianyang-CS (57.9). UP-PCBs (mainly PCB-11) contributed around 50% of ∑PCBs in serum, which is consistent with the environmental samples. Environmental burden and dietary intake may account for the differences in the exposure levels, while the historical production and release may have impacted the homologue profiles. Prenatal exposure to PCB-126 was associated with increased birth weight (n = 80, adjusted β = 0.270, p = 0.030). The body burden of dioxin-like PCBs of newborns in Hangzhou was 82.4 pg TEQ/kg bw, suggesting certain health risks under WHO tolerable daily intake of 1-4 pg TEQ/kg bw. Log10 KOW was negatively correlated with log10-transformed transplacental transfer efficiency (R2 = 0.36, p < 0.001), serving its importance for PCBs' transplacental transfer. This study is the first to investigate maternal and fetal exposure to PCBs in China based on their levels, congener and homologue profiles, and potential adverse effects. Our findings help to provide insights into the processes and factors influencing the transplacental transfer of PCBs.
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Affiliation(s)
- Xiaomeng Yang
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, Zhejiang University, Hangzhou, 310058, China
| | - Yingxue Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, Zhejiang University, Hangzhou, 310058, China
| | - Shuren Liu
- Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Interdisciplinary Research Academy (IRA), Zhejiang Shuren University, Hangzhou, 310015, China
| | - Ping Zheng
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, Zhejiang University, Hangzhou, 310058, China
| | - Xiaoxia Bai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Lena Q Ma
- Zhejiang Provincial Key Laboratory of Agricultural Resources and Environment, Institute of Soil and Water Resources and Environmental Science, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Weiping Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, Zhejiang University, Hangzhou, 310058, China; Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Interdisciplinary Research Academy (IRA), Zhejiang Shuren University, Hangzhou, 310015, China.
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17
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Iyanna N, Yolton K, LeMasters G, Lanphear BP, Cecil KM, Schwartz J, Brokamp C, Rasnick E, Xu Y, MacDougall MC, Ryan PH. Air pollution exposure and social responsiveness in childhood: The cincinnati combined childhood cohorts. Int J Hyg Environ Health 2023; 251:114172. [PMID: 37116232 PMCID: PMC10682723 DOI: 10.1016/j.ijheh.2023.114172] [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: 01/18/2023] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
Autism Spectrum Disorder (ASD) affects about 1 in 44 children and environmental exposures may contribute to disease onset. Air pollution has been associated with adverse neurobehavioral outcomes, yet little research has examined its association with autistic-like behaviors. Therefore, our objective was to examine the association between exposure to air pollution, including NO2 and PM2.5, during pregnancy and the first year of life to ASD-like behaviors during childhood. Participants (n = 435) enrolled in the Cincinnati Childhood Allergy and Air Pollution Study and the Health Outcomes and Measures of the Environment Study were included in the analysis. Daily exposures to NO2 and PM2.5 at the residential addresses of participants were estimated using validated spatiotemporal models and averaged to obtain prenatal and first year exposure estimates. ASD-like behaviors were assessed via the Social Responsiveness Scale (SRS) questionnaire at age 12. Linear regression models adjusting for confounders were applied to estimate the association between pollutants and SRS scores. After adjusting for covariates, the association between NO2 and PM2.5 and SRS scores remained positive but were no longer statistically significant. Prenatal and first year exposure to NO2 were associated with total SRS T-scores with an estimated 0.4 point increase (95% CI: -0.7, 1.6) per 5.2 ppb increase in NO2 exposure and 0.7 point (95% CI: -0.3, 1.6) per 4.2 ppb increase in NO2 exposure, respectively. For PM2.5, a 2.6 μg/m3 increase in prenatal exposure was associated with a 0.1 point increase (95% CI: -1.1, 1.4) in SRS Total T-scores and a 1.3 μg/m3 increase first year of life was associated with a 1 point increase (95% CI: -0.2, 2.3). In summary, exposure to NO2 and PM2.5 during pregnancy and the first year of life were not significantly associated with higher autistic-like behaviors measured with SRS scores after adjustment of covariates. Additional research is warranted given prior studies suggesting air pollution contributes to ASD.
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Affiliation(s)
- Nidhi Iyanna
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Grace LeMasters
- Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's and Women's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Kim M Cecil
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, USA
| | - Cole Brokamp
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Erika Rasnick
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melinda C MacDougall
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patrick H Ryan
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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18
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Ruis M, Hoffman K, Stapleton HM. Brominated flame retardants and legacy organochlorines in archived human placenta samples: Sex differences, temporal analysis and associations with infant birth weight. CHEMOSPHERE 2023; 322:138170. [PMID: 36804493 PMCID: PMC10039416 DOI: 10.1016/j.chemosphere.2023.138170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Perinatal exposure to persistent organic pollutants (POPs) has been suggested to play a role in the etiology of adverse pregnancy outcomes. This study evaluated temporal changes in the accumulation of several classes of POPs, including polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and several organochlorine pesticides in human placenta and examined their associations with birth outcomes at delivery. Placental tissues (n = 99) previously collected and archived at the Duke University Medical Center from 2009 to 2015 were analyzed for 22 POPs using gas chromatography mass spectrometry. The mean age of mothers was 30.6 years; 8% of newborns were characterized as low birthweight (<2500 g). Of the 22 POPs targeted in the analysis, only p,p'-DDE, BDE-47 and BDE-100 were detected in more than 50% of the samples, with median concentrations of 0.110, 0.310, and 0.033 ng/g wet weight, respectively. Placental PBDE concentrations generally decreased over time, particularly BDE-47. Placental tissues associated with female infants had significantly higher levels of BDE-100 than placental tissues associated with male infants (p = 0.02) and a similar, but not statistically significant trend was observed for BDE-47 (p = 0.07). Multivariate regression models revealed that placental BDE-47 concentrations were associated with a significantly lower birthweight among male, but not female infants. A similar, although non-statistically significant, trend was observed for other POPs, further suggesting sex-specific associations between gestational exposure to POPs and birthweight.
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Affiliation(s)
- Matthew Ruis
- Nicholas School of the Environment, Levine Science Research Center, Duke University, Durham, NC, 27710, USA
| | - Kate Hoffman
- Nicholas School of the Environment, Levine Science Research Center, Duke University, Durham, NC, 27710, USA; Children's Health Discovery Initiative, Duke School of Medicine, North Carolina, United States
| | - Heather M Stapleton
- Nicholas School of the Environment, Levine Science Research Center, Duke University, Durham, NC, 27710, USA.
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19
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Krawczyk K, Marynowicz W, Pich K, Jedruch O, Kania G, Gogola-Mruk J, Tworzydlo W, Polanski Z, Ptak A. Persistent organic pollutants affect steroidogenic and apoptotic activities in granulosa cells and reactive oxygen species concentrations in oocytes in the mouse. Reprod Fertil Dev 2023; 35:294-305. [PMID: 36403477 DOI: 10.1071/rd21326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 10/28/2022] [Indexed: 11/21/2022] Open
Abstract
CONTEXT The destruction of granulosa cells (GCs), the main functional cell type in the ovary, prevents steroid hormone production, which in turn may damage oocytes, resulting in ovarian failure. The accumulation of a number of persistent organic pollutants (POPs) in the ovarian follicular fluid (FF) has been documented, which raises serious questions regarding their impact on female fertility. AIMS We aimed to determine whether a mixture of POPs reflecting the profile found in FF influences mouse GCs or oocyte function and viability. METHODS A mixture of POPs, comprising perfluorooctanoate, perfluorooctane sulfonate, 2,2-dichlorodiphenyldichloroethylene, polychlorinated biphenyl 153, and hexachlorobenzene, was used. In addition to using the exact concentration of POPs previously measured in human FF, we tested two other mixtures, one with10-fold lower and another with 10-fold higher concentrations of each POP. KEY RESULTS Steroidogenesis was disrupted in GCs by the POP mixture, as demonstrated by lower oestradiol and progesterone secretion and greater lipid droplet accumulation. Furthermore, the POP mixture reduced GC viability and increased apoptosis, assessed using caspase-3 activity. The POP mixture significantly increased the number of oocytes that successfully progressed to the second meiotic metaphase and the oocyte reactive oxygen species (ROS) concentration. CONCLUSIONS Thus, a mixture of POPs that are typically present in human FF has detrimental effects on ovarian function: it reduces the viability of GCs, and increases the oocyte concentrations of ROS. IMPLICATIONS These results indicate that chronic exposure to POPs adversely affects female reproductive health.
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Affiliation(s)
- Kinga Krawczyk
- Laboratory of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Weronika Marynowicz
- Laboratory of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Karolina Pich
- Laboratory of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Oliwia Jedruch
- Laboratory of Genetics and Evolution, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Gabriela Kania
- Laboratory of Genetics and Evolution, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Justyna Gogola-Mruk
- Laboratory of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Waclaw Tworzydlo
- Department of Developmental Biology and Invertebrate Morphology, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Zbigniew Polanski
- Laboratory of Genetics and Evolution, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
| | - Anna Ptak
- Laboratory of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, Gronostajowa 9, 30-387 Krakow, Poland
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20
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Tesfamariam K, Gebreyesus SH, Lachat C, Hanley-Cook GT, Roro M, Mengistu YG, Endris BS, Belachew T, Kolsteren P, De Saeger S, De Boevre M, Argaw A. Chronic aflatoxin exposure during pregnancy is associated with lower fetal growth trajectories: a prospective cohort from the Butajira Nutrition, Mental Health, and Pregnancy (BUNMAP) Study in rural Ethiopia. Am J Clin Nutr 2022; 116:1634-1641. [PMID: 36178051 DOI: 10.1093/ajcn/nqac280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 09/28/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed. OBJECTIVES In the present study, we examined the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural setting in Ethiopia. METHODS In a prospective cohort study, we enrolled 492 pregnant females, with a singleton pregnancy and before 28 wk of gestation. Serum aflatoxin B1-lysine concentration was measured using LC-tandem MS. Three rounds of ultrasound measurements were conducted to estimate fetal weight at mean ± SD gestational age weeks of 19.1 ± 3.71, 28.5 ± 3.51, and 34.5 ± 2.44. Estimated fetal weight was expressed in centiles using the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B1-lysine concentration above or equal to the limit of detection) and unexposed mothers in the study. RESULTS Mothers had a mean ± SD age of 26.0 ± 4.58 y. The median (25th, 75th percentile) serum aflatoxin B1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the females enrolled provided at least 2 ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational-age centile than the unexposed group (ß = -0.92; 95% CI: -1.77, -0.06 centiles/week; P = 0.037). CONCLUSIONS Chronic maternal aflatoxin exposure is associated with lower fetal growth over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure and adopting food safety measures in low-income settings, in particular during the fetal period of development.
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Affiliation(s)
- Kokeb Tesfamariam
- Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.,Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.,Center of Excellence in Mycotoxicology and Public Health, MYTOX-SOUTH Coordination Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.,Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Seifu H Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Carl Lachat
- Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Meselech Roro
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork G Mengistu
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bilal S Endris
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tefera Belachew
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Patrick Kolsteren
- Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Sarah De Saeger
- Center of Excellence in Mycotoxicology and Public Health, MYTOX-SOUTH Coordination Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.,Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, Gauteng, South Africa
| | - Marthe De Boevre
- Center of Excellence in Mycotoxicology and Public Health, MYTOX-SOUTH Coordination Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Alemayehu Argaw
- Department of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.,Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Melanda VS, Galiciolli MEA, Lima LS, Figueiredo BC, Oliveira CS. Impact of Pesticides on Cancer and Congenital Malformation: A Systematic Review. TOXICS 2022; 10:toxics10110676. [PMID: 36355967 PMCID: PMC9692481 DOI: 10.3390/toxics10110676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 05/23/2023]
Abstract
Pesticide exposure has deleterious effects on human health and development; however, no review has been conducted on human exposure to pesticides and the risk of congenital malformations and cancer in the same cohort. We systematically reviewed the evidence for this relationship following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Four databases, namely, PubMed, Scopus, Cochrane Library, and BVS, were searched for studies deposited till July 2020 that examined the influence of pesticide exposure on congenital malformations and cancer outcomes in the same cohort. Seven studies were systematically included in this review. Among these, four were case-control studies, two were cross-sectional studies, and one was a longitudinal cohort study. The sources of contamination were food, water, or exposure during agricultural work. A link between the occurrence of cancer, congenital malformations, and exposure to pesticides was observed in most studies.
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Affiliation(s)
- Viviane Serra Melanda
- Instituto de Pesquisa Pelé Pequeno Príncipe, Rua Silva Jardim, 1632, Curitiba 80250-060, PR, Brazil
- Faculdades Pequeno Príncipe, Avenida Iguaçu, 333, Curitiba 80230-020, PR, Brazil
| | - Maria Eduarda A. Galiciolli
- Instituto de Pesquisa Pelé Pequeno Príncipe, Rua Silva Jardim, 1632, Curitiba 80250-060, PR, Brazil
- Faculdades Pequeno Príncipe, Avenida Iguaçu, 333, Curitiba 80230-020, PR, Brazil
| | - Luíza S. Lima
- Instituto de Pesquisa Pelé Pequeno Príncipe, Rua Silva Jardim, 1632, Curitiba 80250-060, PR, Brazil
- Faculdades Pequeno Príncipe, Avenida Iguaçu, 333, Curitiba 80230-020, PR, Brazil
| | - Bonald C. Figueiredo
- Instituto de Pesquisa Pelé Pequeno Príncipe, Rua Silva Jardim, 1632, Curitiba 80250-060, PR, Brazil
- Faculdades Pequeno Príncipe, Avenida Iguaçu, 333, Curitiba 80230-020, PR, Brazil
| | - Cláudia S. Oliveira
- Instituto de Pesquisa Pelé Pequeno Príncipe, Rua Silva Jardim, 1632, Curitiba 80250-060, PR, Brazil
- Faculdades Pequeno Príncipe, Avenida Iguaçu, 333, Curitiba 80230-020, PR, Brazil
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Pesticides and Their Impairing Effects on Epithelial Barrier Integrity, Dysbiosis, Disruption of the AhR Signaling Pathway and Development of Immune-Mediated Inflammatory Diseases. Int J Mol Sci 2022; 23:ijms232012402. [PMID: 36293259 PMCID: PMC9604036 DOI: 10.3390/ijms232012402] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
The environmental and occupational risk we confront from agricultural chemicals increases as their presence in natural habitats rises to hazardous levels, building a major part of the exposome. This is of particular concern in low- and middle-income countries, such as Brazil, known as a leading producer of agricultural commodities and consumer of pesticides. As long as public policies continue to encourage the indiscriminate use of pesticides and governments continue to support this strategy instead of endorsing sustainable agricultural alternatives, the environmental burden that damages epithelial barriers will continue to grow. Chronic exposure to environmental contaminants in early life can affect crucial barrier tissue, such as skin epithelium, airways, and intestine, causing increased permeability, leaking, dysbiosis, and inflammation, with serious implications for metabolism and homeostasis. This vicious cycle of exposure to environmental factors and the consequent damage to the epithelial barrier has been associated with an increase in immune-mediated chronic inflammatory diseases. Understanding how the harmful effects of pesticides on the epithelial barrier impact cellular interactions mediated by endogenous sensors that coordinate a successful immune system represents a crucial challenge. In line with the epithelial barrier hypothesis, this narrative review reports the available evidence on the effects of pesticides on epithelial barrier integrity, dysbiosis, AhR signaling, and the consequent development of immune-mediated inflammatory diseases.
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Toutounchi NS, Braber S, Land BV, Thijssen S, Garssen J, Folkerts G, Hogenkamp A. Deoxynivalenol exposure during pregnancy has adverse effects on placental structure and immunity in mice model. Reprod Toxicol 2022; 112:109-118. [PMID: 35840118 DOI: 10.1016/j.reprotox.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/10/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022]
Abstract
Deoxynivalenol (DON), a highly prevalent food contaminant, is known to induce reproductive and immunotoxicity in humans upon exposure. The present study focused on the consequences of exposure to DON during pregnancy for placental barrier and immune function, as well as fetal survival. Female mice received diets contaminated with DON (6.25 and 12.5 mg/kg of diet), starting immediately after mating until the end of the experiment. On day 17 of pregnancy the animals were killed, and maternal and fetal samples were collected for further analysis. Feeding on DON-contaminated diets decreased fetal survival, and DON was detected at significant levels in the fetus. Placentae from DON-exposed mice revealed a reduction in expression of junctional proteins, ZO-1, E-cadherin and claudins, upregulation of AHR mRNA expressions, and increase in IFN-ꝩ, IL-6 and IL-4 production. In conclusion, results of this study demonstrate harmful effects of DON on the course of pregnancy and fetal survival, which might be due to immunological changes in maternal immune organs and placenta. Altogether, these data underline the importance of the quality of maternal diet during pregnancy as they clearly demonstrate the potential harmful effects of a commonly present food-contaminant.
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Affiliation(s)
- Negisa Seyed Toutounchi
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Saskia Braber
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Belinda Van't Land
- Department of Immunology, Danone Nutricia Research, Utrecht, the Netherlands; Laboratory of Translational Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Suzan Thijssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; Department of Immunology, Danone Nutricia Research, Utrecht, the Netherlands
| | - Gert Folkerts
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Astrid Hogenkamp
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands.
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The DevTox Germ Layer Reporter Platform: An Assay Adaptation of the Human Pluripotent Stem Cell Test. TOXICS 2022; 10:toxics10070392. [PMID: 35878297 PMCID: PMC9321663 DOI: 10.3390/toxics10070392] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/14/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022]
Abstract
Environmental chemical exposures are a contributing factor to birth defects affecting infant morbidity and mortality. The USA EPA is committed to developing new approach methods (NAMs) to detect chemical risks to susceptible populations, including pregnant women. NAM-based coverage for cellular mechanisms associated with early human development could enhance identification of potential developmental toxicants (DevTox) for new and existing data-poor chemicals. The human pluripotent stem cell test (hPST) is an in vitro test method for rapidly identifying potential human developmental toxicants that employs directed differentiation of embryonic stem cells to measure reductions in SOX17 biomarker expression and nuclear localization. The objective of this study was to expand on the hPST principles to develop a model platform (DevTox GLR) that utilizes the transgenic RUES2-GLR cell line expressing fluorescent reporter fusion protein biomarkers for SOX17 (endoderm marker), BRA (mesoderm marker), and SOX2 (ectoderm and pluripotency marker). Initial assay adaption to definitive endoderm (DevTox GLR-Endo) was performed to emulate the hPST SOX17 endpoint and enable comparative evaluation of concordant chemical effects. Assay duration was reduced to two days and screening throughput scaled to 384-well format for enhanced speed and efficiency. Assay performance for 66 chemicals derived from reference and training set data resulted in a balanced accuracy of 72% (79% sensitivity and 65% specificity). The DevTox GLR-Endo assay demonstrates successful adaptation of the hPST concept with increased throughput, shorter assay duration, and minimal endpoint processing. The DevTox GLR model platform expands the in vitro NAM toolbox to rapidly identify potential developmental hazards and mechanistically characterize toxicant effects on pathways and processes associated with early human development.
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Wing SE, Larson TV, Hudda N, Boonyarattaphan S, Del Rosario I, Fruin S, Ritz B. Aircraft noise and vehicle traffic-related air pollution interact to affect preterm birth risk in Los Angeles, California. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 829:154678. [PMID: 35314238 DOI: 10.1016/j.scitotenv.2022.154678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Air pollution has been linked to preterm birth (PTB) while findings for noise exposure have been mixed. Few studies - none considering airports - have investigated combined exposures. We explore the relationship between joint exposure to airport-related noise, airport ultrafine particles (UFP), and vehicle traffic-related air pollution (TRAP) on risk of PTB near Los Angeles International Airport (LAX). METHODS We used comprehensive birth data for mothers living ≤15 km from LAX from 2008 to 2016 (n = 174,186) Noise data were generated by monitor-validated models. NO2 was used as a TRAP proxy, estimated with a seasonally-adjusted, validated land-use regression model. We estimated the effects of exposure to airport-related noise and TRAP on PTB employing logistic regression models that adjusted for known maternal risk factors for PTB as well as aircraft-origin UFP and neighborhood characteristics. RESULTS The adjusted odds ratio (aOR) for PTB from high noise exposure (i.e. > 65 dB) was 1.10 (95% CI: 1.01-1.19). Relative to the first quartile, the aORs for PTB in the second, third, and fourth TRAP quartiles were 1.10 (95% CI: 1.05-1.16), 1.11 (95% CI: 1.05-1.16), and 1.15 (95% CI: 1.10-1.22), respectively. When stratifying by increasing TRAP quartiles, the aORs for PTB with high airport-related noise were 1.04 (95% CI: 0.91-1.18), 1.02 (95% CI: 0.88-1.19), 1.24 (95% CI: 1.03-1.48), and 1.44 (95% CI: 1.08-1.91) (p-interaction = 0.06). CONCLUSION Our results suggest a potential synergism between airport-related noise and TRAP exposures on increasing the risk of PTB in this metropolitan area.
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Affiliation(s)
- Sam E Wing
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Timothy V Larson
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States.
| | - Neelakshi Hudda
- Department of Civil & Environmental Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, United States.
| | - Sarunporn Boonyarattaphan
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States
| | - Irish Del Rosario
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Scott Fruin
- Division of Environmental Health, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90033, United States
| | - Beate Ritz
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
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Chen X, Huang L, Li Q, Zhang X, Wang X, Sun G, Yi N, Xiong G, Yang X, Hao L, Yang H, Yang N. Effect of maternal thallium exposure in early pregnancy on the risk of preterm birth. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:49966-49975. [PMID: 35220538 DOI: 10.1007/s11356-022-19332-6] [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: 09/07/2021] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Human activities have significantly increased the release of thallium (Tl) to the environment. However, the study of the relationship between maternal Tl exposure during pregnancy and the risk of preterm birth (PTB) is scarce so far. We aimed to investigate the association between Tl exposure in early pregnancy and the risk of PTB. A total of 2104 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China were enrolled in the analysis. We collected the urine samples in early pregnancy (< 20 weeks) and inductively coupled plasma mass spectrometry (ICP-MS) was used to detect urinary Tl levels. The association between Tl levels and the risk of PTB was evaluated by an unconditional logistic regression. The median and geometric mean values of Tl levels were 0.35 μg/L (0.47 μg/g creatinine) and 0.33 μg/L (0.47 μg/g creatinine), respectively. Compared with the lowest tertile of Tl levels (≤ 0.37 μg/g creatinine), the highest tertile (> 0.57 μg/g creatinine) was associated with an increased risk of PTB with an adjusted odds ratio (OR) of 2.11 (95% confidence interval (CI): 1.08, 4.12). Stratified analyses showed an elevated risk of PTB related to the highest tertile of Tl levels for male newborns. After excluding women with miss covariate information, gestational diabetes mellitus, pregnancy-induced hypertension, reporting fish intake, or exposed to smoke, the association remained stable. Our results suggested that maternal Tl exposure during early pregnancy was positively associated with the risk of PTB, and Tl exposure may have a sex-specific effect on PTB.
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Affiliation(s)
- Xi Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xiaoyi Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Guoqiang Sun
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Nianhua Yi
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, Hubei, 430013, People's Republic of China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Hongying Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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Huang R, Yang S, Lei Y. Birth weight influences differently on systolic and diastolic blood pressure in children and adolescents aged 8-15. BMC Pediatr 2022; 22:278. [PMID: 35562698 PMCID: PMC9103067 DOI: 10.1186/s12887-022-03346-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/03/2022] [Indexed: 11/29/2022] Open
Abstract
AIM Globally, hypertension is one of the main threats to public health and a significant risk factor predisposing individuals to various cardiovascular conditions. Hypertension in the young is particularly complex and challenging. Accumulating evidence has implicated that low birth weight is vital for elevated blood pressure, and birth weight was negatively correlated with blood pressure. However, fewer studies with conflicting results have addressed the associations between birth weight and blood pressure in children and adolescents, and there is no relevant research conducted in the NHANES population. The principal objective of this project was to investigate the relationship between birth weight and blood pressure in children and adolescents in NHANES. METHODS A total of 7600 subjects aged 8 to15 were enrolled in the present study from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Outcome variables were systolic blood pressure(SBP) and diastolic blood pressure(DBP). Birth weight was regarded as an independent variable. EmpowerStats software and R (version 3.4.3) were performed to examine the association between birth weight and SBP or DBP. RESULTS Birth weight was negatively correlated with SBP in the fully-adjusted model(β = -0.02, 95%CI: -0.04 to -0.04, p = 0.0013), especially in non-Hispanic White (β = -0.03, 95%CI: -0.06 to -0.00,p = 0.0446), aged between 13 to 15(β = -0.03, 95%CI: -0.04 to -0.01, p = 0.0027), and male individuals(β = -0.03, 95%CI: -0.05 to -0.01, p = 0.0027). However, there was no unidirectional association between birth weight and DBP in the fully adjusted model(β = -0.01, 95%CI: -0.03 to 0.02, p = 0.5668) and in sub-analysis. An inverted U-shaped and J-shaped relationship was uncovered between birth weight and DBP in those aged 13 or above and Mexican Americans, respectively. The inflection point calculated by a recursive algorithm of birth weight in these groups was all 105 oz. CONCLUSIONS The current study identified that birth weight was negatively related to SBP but not significantly related to DBP in children and adolescents aged 8 to 15, highlighting different potential mechanisms behind high SBP and high DBP in the young. However, an inverted U-shaped and J-shaped relationship between birth weight and DBP was observed, suggesting that targeted intervention measures should be taken for different groups of people rather than generalizations.
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Affiliation(s)
- Rui Huang
- Cardiovascular Disease Center, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, No.158 Wuyang Avenue, Hubei Province, 445000, Enshi City, China
| | - Shengxiang Yang
- Cardiovascular Disease Center, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, No.158 Wuyang Avenue, Hubei Province, 445000, Enshi City, China
| | - Yuhua Lei
- Cardiovascular Disease Center, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, No.158 Wuyang Avenue, Hubei Province, 445000, Enshi City, China.
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Pascual F. Trophoblast Organoids: A New Tool for Studying Placental Development. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:54003. [PMID: 35638568 PMCID: PMC9153080 DOI: 10.1289/ehp11351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
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Blaauwendraad SM, Gaillard R, Santos S, Sol CM, Kannan K, Trasande L, Jaddoe VW. Maternal Phthalate and Bisphenol Urine Concentrations during Pregnancy and Early Markers of Arterial Health in Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:47007. [PMID: 35471947 PMCID: PMC9041527 DOI: 10.1289/ehp10293] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Fetal exposure to endocrine-disrupting chemicals such as phthalates and bisphenols might lead to fetal cardiovascular developmental adaptations and predispose individuals to cardiovascular disease in later life. OBJECTIVES We examined the associations of maternal urinary bisphenol and phthalate concentrations in pregnancy with offspring carotid intima-media thickness and distensibility at the age of 10 y. METHODS In a population-based, prospective cohort study of 935 mother-child pairs, we measured maternal urinary phthalate and bisphenol concentrations at each trimester. Later, we measured child carotid intima-media thickness and distensibility in the children at age 10 y using ultrasound. RESULTS Maternal urinary average or trimester-specific phthalate concentrations were not associated with child carotid intima-media thickness at age 10 y. Higher maternal average concentrations of total bisphenol, especially bisphenol A, were associated with a lower carotid intima-media thickness [differences -0.15 standard deviation score and 95% confidence interval (CI): -0.24, -0.09 and -0.13 (95% CI: -0.22, -0.04) per interquartile range (IQR) increase in maternal urinary total bisphenol and bisphenol A concentration]. Trimester-specific analysis showed that higher maternal third-trimester total bisphenol and bisphenol A concentrations were associated with lower child carotid intima-media thickness [differences -0.13 (95% CI: -0.22, -0.04) and -0.13 (95% CI: -0.22, -0.05) per IQR increase in maternal urinary bisphenol concentration]. Maternal urinary bisphenol or phthalate concentrations were not associated with child carotid distensibility. DISCUSSION In this large prospective cohort, higher maternal urinary bisphenols concentrations were associated with smaller childhood carotid intima-media thickness. Further studies are needed to replicate this association and to identify potential underlying mechanisms. https://doi.org/10.1289/EHP10293.
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Affiliation(s)
- Sophia M. Blaauwendraad
- The Generation R Study Group, Erasmus Medical Center (MC), University Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus Medical Center (MC), University Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus Medical Center (MC), University Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Chalana M. Sol
- The Generation R Study Group, Erasmus Medical Center (MC), University Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
- Department of Population Health, New York University School of Medicine, New York, New York, USA
- New York University Wagner School of Public Service, New York University, New York, New York, USA
- New York University College of Global Public Health, New York University, New York, New York, USA
| | - Vincent W.V. Jaddoe
- The Generation R Study Group, Erasmus Medical Center (MC), University Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Lopes-Ferreira M, Maleski ALA, Balan-Lima L, Bernardo JTG, Hipolito LM, Seni-Silva AC, Batista-Filho J, Falcao MAP, Lima C. Impact of Pesticides on Human Health in the Last Six Years in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063198. [PMID: 35328887 PMCID: PMC8951416 DOI: 10.3390/ijerph19063198] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 12/15/2022]
Abstract
Every year, Brazil intensifies its activity in agriculture and, as a result, it has become one of the biggest consumers of pesticides in the world. The high rate of these substances raises environmental and human health concerns. Therefore, we collected papers from PubMed, Scopus, Scielo, and Web of Science databases, from 2015 to 2021. After a blind selection using the software Rayyan QCRI by two authors, 51 studies were included. Researchers from the South and the Southeast Brazilian regions contributed to most publications, from areas that concentrate agricultural commodity complexes. Among the pesticides described in the studies, insecticides, herbicides, and fungicides were the most frequent. The articles reported multiple toxic effects, particularly in rural workers. The results obtained can be used to direct policies to reduce the use of pesticides, and to protect the health of the population.
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Affiliation(s)
- Monica Lopes-Ferreira
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
- Correspondence:
| | - Adolfo Luis Almeida Maleski
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
- Post-Graduation Program of Toxinology, Butantan Institute, São Paulo 05503-009, Brazil
| | - Leticia Balan-Lima
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
| | - Jefferson Thiago Gonçalves Bernardo
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
| | - Lucas Marques Hipolito
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
| | - Ana Carolina Seni-Silva
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
- Post-Graduation Program of Toxinology, Butantan Institute, São Paulo 05503-009, Brazil
| | - Joao Batista-Filho
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
- Post-Graduation Program of Toxinology, Butantan Institute, São Paulo 05503-009, Brazil
| | - Maria Alice Pimentel Falcao
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
| | - Carla Lima
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, Vital Brazil Avenue, 1500, Butantan, São Paulo 05503-009, Brazil; (A.L.A.M.); (L.B.-L.); (J.T.G.B.); (L.M.H.); (A.C.S.-S.); (J.B.-F.); (M.A.P.F.); (C.L.)
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Doherty BT, McRitchie SL, Pathmasiri WW, Stewart DA, Kirchner D, Anderson KA, Gui J, Madan JC, Hoen AG, Sumner SJ, Karagas MR, Romano ME. Chemical exposures assessed via silicone wristbands and endogenous plasma metabolomics during pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:259-267. [PMID: 34702988 PMCID: PMC8930423 DOI: 10.1038/s41370-021-00394-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND Metabolomics is a promising method to investigate physiological effects of chemical exposures during pregnancy, with the potential to clarify toxicological mechanisms, suggest sensitive endpoints, and identify novel biomarkers of exposures. OBJECTIVE Investigate the influence of chemical exposures on the maternal plasma metabolome during pregnancy. METHODS Data were obtained from participants (n = 177) in the New Hampshire Birth Cohort Study, a prospective pregnancy cohort. Chemical exposures were assessed via silicone wristbands worn for one week at ~13 gestational weeks. Metabolomic features were assessed in plasma samples obtained at ~24-28 gestational weeks via the Biocrates AbsoluteIDQ® p180 kit and nuclear magnetic resonance (NMR) spectroscopy. Associations between chemical exposures and plasma metabolomics were investigated using multivariate modeling. RESULTS Chemical exposures predicted 11 (of 226) and 23 (of 125) metabolomic features in Biocrates and NMR, respectively. The joint chemical exposures did not significantly predict pathway enrichment, though some individual chemicals were associated with certain amino acids and related metabolic pathways. For example, N,N-diethyl-m-toluamide was associated with the amino acids glycine, L-glutamic acid, L-asparagine, and L-aspartic acid and enrichment of the ammonia recycling pathway. SIGNIFICANCE This study contributes evidence to the potential effects of chemical exposures during pregnancy upon the endogenous maternal plasma metabolome.
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Affiliation(s)
- Brett T Doherty
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Susan L McRitchie
- Nutrition Research Institute, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wimal W Pathmasiri
- Nutrition Research Institute, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delisha A Stewart
- Nutrition Research Institute, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David Kirchner
- Nutrition Research Institute, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kim A Anderson
- Department of Environmental and Molecular Toxicology, Oregon Status University, Corvallis, OR, USA
| | - Jiang Gui
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
| | - Juliette C Madan
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Department of Pediatrics and Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Anne G Hoen
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
| | - Susan J Sumner
- Nutrition Research Institute, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margaret R Karagas
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan E Romano
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
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Veras M, Waked D, Saldiva P. Safe in the womb? Effects of air pollution to the unborn child and neonates. J Pediatr (Rio J) 2022; 98 Suppl 1:S27-S31. [PMID: 34740534 PMCID: PMC9510928 DOI: 10.1016/j.jped.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE In this brief review, the authors focus on the effects of gestational exposures to urban air pollution on fetal development and neonatal outcomes. SOURCE OF DATA In this review the authors used PubMed, Web of Science and SciELO research platforms, analyzing papers from the last 30 years. SUMMARY OF THE FINDINGS Epidemiological and experimental evidence agree that gestational exposure to air pollution in urban increases the risks for low birth weight, preterm birth, congenital malformation, intrauterine growth restriction, and neonatal mortality. Furthermore, exposures are associated with increased risks for preeclampsia, hypertension, gestational diabetes. CONCLUSIONS Therefore, it is time for greater involvement and engagement of the health sector in the discussion of public policies that may affect the quality of the environment, and that directly or indirectly impact the health of those who were not yet born.
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Affiliation(s)
- Mariana Veras
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil.
| | - Dunia Waked
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil
| | - Paulo Saldiva
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil
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Tesfamariam K, Argaw A, Hanley-Cook GT, Gebreyesus SH, Kolsteren P, Belachew T, Van de Velde M, De Saeger S, De Boevre M, Lachat C. Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes: a prospective cohort study in rural Ethiopia. ENVIRONMENT INTERNATIONAL 2022; 160:107052. [PMID: 34952355 DOI: 10.1016/j.envint.2021.107052] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes in low- and middle-income countries. The evidence, however, is inconsistent and mainly limited to the assessment of a single mycotoxin. We assessed biomarkers of exposure to multiple mycotoxins during pregnancy and their associations with adverse birth outcomes in rural Ethiopia. METHODS We analyzed data from 579 pregnant women between 8 and 24 weeks of completed gestation enrolled in a prospective cohort study. Serum mycotoxin concentrations were determined using liquid chromatography coupled with tandem mass spectrometry. Multivariable linear probability models, adjusted for potential confounding factors and multiple comparisons, were fitted to assess the associations between mycotoxin exposure and small for gestational age and preterm birth. We applied principal component analysis to reduce the dimensionality of biomarker data from several taxonomic mycotoxin groups. RESULTS All pregnant women were co-exposed to at least five mycotoxins, and one pregnant woman was co-exposed to 27 mycotoxins. Fumonisins (FB), i.e., FB2, FB3, FB1, and tenuazonic acid were the most frequently identified mycotoxins in 98.8, 95.3, 93.3, and 81.4% of the samples respectively. Deoxynivalenol was detected in 38.7%, nivalenol in 50.1%, ochratoxin α in 67.9%, and zearalenone in 50.9% of the serum samples. After adjustment, we found no statistically significant (all P ≥ 0.05) associations between mycotoxin exposures and birth outcomes. CONCLUSIONS Despite our study providing no evidence for relationships between mycotoxin biomarkers and adverse birth outcomes, our findings do indicate an extensive presence of multiple mycotoxin exposure among pregnant women. Public health policies and nutrition-sensitive interventions must ensure exposure to mycotoxins is reduced in rural Ethiopia.
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Affiliation(s)
- Kokeb Tesfamariam
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium; Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium; Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Alemayehu Argaw
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium; Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Seifu H Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Tefera Belachew
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mario Van de Velde
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium
| | - Sarah De Saeger
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium; Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, Gauteng, South Africa
| | - Marthe De Boevre
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
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Rumph JT, Stephens VR, Martin JL, Brown LK, Thomas PL, Cooley A, Osteen KG, Bruner-Tran KL. Uncovering Evidence: Associations between Environmental Contaminants and Disparities in Women's Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031257. [PMID: 35162279 PMCID: PMC8835285 DOI: 10.3390/ijerph19031257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
Over the years, industrial accidents and military actions have led to unintentional, large-scale, high-dose human exposure to environmental contaminants with endocrine-disrupting action. These historical events, in addition to laboratory studies, suggest that exposure to toxicants such as dioxins and polychlorinated biphenyls negatively impact the reproductive system and likely influence the development of gynecologic diseases. Although high-level exposure to a single toxicant is rare, humans living in industrialized countries are continuously exposed to a complex mixture of manmade and naturally produced endocrine disruptors, including persistent organic pollutants and heavy metals. Since minorities are more likely to live in areas with known environmental contamination; herein, we conducted a literature review to identify potential associations between toxicant exposure and racial disparities in women's health. Evidence within the literature suggests that the body burden of environmental contaminants, especially in combination with inherent genetic variations, likely contributes to previously observed racial disparities in women's health conditions such as breast cancer, endometriosis, polycystic ovarian syndrome, uterine fibroids, and premature birth.
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Affiliation(s)
- Jelonia T. Rumph
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (J.T.R.); (J.L.M.); (L.K.B.); (P.L.T.); (A.C.)
- Women’s Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (V.R.S.); (K.G.O.)
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
| | - Victoria R. Stephens
- Women’s Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (V.R.S.); (K.G.O.)
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Joanie L. Martin
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (J.T.R.); (J.L.M.); (L.K.B.); (P.L.T.); (A.C.)
| | - LaKendria K. Brown
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (J.T.R.); (J.L.M.); (L.K.B.); (P.L.T.); (A.C.)
| | - Portia L. Thomas
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (J.T.R.); (J.L.M.); (L.K.B.); (P.L.T.); (A.C.)
| | - Ayorinde Cooley
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (J.T.R.); (J.L.M.); (L.K.B.); (P.L.T.); (A.C.)
| | - Kevin G. Osteen
- Women’s Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (V.R.S.); (K.G.O.)
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- VA Tennessee Valley Healthcare System, Nashville, TN 37208, USA
| | - Kaylon L. Bruner-Tran
- Women’s Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (V.R.S.); (K.G.O.)
- Correspondence:
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Li J, Lin S, Wu J, Pei L, Shang X. OUP accepted manuscript. Int Health 2022; 15:299-308. [PMID: 35521756 PMCID: PMC10153556 DOI: 10.1093/inthealth/ihac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/15/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Maternal exposure to pesticides during early pregnancy is associated with increased risks of birth defects, while the association between maternal exposure to chemical fertilizer during pregnancy and the risk of birth defects remains unknown. METHODS Data were from a population-based birth defects surveillance system between 2007 and 2012 in Pingding County, Shanxi Province, northern China. A total of 14 074 births with 235 birth defects were used to estimate spatial clustering and correlations at the village level. A population-based case-control study of 157 cases with birth defects and 204 controls was performed to investigate the association between maternal chemical fertilizer exposure and the risk of birth defects by a two-level logistic model. RESULTS The total prevalence of birth defects between 2007 and 2012 was 167.0/10 000 births. The spatial analysis indicated a remarkable high-risk area of birth defects in the southeast of Pingding County and the use of chemical fertilizer was associated with the risk of birth defects at the village level. After adjusting for confounders at the individual level, mothers who live in villages with chemical fertilizer application ≥65 tons/y had an increased risk of birth defects (adjusted odds ratio 2.06 [95% confidence interval 1.23 to 3.46]) compared with those of <65 tons/y. CONCLUSIONS Our findings suggest that the risk of birth defects may be associated with the use of chemical fertilizer in rural northern China. The findings must be cautiously interpreted and need to be investigated on larger samples.
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Affiliation(s)
| | | | - Jilei Wu
- Institute of Population Research/China Center on Population Health and Development, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing,100871, China
| | - Lijun Pei
- Corresponding authors: Tel: +86 010-62751974; E-mail:
| | - Xuejun Shang
- Corresponding authors: Tel: +86 025-84815775; E-mail:
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Sun G, Li Y. Molecular mechanisms of developmental toxicity induced by BBP in zebrafish embryos. Toxicology 2021; 466:153078. [PMID: 34933018 DOI: 10.1016/j.tox.2021.153078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/30/2021] [Accepted: 12/16/2021] [Indexed: 02/07/2023]
Abstract
Butylbenzyl phthalate (BBP) has been shown to negatively affect the development of zebrafish embryos, however, its underlying mechanisms remain unclear. Therefore, our study aims to reveal the molecular mechanisms of developmental toxicity on zebrafish embryos. Zebrafish embryos were exposed to BBP (0, 0.6, and 1.2 mg/L) from 4 to 72 h post-fertilization (hpf). The adverse effects on zebrafish embryos were evaluated and the transcriptional profiles of zebrafish embryos were analyzed at 72hpf. Exposure to BBP decreased hatching and survival rates and induced obvious morphology abnormalities in zebrafish embryos. The activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) significantly decrease and the malondialdehyde (MDA) content significantly increased with 1.2 mg/L BBP exposure. Global transcriptome profiling analysis demonstrated that 578 and 1257 genes were differentially expressed in zebrafish embryos in the 0.6 and 1.2 mg/L groups, respectively. Gene Ontology (GO) term enrichment analysis demonstrated that DEGs are related to many aspects of cell composition, biological processes, and molecular functions. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis demonstrated that 13 and 22 pathways were significantly enriched in the 0.6 and 1.2 mg/L groups, respectively. DEGs were primarily concentrated in the metabolism of the 0.6 mg/L group and in the organismal systems and particularly affected vision and digestion in the 1.2 mg/L group. Our results contribute to a better understanding of the underlying mechanisms of developmental toxicity induced by phthalates.
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Affiliation(s)
- Guijin Sun
- School of Food Science and Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China.
| | - Yingqiu Li
- School of Food Science and Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
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Seyed Toutounchi N, Braber S, van’t Land B, Thijssen S, Garssen J, Kraneveld AD, Folkerts G, Hogenkamp A. Exposure to Deoxynivalenol During Pregnancy and Lactation Enhances Food Allergy and Reduces Vaccine Responsiveness in the Offspring in a Mouse Model. Front Immunol 2021; 12:797152. [PMID: 34975906 PMCID: PMC8718709 DOI: 10.3389/fimmu.2021.797152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
Deoxynivalenol (DON), a highly prevalent contaminant of grain-based products, is known to induce reproductive- and immunotoxicities. Considering the importance of immune development in early life, the present study investigated the effects of perinatal DON exposure on allergy development and vaccine responsiveness in the offspring. Pregnant mice received control or DON-contaminated diets (12.5 mg/kg diet) during pregnancy and lactation. After weaning, female offspring were sensitized to ovalbumin (OVA) by oral administration of OVA with cholera toxin (CT). Male offspring were injected with Influvac vaccine. OVA-specific acute allergic skin response (ASR) in females and vaccine-specific delayed-type hypersensitivity (DTH) in males were measured upon intradermal antigen challenge. Immune cell populations in spleen and antigen-specific plasma immunoglobulins were analyzed. In female CT+OVA-sensitized offspring of DON-exposed mothers ASR and OVA-specific plasma immunoglobulins were significantly higher, compared to the female offspring of control mothers. In vaccinated male offspring of DON-exposed mothers DTH and vaccine-specific antibody levels were significantly lower, compared to the male offspring of control mothers. In both models a significant reduction in regulatory T cells, Tbet+ Th1 cells and Th1-related cytokine production of the offspring of DON-exposed mothers was observed. In conclusion, early life dietary exposure to DON can adversely influence immune development in the offspring. Consequently, the immune system of the offspring may be skewed towards an imbalanced state, resulting in an increased allergic immune response to food allergens and a decreased immune response to vaccination against influenza virus in these models.
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Affiliation(s)
- Negisa Seyed Toutounchi
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Saskia Braber
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Belinda van’t Land
- Danone Nutricia Research, Utrecht, Netherlands
- Center of Translational Immunology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Suzan Thijssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
- Danone Nutricia Research, Utrecht, Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Gert Folkerts
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Astrid Hogenkamp
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
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Merrill AK, Anderson T, Conrad K, Marvin E, James-Todd T, Cory-Slechta DA, Sobolewski M. Protracted Impairment of Maternal Metabolic Health in Mouse Dams Following Pregnancy Exposure to a Mixture of Low Dose Endocrine-Disrupting Chemicals, a Pilot Study. TOXICS 2021; 9:346. [PMID: 34941779 PMCID: PMC8706199 DOI: 10.3390/toxics9120346] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/19/2021] [Accepted: 12/07/2021] [Indexed: 12/22/2022]
Abstract
Pregnancy, a period of increased metabolic demands coordinated by fluctuating steroid hormones, is an understudied critical window of disease susceptibility for later-life maternal metabolic health. Epidemiological studies have identified associations between exposures to various endocrine-disrupting chemicals (EDCs) with an increased risk for metabolic syndrome, obesity, and diabetes. Whether such adverse outcomes would be heightened by concurrent exposures to multiple EDCs during pregnancy, consistent with the reality that human exposures are to EDC mixtures, was examined in the current pilot study. Mouse dams were orally exposed to relatively low doses of four EDCs: (atrazine (10 mg/kg), bisphenol-A (50 µg/kg), perfluorooctanoic acid (0.1 mg/kg), 2,3,7,8-tetrachlorodibenzo-p-dioxin (0.036 µg/kg)), or the combination (MIX), from gestational day 7 until birth or for an equivalent 12 days in non-pregnant females. Glucose intolerance, serum lipids, weight, and visceral adiposity were assessed six months later. MIX-exposed dams exhibited hyperglycemia with a persistent elevation in blood glucose two hours after glucose administration in a glucose tolerance test, whereas no such effects were observed in MIX-exposed non-pregnant females. Correspondingly, MIX dams showed elevated serum low-density lipoprotein (LDL). There were no statistically significant differences in weight or visceral adipose; MIX dams showed an average visceral adipose volume to body volume ratio of 0.09, while the vehicle dams had an average ratio of 0.07. Collectively, these findings provide biological plausibility for the epidemiological associations observed between EDC exposures during pregnancy and subsequent maternal metabolic dyshomeostasis, and proof of concept data that highlight the importance of considering complex EDC mixtures based of off common health outcomes, e.g., for increased risk for later-life maternal metabolic effects following pregnancy.
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Affiliation(s)
- Alyssa K. Merrill
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
| | - Timothy Anderson
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
| | - Katherine Conrad
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
| | - Elena Marvin
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard University, Boston, MA 02115, USA;
| | - Deborah A. Cory-Slechta
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
| | - Marissa Sobolewski
- Department of Environmental Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA; (A.K.M.); (T.A.); (K.C.); (E.M.); (D.A.C.-S.)
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Lazarevic N, Barnett AG, Sly PD, Callan AC, Stasinska A, Heyworth JS, Hinwood AL, Knibbs LD. Prenatal exposure to mixtures of persistent environmental chemicals and fetal growth outcomes in Western Australia. Int J Hyg Environ Health 2021; 240:113899. [PMID: 34883336 DOI: 10.1016/j.ijheh.2021.113899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/21/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Environmental chemicals have been implicated in the etiology of impaired fetal growth. However, few studies have assessed the effects of chemical mixtures or considered the possibility of non-monotonic exposure-response relationships for chemicals that act through the endocrine system. METHODS We assessed exposure to polybrominated diphenyl ethers, organochlorine pesticides, metals, and perfluorinated alkyl substances in blood and urine samples collected approximately two weeks prior to delivery in 166 non-smoking pregnant women, and subsequent birth weight, length, and head circumference of neonates who were part of the Australian Maternal Exposures to Toxic Substances (AMETS) study. We used Bayesian structured additive regression models with spike-slab priors to estimate mixture effects, identify important exposures, and model non-linearity in exposure-response relationships. RESULTS Mixtures of polybrominated diphenyl ethers, organochlorine pesticides, metals, and perfluorinated alkyl substances were not associated with fetal growth outcomes. Estimated change in fetal growth outcomes for an increase in exposure from the 25th to 75th percentile suggested no meaningful associations; the strongest evidence was for a small inverse association between birth weight and cesium exposure measured in whole blood (-124 g, 90% credible interval: -240 to -3 g). We identified several chemicals that may be associated with fetal growth non-linearly; however, 90% credible intervals contained small values consistent with no meaningful association. CONCLUSIONS Using a Bayesian penalized regression method, we assessed the shapes of exposure-response relationships, controlled for confounding by co-exposure, and estimated the single and combined effects of a large mixture of correlated environmental chemicals on fetal growth. Our findings, based on a small sample of mother-neonate pairs, suggest that mixtures of persistent chemicals are not associated with birth weight, length, and head circumference. The potential for non-monotonic relationships between environmental chemicals and fetal growth outcomes warrants further study.
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Affiliation(s)
- Nina Lazarevic
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia; National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, 2600, Australia.
| | - Adrian G Barnett
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, 4101, Australia
| | - Anna C Callan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Ania Stasinska
- School of Population and Global Health, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Jane S Heyworth
- School of Population and Global Health, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Andrea L Hinwood
- United Nations Environment Programme, Nairobi, Kenya; School of Science, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Luke D Knibbs
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia
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40
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Vandenberg LN, Pelch KE. Systematic Review Methodologies and Endocrine Disrupting Chemicals: Improving Evaluations of the Plastic Monomer Bisphenol A. Endocr Metab Immune Disord Drug Targets 2021; 22:748-764. [PMID: 34610783 DOI: 10.2174/1871530321666211005163614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/25/2021] [Accepted: 08/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Endocrine disrupting chemicals (EDCs) are found in plastics, personal care products, household items, and other consumer goods. Risk assessments are intended to characterize a chemical's hazards, identify the doses at which adverse outcomes are observed, quantify exposure levels, and then compare these doses to determine the likelihood of risk in a given population. There are many problems with risk assessments for EDCs, allowing people to be exposed to levels that are later associated with serious health outcomes in epidemiology studies. OBJECTIVE In this review, we examine issues that affect the evaluation of EDCs in risk assessments (e.g., use of insensitive rodent strains and absence of disease-oriented outcomes in hazard assessments; inadequate exposure assessments). We then review one well-studied chemical, Bisphenol A (BPA; CAS #80-05-7) an EDC found in plastics, food packaging, and other consumer products. More than one hundred epidemiology studies suggest associations between BPA exposures and adverse health outcomes in environmentally exposed human populations. FINDINGS We present support for the use of systematic review methodologies in the evaluation of BPA and other EDCs. Systematic reviews would allow studies to be evaluated for their reliability and risk of bias. They would also allow all data to be used in risk assessments, which is a requirement for some regulatory agencies. CONCLUSION Systematic review methodologies can be used to improve evaluations of BPA and other EDCs. Their use could help to restore faith in risk assessments and ensure that all data are utilized in decision-making. Regulatory agencies are urged to conduct transparent, well-documented and proper systematic reviews for BPA and other EDCs.
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Affiliation(s)
- Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts - Amherst, United States
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41
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Cecchi A, Alvarez G, Quidel N, Bertone MC, Anderle S, Sabino G, Magnarelli GG, Rovedatti MG. Residential proximity to pesticide applications in Argentine Patagonia: impact on pregnancy and newborn parameters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:56565-56579. [PMID: 34060016 DOI: 10.1007/s11356-021-14574-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
Among residents living close to agricultural fields who are potentially exposed to pesticides, pregnant women and their fetuses are of particular concern for their vulnerability to environmental chemicals. In this collaborative multicenter study, we covered a wide distribution of participants in the most important fruit production zone of north Patagonia (Argentina) to investigate whether maternal residential proximity to fruit croplands with intense pesticide applications (rural group -RG-) is associated with pregnancy complications and alterations in their newborn parameters compared to the urban population (urban group -UG-). A total of 776 pregnant women met the inclusion criteria. The percentage of threatened miscarriage was significantly higher in the RG than in the UG. The percentage of miscarriage, threat of premature labor, intrauterine fetal death, preterm premature rupture of membranes, and intrauterine growth retardation were similar in both groups. Newborn anthropometric parameters were corrected by sex and gestational age prior to statistical analysis. Length at birth and head circumference were lower in the RG than in the UG. Birth weight was similar in both groups. The percentage of head circumference less than the 5th percentile and the ponderal index were greater in the RG than in the UG. Our results suggest that proximity to pesticide applications may increase the risk of pregnancy complications and altered newborn parameters.
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Affiliation(s)
- Amalia Cecchi
- Hospital Allen Dr. Ernesto Accame, Ingeniero Quesnel s/n, Allen, Río Negro, Argentina
| | - Gabriel Alvarez
- Hospital Provincial Neuquén Dr. Castro Rendón, Buenos Aires 450, (8300) Neuquén, 450, Neuquén, Argentina
| | - Natalia Quidel
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Av. Luis Toschi y Los Arrayanes, (8324) Cipolletti, Río Negro, Argentina
| | - María Cecilia Bertone
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Av. Luis Toschi y Los Arrayanes, (8324) Cipolletti, Río Negro, Argentina
| | - Sofia Anderle
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Av. Luis Toschi y Los Arrayanes, (8324) Cipolletti, Río Negro, Argentina
| | - Guillermo Sabino
- Facultad de Economía y Administración, Universidad Nacional del Comahue, Buenos Aires 1400, (8300), Neuquén, Argentina
| | - Gladis G Magnarelli
- Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Av. Luis Toschi y Los Arrayanes, (8324) Cipolletti, Río Negro, Argentina
| | - María Gabriela Rovedatti
- Departamento de Biodiversidad y Biología Experimental, and Laboratorio de Toxicología de Mezclas Químicas (LATOMEQ), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón II, 4to piso. Intendente Güiraldes 2160, (C1428EGA), Ciudad Autónoma de Buenos Aires, Argentina.
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42
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Blaauwendraad SM, Voerman E, Trasande L, Kannan K, Santos S, Ruijter GJG, Sol CM, Marchioro L, Shokry E, Koletzko B, Jaddoe VWV, Gaillard R. Associations of maternal bisphenol urine concentrations during pregnancy with neonatal metabolomic profiles. Metabolomics 2021; 17:84. [PMID: 34518915 PMCID: PMC8437833 DOI: 10.1007/s11306-021-01836-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 08/31/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fetal exposure to bisphenols is associated with altered fetal growth, adverse birth outcomes and childhood cardio-metabolic risk factors. Metabolomics may serve as a tool to identify the mechanisms underlying these associations. We examined the associations of maternal bisphenol urinary concentrations in pregnancy with neonatal metabolite profiles from cord blood. METHODS In a population-based prospective cohort study among 225 mother-child pairs, maternal urinary bisphenol A, S and F concentrations in first, second and third trimester were measured. LC-MS/MS was used to determine neonatal concentrations of amino acids, non-esterified fatty acids (NEFA), phospholipids (PL), and carnitines in cord blood. RESULTS No associations of maternal total bisphenol concentrations with neonatal metabolite profiles were present. Higher maternal average BPA concentrations were associated with higher neonatal mono-unsaturated alkyl-lysophosphatidylcholine concentrations, whereas higher maternal average BPS was associated with lower neonatal overall and saturated alkyl-lysophosphatidylcholine (p-values < 0.05).Trimester-specific analyses showed that higher maternal BPA, BPS and BPF were associated with alterations in neonatal NEFA, diacyl-phosphatidylcholines, acyl-alkyl-phosphatidylcholines, alkyl-lysophosphatidylcholine, sphingomyelines and acyl-carnitines, with the strongest effects for third trimester maternal bisphenol and neonatal diacyl-phosphatidylcholine, sphingomyeline and acyl-carnitine metabolites (p-values < 0.05). Associations were not explained by maternal socio-demographic and lifestyle characteristics or birth characteristics. DISCUSSION Higher maternal bisphenol A, F and S concentrations in pregnancy are associated with alterations in neonatal metabolite profile, mainly in NEFA, PL and carnitines concentrations. These findings provide novel insight into potential mechanisms underlying associations of maternal bisphenol exposure during pregnancy with adverse offspring outcomes but need to be replicated among larger, diverse populations.
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Affiliation(s)
- Sophia M Blaauwendraad
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Ellis Voerman
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Leonardo Trasande
- Department of Paediatrics, New York University School of Medicine, New York City, NY, 10016, USA
- Department of Environmental Medicine, New York University School of Medicine, New York City, NY, 10016, USA
- Department of Population Health, New York University School of Medicine, New York City, NY, USA
- School of Public Service, New York University Wagner, New York City, NY, 10016, USA
- New York University College of Global Public Health, New York City, NY, 10016, USA
| | - Kurunthachalam Kannan
- Department of Paediatrics, New York University School of Medicine, New York City, NY, 10016, USA
- Department of Environmental Medicine, New York University School of Medicine, New York City, NY, 10016, USA
| | - Susana Santos
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - George J G Ruijter
- Department of Clinical Genetics, Center for Lysosomal and Metabolic Disease, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Chalana M Sol
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Linda Marchioro
- Division of Metabolic and Nutritional Medicine, Dr. Von Hauner Children's Hospital, LMU-Ludwig-Maximilians Universität München, Munich, Germany
| | - Engy Shokry
- Division of Metabolic and Nutritional Medicine, Dr. Von Hauner Children's Hospital, LMU-Ludwig-Maximilians Universität München, Munich, Germany
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. Von Hauner Children's Hospital, LMU-Ludwig-Maximilians Universität München, Munich, Germany
| | - Vincent W V Jaddoe
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Romy Gaillard
- The Generation R Study Group (Na-29), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Abrahamsson DP, Wang A, Jiang T, Wang M, Siddharth A, Morello-Frosch R, Park JS, Sirota M, Woodruff TJ. A Comprehensive Non-targeted Analysis Study of the Prenatal Exposome. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:10542-10557. [PMID: 34260856 PMCID: PMC8338910 DOI: 10.1021/acs.est.1c01010] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Recent technological advances in mass spectrometry have enabled us to screen biological samples for a very broad spectrum of chemical compounds allowing us to more comprehensively characterize the human exposome in critical periods of development. The goal of this study was three-fold: (1) to analyze 590 matched maternal and cord blood samples (total 295 pairs) using non-targeted analysis (NTA); (2) to examine the differences in chemical abundance between maternal and cord blood samples; and (3) to examine the associations between exogenous chemicals and endogenous metabolites. We analyzed all samples with high-resolution mass spectrometry using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) in both positive and negative electrospray ionization modes (ESI+ and ESI-) and in soft ionization (MS) and fragmentation (MS/MS) modes for prioritized features. We confirmed 19 unique compounds with analytical standards, we tentatively identified 73 compounds with MS/MS spectra matching, and we annotated 98 compounds using an annotation algorithm. We observed 103 significant associations in maternal and 128 in cord samples between compounds annotated as endogenous and compounds annotated as exogenous. An example of these relationships was an association between three poly and perfluoroalkyl substances (PFASs) and endogenous fatty acids in both the maternal and cord samples indicating potential interactions between PFASs and fatty acid regulating proteins.
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Affiliation(s)
- Dimitri Panagopoulos Abrahamsson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, 94143, California, United States
| | - Aolin Wang
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, 94143, California, United States
| | - Ting Jiang
- California Environmental Protection Agency, Department of Toxic Substances Control, Environmental Chemistry Laboratory, Berkeley, 94710, California, United States
| | - Miaomiao Wang
- California Environmental Protection Agency, Department of Toxic Substances Control, Environmental Chemistry Laboratory, Berkeley, 94710, California, United States
| | - Adi Siddharth
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, 94143, California, United States
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, 94720, California, United States
| | - June-Soo Park
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, 94143, California, United States
- California Environmental Protection Agency, Department of Toxic Substances Control, Environmental Chemistry Laboratory, Berkeley, 94710, California, United States
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, California, United States
- Department of Pediatrics, University of California San Francisco, San Francisco, 94158, California, United States
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, 94143, California, United States
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Shi F, Feng X. Decabromodiphenyl ethane exposure damaged the asymmetric division of mouse oocytes by inhibiting the inactivation of cyclin-dependent kinase 1. FASEB J 2021; 35:e21449. [PMID: 33724544 DOI: 10.1096/fj.202002585r] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/11/2022]
Abstract
Decabromodiphenyl ethane (DBDPE) is a new brominated flame retardant and is widely added to flammable materials to prevent fire. Because it has been continuously detected in a variety of organisms and humans, it is important to reveal the biological toxicity of DBDPE. However, the influence of DBDPE for female reproduction is unclear. In this study, we investigated whether and how DBDPE exposure affects oocyte development. Female mice as a model were orally exposed to DBDPE by 0, 0.05, 0.5, 5, 50 μg/kg bw/day for 30 days (0.05 μg/kg bw/day is close to the environmental exposure concentration). We found that exposure of mice to DBDPE did not affect the first polar body extrusion (PBE) of oocytes. Strikingly, however, asymmetric division of oocytes was markedly impaired in 5 and 50 μg/kg bw/day DBDPE exposed group, which resulted in oocytes with larger polar bodies (PBs). Then, we further explored and found that DBDPE exposure inhibited the spindle migration and membrane protrusion in oocytes during anaphase of meiosis I (anaphase I), thereby impairing asymmetric division. Additionally, we found that DBDPE exposure suppressed the inactivation of cyclin-dependent kinase 1 (Cdk1), resulting in the decrease of cytoplasmic formin2 (FMN2)-mediated F-actin polymerization in oocytes at the onset of anaphase I. Simultaneously, DBDPE exposure damaged the structural integrity of the spindle and the perpendicular relationship between spindle and cortex. These together led to the failure of spindle migration and membrane protrusion required for oocytes asymmetric division. Finally, DBDPE exposure injured the development of blastocysts, leading to blastocyst apoptosis.
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Affiliation(s)
- Feifei Shi
- College of Life Science, The Key Laboratory of Bioactive Materials, Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
| | - Xizeng Feng
- College of Life Science, The Key Laboratory of Bioactive Materials, Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
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Zhou H, Sun X, Wang Y, Ye Y, Chen H, Chen Q, He G, Wang J, Liu X, Dong M, Chen D, Chen G, Yuan L, Xiao J, Hu J, Zeng W, Rong Z, Zhang Q, Zhou M, Guo L, Lv Y, Fan J, Pu Y, Ma W, Zhang B, Liu T. The Mediating Role of Placental Weight Change in the Association Between Prenatal Exposure to Thallium and Birth Weight: A Prospective Birth Cohort Study. Front Public Health 2021; 9:679406. [PMID: 34277546 PMCID: PMC8283527 DOI: 10.3389/fpubh.2021.679406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Previous studies have demonstrated the embryotoxicity and fetotoxicity of thallium (Tl). However, the effects of prenatal exposure to Tl on birth weight and placental weight and the mediating role of placental weight in the association of Tl with birth weight remain unclear. Methods: We recruited 2,748 participants from the ongoing Prenatal Environment and Offspring Health Cohort (PEOH Cohort) study, which was initiated in 2016 in Guangzhou, China. The Tl concentrations in maternal urine samples collected during the first and third trimester were determined by inductively coupled plasma mass spectrometry. Birth weight and placental weight were extracted from maternal medical records. Results: Pregnant women exposed to the highest tertile of Tl in the first trimester (β = −42.7 g, 95% CI: −82.3, −3.1 g) and third trimester (β = −50.6 g, 95% CI: −99.0, −2.3 g) had babies with lower birth weights than those exposed to the lowest tertile. We also found significant negative associations of exposure to Tl concentrations in the first and third trimester with placental weight. Mediation analyses showed that 50.3% (95% CI: 15.9, 79.2%) and 33.5% (95% CI: 1.3, 80.3%) of the effects of Tl exposure in the first and third trimester on birth weight were mediated by decreased placental weight. Conclusion: Our results suggest that prenatal exposure to Tl is negatively associated with birth weight and that this association may be mediated by decreased placental weight.
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Affiliation(s)
- He Zhou
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yiding Wang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jiaqi Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xin Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Moran Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Dengzhou Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Guimin Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Lixia Yuan
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Qianqian Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengya Zhou
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lingchuan Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yanyun Lv
- Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Health Care Hospital, Southern Medical University, Shenzhen, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Tao Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Medicine, Jinan University, Guangzhou, China
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46
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Stingone JA, Triantafillou S, Larsen A, Kitt JP, Shaw GM, Marsillach J. Interdisciplinary data science to advance environmental health research and improve birth outcomes. ENVIRONMENTAL RESEARCH 2021; 197:111019. [PMID: 33737076 PMCID: PMC8187296 DOI: 10.1016/j.envres.2021.111019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 05/30/2023]
Abstract
Rates of preterm birth and low birthweight continue to rise in the United States and pose a significant public health problem. Although a variety of environmental exposures are known to contribute to these and other adverse birth outcomes, there has been a limited success in developing policies to prevent these outcomes. A better characterization of the complexities between multiple exposures and their biological responses can provide the evidence needed to inform public health policy and strengthen preventative population-level interventions. In order to achieve this, we encourage the establishment of an interdisciplinary data science framework that integrates epidemiology, toxicology and bioinformatics with biomarker-based research to better define how population-level exposures contribute to these adverse birth outcomes. The proposed interdisciplinary research framework would 1) facilitate data-driven analyses using existing data from health registries and environmental monitoring programs; 2) develop novel algorithms with the ability to predict which exposures are driving, in this case, adverse birth outcomes in the context of simultaneous exposures; and 3) refine biomarker-based research, ultimately leading to new policies and interventions to reduce the incidence of adverse birth outcomes.
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Affiliation(s)
- Jeanette A Stingone
- Department of Epidemiology, Columbia University's Mailman School of Public Health, 722 West 168th St, Room 1608, New York, NY, 10032, USA.
| | - Sofia Triantafillou
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alexandra Larsen
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Jay P Kitt
- Departments of Chemistry and Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Judit Marsillach
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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47
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Chen X, Huang L, Zhong C, Li Q, Chen R, Sun G, Jin Z, Yang X, Hao L, Yang H, Yang N. Association between environmental tobacco smoke before and during pregnancy and the risk of adverse birth outcomes: a birth cohort study in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:27230-27237. [PMID: 33506423 DOI: 10.1007/s11356-021-12626-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
Associations between environmental tobacco smoke (ETS) and the risk of adverse birth outcomes may be confounded. We aimed to clarify the associations of ETS before and during pregnancy with the risk of adverse birth outcomes and determine whether the associations were modified by key potential confounders. A total of 7147 non-smoking mothers from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China, were included in the final analyses. ETS status was self-reported by pregnant women at their first antenatal care visit before 16 gestational weeks. Information on birth outcomes was extracted from delivery records. Poisson regression was used to identify the association between ETS before and during pregnancy and the risk of adverse birth outcomes. Exposures to ETS before and during pregnancy were reported by 645 (9.0%) and 464 (6.5%) mothers, respectively. Compared with no ETS, continued ETS during pregnancy was associated with an increased risk of preterm birth (PTB) (RR: 1.55, 95% CI: 1.07, 2.25) after adjustment for potential confounders. The association remained consistent in medically indicated PTB and late PTB. The risk of PTB associated with continued ETS during pregnancy was significantly increased in mothers more educated (P for interaction < 0.05). However, the increased risk of low birth weight (LBW) or small for gestational age (SGA) births by ETS during pregnancy was not observed. Exposure to ETS during pregnancy was associated with a higher risk of PTB, but not LBW or SGA births in a Chinese birth cohort.
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Affiliation(s)
- Xi Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Renjuan Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Guoqiang Sun
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Zhichun Jin
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China
| | - Hongying Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China.
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48
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Fénichel P, Coquillard P, Brucker-Davis F, Marchand P, Cano-Sancho G, Boda M, Antignac JP, Iannelli A, Gugenheim J, Le Bizec B, Chevalier N. Sustained bloodstream release of persistent organic pollutants induced by extensive weight loss after bariatric surgery: Implications for women of childbearing age. ENVIRONMENT INTERNATIONAL 2021; 151:106400. [PMID: 33611106 DOI: 10.1016/j.envint.2021.106400] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Lipophilic persistent organic pollutants (POPs) are stored in adipose tissues and released in case of weight loss. OBJECTIVES To analyze the kinetics and characteristics of this release during drastic weight loss after bariatric surgery and compare the results in case of women of childbearing age (WCBA) with critical blood concentration thresholds. METHODS 100 morbidly obese patients (73 women including 53 of childbearing age and 27 men) were screened before and 3, 6 and 12 months after bariatric surgery for serum concentrations of 67 congeners or metabolites of banned or not yet banned organohalogenated persistent pollutants, including highly lipophilic polychlorobiphenyls (PCBs), organochlorine pesticides (OCPs), brominated flame retardants (BFRs), and less lipophilic perfluorinated alkylated substances (PFASs). RESULTS Circulating levels of all chemicals, except PFASs, increased progressively after surgery, reaching after one year an increase between 30 and 139% compared to initial pre-surgical levels; median levels increased for PCB153 from 36.8 to 86.4 ng/g lw (+130%), for dichlorodiphenyldichloroethylene (p,p'-DDE) from 59.8 to 136.1 ng/g lw (+120%), and for hexachlorobenzene (HCB) from 9.8 to 20.3 ng/g lw (+110%). Weight loss averaging 30% of initial body weight at 12 months in both sexes (mean: 40.0 kg for men, 36.1 kg for women), was the main parameter related to the concentration increases (3.1 to 3.6% per kilogram weight loss). They were not dependent on initial BMI, presence of metabolic syndrome or type of surgical procedure but influenced by gender and biochemical properties such as degree of chlorination for PCBs and/or lipophilicity since PFASs did not increase at all. ∑PCB6 in blood after one year exceeded the critical concentration threshold for 24.5% women of childbearing age (13/53) versus 3.6% (2/53) before surgery. DISCUSSION Massive weight loss within the first year following bariatric surgery is associated with a sustained increase of circulating lipophilic POPs. Short- and long-term consequences should be considered, mostly for childbearing age obese women, because of potential health risks for the future fetus and breastfeeding infant.
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Affiliation(s)
- Patrick Fénichel
- Université Côte d'Azur, University Hospital of Nice, Department of Endocrinology, Diabetology and Reproduction, Nice, France; Université Côte d'Azur, INSERM U1065, C3M, Nice, France.
| | | | - Françoise Brucker-Davis
- Université Côte d'Azur, University Hospital of Nice, Department of Endocrinology, Diabetology and Reproduction, Nice, France.
| | | | | | - Mireille Boda
- Université Côte d'Azur, University Hospital of Nice, Department of Endocrinology, Diabetology and Reproduction, Nice, France.
| | | | - Antonio Iannelli
- Department of DigestiveSurgery, Archet II Hospital, Université Côte d'Azur, Nice, France.
| | - Jean Gugenheim
- Department of DigestiveSurgery, Archet II Hospital, Université Côte d'Azur, Nice, France.
| | | | - Nicolas Chevalier
- Université Côte d'Azur, University Hospital of Nice, Department of Endocrinology, Diabetology and Reproduction, Nice, France; Université Côte d'Azur, INSERM U1065, C3M, Nice, France.
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49
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Finnell RH, Caiaffa CD, Kim SE, Lei Y, Steele J, Cao X, Tukeman G, Lin YL, Cabrera RM, Wlodarczyk BJ. Gene Environment Interactions in the Etiology of Neural Tube Defects. Front Genet 2021; 12:659612. [PMID: 34040637 PMCID: PMC8143787 DOI: 10.3389/fgene.2021.659612] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/31/2021] [Indexed: 12/24/2022] Open
Abstract
Human structural congenital malformations are the leading cause of infant mortality in the United States. Estimates from the United States Center for Disease Control and Prevention (CDC) determine that close to 3% of all United States newborns present with birth defects; the worldwide estimate approaches 6% of infants presenting with congenital anomalies. The scientific community has recognized for decades that the majority of birth defects have undetermined etiologies, although we propose that environmental agents interacting with inherited susceptibility genes are the major contributing factors. Neural tube defects (NTDs) are among the most prevalent human birth defects and as such, these malformations will be the primary focus of this review. NTDs result from failures in embryonic central nervous system development and are classified by their anatomical locations. Defects in the posterior portion of the neural tube are referred to as meningomyeloceles (spina bifida), while the more anterior defects are differentiated as anencephaly, encephalocele, or iniencephaly. Craniorachischisis involves a failure of the neural folds to elevate and thus disrupt the entire length of the neural tube. Worldwide NTDs have a prevalence of approximately 18.6 per 10,000 live births. It is widely believed that genetic factors are responsible for some 70% of NTDs, while the intrauterine environment tips the balance toward neurulation failure in at risk individuals. Despite aggressive educational campaigns to inform the public about folic acid supplementation and the benefits of providing mandatory folic acid food fortification in the United States, NTDs still affect up to 2,300 United States births annually and some 166,000 spina bifida patients currently live in the United States, more than half of whom are now adults. Within the context of this review, we will consider the role of maternal nutritional status (deficiency states involving B vitamins and one carbon analytes) and the potential modifiers of NTD risk beyond folic acid. There are several well-established human teratogens that contribute to the population burden of NTDs, including: industrial waste and pollutants [e.g., arsenic, pesticides, and polycyclic aromatic hydrocarbons (PAHs)], pharmaceuticals (e.g., anti-epileptic medications), and maternal hyperthermia during the first trimester. Animal models for these teratogens are described with attention focused on valproic acid (VPA; Depakote). Genetic interrogation of model systems involving VPA will be used as a model approach to discerning susceptibility factors that define the gene-environment interactions contributing to the etiology of NTDs.
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Affiliation(s)
- Richard H. Finnell
- Department of Molecular and Human Genetics and Medicine, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Carlo Donato Caiaffa
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Sung-Eun Kim
- Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, TX, United States
| | - Yunping Lei
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - John Steele
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Xuanye Cao
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Gabriel Tukeman
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Ying Linda Lin
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Robert M. Cabrera
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
| | - Bogdan J. Wlodarczyk
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States
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50
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Nuvolone D, Petri D, Aprea MC, Bertelloni S, Voller F, Aragona I. Thallium Contamination of Drinking Water: Health Implications in a Residential Cohort Study in Tuscany (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084058. [PMID: 33921453 PMCID: PMC8069911 DOI: 10.3390/ijerph18084058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/25/2021] [Accepted: 04/09/2021] [Indexed: 11/24/2022]
Abstract
In 2014–2015, concentrations of thallium above the recommended reference value (EPA: 2 µg/L) were measured in some parts of the drinking water distribution system in the municipality of Pietrasanta (Tuscany, Italy). An extensive campaign of water samples and human biomonitoring surveys were implemented to quantify the exposure of population. A residential cohort epidemiological study was carried out on the population of the municipality of Pietrasanta, aimed at comparing the health status of residents in the areas affected by thallium contamination with residents living in the rest of the municipality. Cohort included people residing in the municipality of Pietrasanta from 1 January 2000 to 31 December 2015. Residence addresses were georeferenced and each subject living in one of the three contaminated areas were defined as exposed. Mortality, hospital discharge data and adverse pregnancy outcomes were taken from administrative health databases. Cox proportional hazard models and logistic models were used to test the association between thallium exposure and health outcome. This study did not show any excess of risk in terms of mortality and hospitalization in the population residing in the areas served by thallium-contaminated aqueduct branches, compared to the rest of the not contaminated area. Increased risks for low birth weight (OR = 1.43 95% CI 0.91–2.25) and pre-term birth (OR = 1.40 95% CI 0.82–2.37) were observed. In view of the paucity of epidemiological studies on thallium, this study is an important contribution to the state of knowledge of the health effects of chronic exposures to low concentrations of thallium.
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Affiliation(s)
- Daniela Nuvolone
- Unit of Epidemiology, Regional Health Agency of Tuscany, 50124 Firenze, Italy; (D.P.); (F.V.)
- Correspondence:
| | - Davide Petri
- Unit of Epidemiology, Regional Health Agency of Tuscany, 50124 Firenze, Italy; (D.P.); (F.V.)
| | - Maria Cristina Aprea
- Department of Occupational Toxicology and Industrial Hygiene, Public Health Laboratory, 53100 Siena, Italy;
| | - Silvano Bertelloni
- Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, 56126 Pisa, Italy;
| | - Fabio Voller
- Unit of Epidemiology, Regional Health Agency of Tuscany, 50124 Firenze, Italy; (D.P.); (F.V.)
| | - Ida Aragona
- Department of Prevention, Health Agency of North-West Tuscany, 56124 Pisa, Italy;
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