Hazardous waste sites and stroke in New York State

Effect Of Persistent Organic Pollutants In Patients With Ischemic Stroke And All Stroke: A Systematic Review And Meta-Analysis

The role of environmental contaminants and their association with stroke is still being determined. Association has been shown with air pollution, noise, and water pollution; however, the results are inconsistent across studies. A systematic review and meta-analysis of the effect of persistent organic pollutants (POP) in ischemic stroke patients were conducted; a comprehensive literature search was carried out until 30^th June 2021 from different databases. The quality of all the articles which met our inclusion criteria was assessed using Newcastle-Ottawa scaling; five eligible studies were included in our systematic review. The most studied POP in ischemic stroke was polychlorinated biphenyls (PCBs), and they have shown a trend for association with ischemic stroke. The study also revealed that living near a source of POPs contamination constitutes a risk of exposure and an increased risk of ischemic stroke. Although our study provides a strong positive association of POPs with ischemic stroke, more extensive studies must be conducted to prove the association.

Serum levels of polychlorinated biphenyls and stroke risk among Chinese: a hospital-based case-control study

Previous studies have revealed the serious human health risk effects of organic pollutants-polychlorinated biphenyls (PCBs). However, the roles of circulating PCBs on stroke risk have not been elucidated. The purpose of this study was to examine whether serum PCBs could increase the risk for stroke among Chinese participants. A total of 241 patients with stroke and age- (5-year interval) and gender-matched controls were recruited in Tianjin, China. Concentrations of 17 PCB congeners were measured by using high-resolution gas chromatography with mass spectrometric detection. Conditional logistic regression models were applied to assess the odds ratio (OR) and 95% confidential interval (CI). Significant positive associations were observed between serum total PCBs and dioxin-like PCBs and the risk for stroke (all p trends < 0.05), and the adjusted ORs for the highest tertile (T3) of serum concentration compared with the lowest tertile (T1) were 1.704 (1.073, 2.506) and 1.846 (1.156, 2.949). However, no significant association was found for non-dioxin-like PCBs (OR for T3 vs. T1: 1.388, 95%CIs: 0.850, 2.266; p trend: 0.118). Stratified analysis by stroke subtypes (ischemic or hemorrhagic strokes) showed no significant heterogeneity (OR for T3 vs. T1: 1.644 vs. 1.824; p for interaction: 0.458). The results suggest detrimental roles of PCBs, mainly dioxin-like PCBs, in stroke risk, irrespective of stroke subtypes. Further well-designed prospective studies with larger sample size are invited to confirm these associations.

Are Persistent Organic Pollutants Linked to Lipid Abnormalities, Atherosclerosis and Cardiovascular Disease? A Review

The term persistent organic pollutants (POPs) denotes chemicals with known or suspected adverse health effects in animals or humans and with chemical properties that make them accumulate in the environment, including animals or humans. Lipid-soluble POPs, like dioxins, polychlorinated biphenyls (PCBs) and organochlorine pesticides are transported by lipoproteins and accumulate in adipose tissue. High levels of these compounds in the circulation have been associated with elevated cholesterol and triglycerides in cross-sectional studies and with an increase in mainly low-density lipoprotein cholesterol in a longitudinal study. Also, non-lipid-soluble POPs, such as perfluoroalkyl substances (PFASs) compounds have been associated with increased total cholesterol levels. Carotid artery atherosclerosis has been related to elevated levels of mainly highly chlorinated PCBs and to highly fluorinated PFASs, but in this case only in women. Both cross-sectional and prospective studies have shown dioxins, PCBs, as well as PFASs to be linked to cardiovascular disease (CVD) and mortality. In conclusion, as highlighted in this review, several lines of evidence support the view that POPs of different chemical classes could be linked to lipid abnormalities, carotid atherosclerosis and overt CVD like myocardial infarction and stroke.

Association of Exposure to Persistent Organic Pollutants With Mortality Risk: An Analysis of Data From the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS) Study

IMPORTANCE

It has been suggested that persistent organic pollutants (POPs) are harmful to human health.

OBJECTIVE

To investigate if POP levels in plasma are associated with future mortality.

DESIGN, SETTING, AND PARTICIPANTS

Cohort study using data from the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, collected between May 2001 and June 2004 when participants reached age 70 years. Participants were followed up for 5 years after the first examination. Mortality was tracked from age 70 to 80 years. Data analysis was conducted in January and February 2018.

EXPOSURES

Eighteen POPs identified by the Stockholm Convention, including polychlorinated biphenyls (PCBs), organochlorine pesticides, and a brominated flame retardant, were measured in plasma levels by gas chromatography-mass spectrometry.

MAIN OUTCOMES AND MEASURES

All-cause mortality.

RESULTS

The study sample initially included 992 individuals (497 [50.1%] men) aged 70 years, who were examined between 2001 and 2004. At the second examination 5 years later, 814 individuals (82.1%; 412 [50.7%] women) completed follow-up. During a follow-up period of 10.0 years, 158 deaths occurred. When updated information on POP levels at ages 70 and 75 years was associated with all-cause mortality using Cox proportional hazard analyses, a significant association was found between hexa-chloro- through octa-chloro-substituted (highly chlorinated) PCBs and all-cause mortality (except PCB 194). The most significant association was observed for PCB 206 (hazard ratio [HR] for 1-SD higher natural log-transformed circulating PCB 206 levels, 1.55; 95% CI, 1.26-1.91; P < .001). Following adjustment for hypertension, diabetes, smoking, body mass index, and cardiovascular disease at baseline, most associations were no longer statistically significant, but PCBs 206, 189, 170, and 209 were still significantly associated with all-cause mortality (PCB 206: adjusted HR, 1.47; 95% CI, 1.19-1.81; PCB 189: adjusted HR, 1.29; 95% CI, 1.08-1.55; PCB 170: adjusted HR, 1.24; 95% CI, 1.02-1.52; PCB 209: adjusted HR, 1.29; 95% CI, 1.04-1.60). In a secondary analysis, these associations were mainly because of death from cardiovascular diseases rather than noncardiovascular diseases. Three organochlorine pesticides, including dichlorodiphenyldichloroethylene, and the brominated flame retardant diphenyl ether 47 were also evaluated but did not show any significant associations with all-cause mortality.

CONCLUSIONS AND RELEVANCE

Higher levels of highly chlorinated PCBs were associated with an increased mortality risk, especially from cardiovascular diseases. These results suggest that public health actions should be undertaken to minimize exposure to highly chlorinated PCBs.

Ecology of the cardiovascular system: Part II - A focus on non-air related pollutants

An integrated exposomic view of the relation between environment and cardiovascular health should consider the effects of both air and non-air related environmental stressors. Cardiovascular impacts of ambient air temperature, indoor and outdoor air pollution were recently reviewed. We aim, in this second part, to address the cardiovascular effects of noise, food pollutants, radiation, and some other emerging environmental factors. Road traffic noise exposure is associated with increased risk of premature arteriosclerosis, coronary artery disease, and stroke. Numerous studies report an increased prevalence of hypertension in people exposed to noise, especially while sleeping. Sleep disturbances generated by nocturnal noise are followed by a neuroendocrine stress response. Some oxidative and inflammatory endothelial reactions are observed during experimental session of noise exposure. Moreover, throughout the alimentation, the cardiovascular system is exposed to persistent organic pollutants (POPs) as dioxins or pesticides, and plastic associated chemicals (PACs), such as bisphenol A. Epidemiological studies show positive associations of exposures to POPs and PACs with diabetes, arteriosclerosis and cardiovascular disease incidence. POPs and PACS share some abilities to interact with nuclear receptors activating different pathways leading to oxidative stress, insulin resistance and angiotensin potentiation. Regarding radiation, survivors of nuclear explosion have an excess risk of cardiovascular disease. Dose-effect relationships remain debated, but an increased cardiovascular risk at low dose of radiation exposure may be of concern. Some emerging environmental factors like electromagnetic fields, greenspace and light exposure may also require further attention. Non-air related environmental stressors also play an important role in the burden of cardiovascular disease. Specific methodologies should be developed to assess the interactions between air and non-air related pollutants.

Serum persistent organic pollutants levels and stroke risk

Knowledge of environmental risk factors for stroke and their role are limited. We performed a case-cohort study to evaluate the association between serum persistent organic pollutants (POPs) level and stroke risk. 526 subcohort members and 111 stroke incidence cases were identified from the Korean Cancer Prevention Study-II. Serum levels of POPs were measured using gas chromatography/high-resolution mass spectrometry. The hazard ratios (HRs) for stroke (ischemic, hemorrhagic, and all stroke types) were estimated using the weighted Cox regression model. Age, sex, body mass index, smoking status, physical activity, family history of cardiovascular disease, and hypertension were adjusted in the weighted Cox regression model. After adjusting for potential confounding factors, increased risk for stroke was observed among participants with serum concentration of p,p'-DDE in the highest tertile compared to those in the lowest tertile (HR = 4.10, 95% CI: 1.58, 10.59). A similar association was estimated for PCB118 (HR = 2.33, 95% CI: 1.04, 5.22), PCB156 (HR = 3.42, 95% CI: 1.42, 8.23), and PCB138 (HR = 3.80, 95% CI: 1.48, 9.76). For TEQ, stroke was three times as likely to occur among subjects with TEQ in the highest tertile compared to those in the lowest tertile (HR = 3.12, 95% CI: 1.27, 7.65). PCBs were positively associated with ischemic stroke, but not with hemorrhagic stroke. Elevated serum POPs levels were associated with an increased risk of stroke, especially ischemic stroke.

Environmental Risk Factors for Stroke and Cardiovascular Disease

Besides the classical individual stroke risk factors a new class has appeared, the environmental risk factors. After a review of the evidences demonstrating that air pollution is a potent risk factor (Part 1), we propose an update of other physical, chemical, and biological factors, now considered as risk factors (Part 2). One of the challenges is to precise their specific roles as they can be combined in their noxious impacts (traffic air pollution + noise + weather + infections). This knowledge has practical consequences; From now on, medical advices cannot be limited to individual recommendations but must also deal with environmental public health issues.

Hazardous waste and health impact: a systematic review of the scientific literature

Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO).

POPULATION

people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.

Chemical characterization of simulated landfill soil leachates from Nigeria and India and their cytotoxicity and DNA damage inductions on three human cell lines

Landfill soils are sources of emerging carcinogens, teratogens and mutagens in the environment. There is inadequate information on its possible health risk and cytogenotoxicity. This study evaluated chemical characterization of four simulated landfill leachates with their cytotoxicity and DNA damage in human cells. Hepatocarcinoma (HepG2), lymphoma (Jurkat) and osteosarcoma (HOS) cells, incubated with 6.25, 12.5, 25, 50, 75 and 100% of Aba Eku (AEL), Olusosun (OSL), Awotan (AWL) and Nagpur (NPL) simulated leachates for 24 h, were assessed for cell viability using MTT assay and morphological alterations. DNA damage was also assessed after 24 h treatment of cells with sub-lethal concentrations of the leachates using comet assay. Metals and organic compounds in the soil leachates were determined using inductively coupled plasma-mass spectrometry (ICP-MS) and gas chromatography-mass spectroscopy (GC-MS) respectively. The leachates induced significant cytotoxicity in the treated cells with evidence of apoptosis; shrunken morphologies, detachment from the substratum and cytoplasmic vacuolations. Similarly, there was significant DNA damage induced in the treated cells, with increased Olive tail moment, tail length and % tail DNA. Jurkat was the most sensitive (Jurkat > HepG2 > HOS) to the cytotoxic and genotoxic effects of the leachates. All the analyzed metals except Cd, Fe, Zn and Mn were found at levels lower than standard allowable limits. 32, 17, 23 and 23 different PAHs and PCBs were detected in AEL, AWL, OSL and NPL respectively, at varying retention peak times. These toxic constituents induced the observed cytogenotoxicity in the cells and may suggest possible public health risk.

Associations of dietary polychlorinated biphenyls and long-chain omega-3 fatty acids with stroke risk

BACKGROUND

Little is known about joint exposure to polychlorinated biphenyls (PCBs) and long-chain omega-3 fatty acids [eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)], through fish consumption, on cerebrovascular disease risk.

OBJECTIVE

To explore associations of dietary PCB exposure and EPA-DHA intake with risk of different stroke subtypes.

METHODS

This was assessed in the prospective population-based Cohort of Swedish Men including 39,948, middle-aged and elderly men, who were free of cardiovascular disease and cancer at baseline in 1997. Validated estimates of dietary PCBs and EPA-DHA were obtained via a food frequency questionnaire.

RESULTS

During 12years of follow-up, 2286 and 474 incident cases of ischemic stroke and hemorrhagic stroke, respectively, were ascertained through register linkage. Dietary PCB exposure and EPA-DHA intake were associated with hemorrhagic stroke but not ischemic stroke. Men in the highest quartile of dietary PCB exposure (median 412ng/day) had a multivariable- and EPA-DHA-adjusted RR of hemorrhagic stroke of 2.77 [95% confidence interval (CI), 1.48-5.19] compared with men in the lowest quartile (median 128ng/day; p for trend <0.01). The corresponding RRs in men with and without hypertension were 5.45 (95% CI, 1.34-22.1) and 2.37 (95% CI 1.17-4.79), respectively. The multivariable- and PCB-adjusted RR of hemorrhagic stroke for the highest quartile of EPA-DHA intake (median 0.73g/day) versus the lowest quartile (median 0.18g/day) was 0.42 (95% CI, 0.22-0.79).

CONCLUSION

Dietary PCB exposure was associated with an increased risk of hemorrhagic stroke, whereas a protective association was observed for dietary EPA-DHA intake.

Endosulfan inducing blood hypercoagulability and endothelial cells apoptosis via the death receptor pathway in Wistar rats

Endosulfan induces blood hypercoagulability by causing vWF release from endothelial cell apoptosis in Wistar rats.

Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women

OBJECTIVE

The potentially beneficial effects of fish consumption on stroke may be modified by major food contaminants in fish. Polychlorinated biphenyls (PCBs) in particular are proposed to play a role in the aetiology of stroke. The aim of this study was to assess the association between dietary PCB exposure and stroke risk with the intake of long-chain omega-3 fish fatty acids and fish consumption.

DESIGN

The prospective population-based Swedish Mammography Cohort was examined. It was comprised of 34,591 women free of cardiovascular diseases and cancer at baseline in 1997 and followed up for 12 years. Validated estimates of dietary PCB exposure were obtained via a food frequency questionnaire at baseline. Incident cases of stroke were ascertained through register linkage.

RESULTS

During 12 years of follow-up (397,309 person-years), there were 2015 incident cases of total stroke (1532 ischaemic strokes, 216 intracerebral haemorrhages, 94 subarachnoid haemorrhages and 173 unspecified strokes). Multivariable-adjusted relative risks (RR), controlled for known stroke risk factors and fish consumption, were 1.67 [95% confidence interval (CI), 1.29-2.17] for total stroke, 1.61 (95% CI, 1.19-2.17) for ischaemic stroke and 2.80 (95% CI, 1.42-5.55) for haemorrhagic stroke for women in the highest quartile of dietary PCB exposure (median 288 ng day(-1) ) compared with women in the lowest quartile (median 101 ng day(-1) ).

CONCLUSION

Dietary exposure to PCBs was associated with an increased stroke risk in women, especially haemorrhagic stroke. The results provide important information regarding the risk-benefit analysis of fish consumption, particularly for cerebrovascular disease prevention.

TLR4 signaling is involved in brain vascular toxicity of PCB153 bound to nanoparticles

PCBs bind to environmental particles; however, potential toxicity exhibited by such complexes is not well understood. The aim of the present study is to study the hypothesis that assembling onto nanoparticles can influence the PCB153-induced brain endothelial toxicity via interaction with the toll-like receptor 4 (TLR4). To address this hypothesis, TLR4-deficient and wild type control mice (males, 10 week old) were exposed to PCB153 (5 ng/g body weight) bound to chemically inert silica nanoparticles (PCB153-NPs), PCB153 alone, silica nanoparticles (NPs; diameter, 20 nm), or vehicle. Selected animals were also subjected to 40 min ischemia, followed by a 24 h reperfusion. As compared to exposure to PCB153 alone, treatment with PCB153-NP potentiated the brain infarct volume in control mice. Importantly, this effect was attenuated in TLR4-deficient mice. Similarly, PCB153-NP-induced proinflammatory responses and disruption of tight junction integrity were less pronounced in TLR4-deficient mice as compared to control animals. Additional in vitro experiments revealed that TLR4 mediates toxicity of PCB153-NP via recruitment of tumor necrosis factor-associated factor 6 (TRAF6). The results of current study indicate that binding to seemingly inert nanoparticles increase cerebrovascular toxicity of PCBs and suggest that targeting the TLR4/TRAF6 signaling may protect against these effects.

Cerebrovascular toxicity of PCB153 is enhanced by binding to silica nanoparticles

Environmental polychlorinated biphenyls (PCBs) are frequently bound onto nanoparticles (NPs). However, the toxicity and health effects of PCBs assembled onto nanoparticles are unknown. The aim of this study was to study the hypothesis that binding PCBs to silica NPs potentiates PCB-induced cerebrovascular toxicity and brain damage in an experimental stroke model. Mice (C57BL/6, males, 12-week-old) were exposed to PCB153 bound to NPs (PCB153-NPs), PCB153, or vehicle. PCB153 was administered in the amount of 5 ng/g body weight. A group of treated animals was subjected to a 40 min ischemia, followed by a 24 h reperfusion. The blood-brain barrier (BBB) permeability, brain infarct volume, expression of tight junction (TJ) proteins, and inflammatory mediators were assessed. As compared to controls, a 24 h exposure to PCB153-NPs injected into cerebral vasculature resulted in significant elevation of the BBB permeability, disruption of TJ protein expression, increased proinflammatory responses, and enhanced monocyte transmigration in mouse brain capillaries. Importantly, exposure to PCB153-NPs increased stroke volume and potentiated brain damage in mice subjected to ischemia/reperfusion. A long-term (30 days) oral exposure to PCB153-NPs resulted in a higher PCB153 content in the abdominal adipose tissue and amplified adhesion of leukocytes to the brain endothelium as compared to treatment with PCB153 alone. This study provides the first evidence that binding to NPs increases cerebrovascular toxicity of environmental toxicants, such as PCB153.

Background exposure to persistent organic pollutants predicts stroke in the elderly

Background exposure to persistent organic pollutants (POPs), lipophilic xenobiotics that accumulate mainly in adipose tissue, has recently emerged as a new risk factor for cardiovascular diseases. This prospective study was performed to evaluate if plasma concentrations of selected POPs predict incident stroke among the elderly. Twenty-one POPs (including 16 polychlorinated biphenyl (PCB) congeners, 3 organochlorine (OC) pesticides, 1 brominated diphenyl ether (BDE), and 1 dioxin) were measured in plasma collected at baseline in 898 participants aged 70 years of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). Stroke diagnosis was validated by hospital records. During the five year follow-up, 35 subjects developed hospital-treated stroke. After adjusting for known stroke risk factors, most PCBs with 4, 5, or 6 chlorine atoms, p,p'-DDE, trans-nonachlor, and octachlorodibenzo-p-dioxin significantly predicted the risk of stroke. Across quartiles of summary measures of PCBs and OC pesticides, the adjusted ORs were 1.0, 0.8 (95% confidence interval: 0.2-2.5), 1.2 (0.4-3.4), and 2.1 (0.7-6.2) for PCBs and 1.0, 1.2 (0.3-4.2), 2.3 (0.7-6.9), and 3.0 (1.0-9.4) for OC pesticides (P for trend=0.11 and 0.03, respectively). The adjusted ORs among participants ≥ 90th percentile of the summary measures were 5.5 (1.7-18.1) for PCBs and 4.0 (1.1-14.6) for OC pesticides; corresponding ORs for those ≥ 95th percentile were 7.8 (2.1-29.6) and 9.5 (2.3-38.9). Background exposure to POPs may play an important role in development or progression of stroke in the elderly.

Can persistent organic pollutants and plastic-associated chemicals cause cardiovascular disease?

During the last decade, associations between persistent organic pollutants (POPs), such as polychlorinated biphenyls, dioxins and pesticides, and cardiovascular (CV) risk factors and overt CV disease (CVD) have been reported in humans. Recently, associations between plastic-associated chemicals (PACs), such as bisphenol A and phthalates, and CVD have also begun to emerge. Several approaches to evaluating such associations have been used: accidents with a high level of exposure, occupational exposure studies, geographical studies of subjects living near a contaminated area and traditional case-control or cohort studies with measurements of circulating levels of different environmental contaminants in the general population. Exposure to POPs has consistently been associated with diabetes using all the approaches described above, including prospective studies. The evidence regarding associations between exposure to POPs and other CV risk factors, such as hypertension, obesity and lipids, is less strong and is mainly based on cross-sectional data. Associations between overt CVD and POPs have been reported using all the above approaches, but prospective data from population-based studies are still lacking to provide firm evidence of an important and independent role of POP exposure in the pathogenesis of CVD. Nevertheless, taken together, current evidence suggests that further longitudinal and experimental studies should be conducted to investigate the effect of exposure to both POPs and PACs, such as bisphenol A and phthalates.

Association between residential proximity to fuel-fired power plants and hospitalization rate for respiratory diseases

BACKGROUND

Air pollution is known to cause respiratory disease. Unlike motor vehicle sources, fuel-fired power plants are stationary.

OBJECTIVE

Using hospitalization data, we examined whether living near a fuel-fired power plant increases the likelihood of hospitalization for respiratory disease.

METHODS

Rates of hospitalization for asthma, acute respiratory infection (ARI), and chronic obstructive pulmonary disease (COPD) were estimated using hospitalization data for 1993-2008 from New York State in relation to data for residences near fuel-fired power plants. We also explored data for residential proximity to hazardous waste sites.

RESULTS

After adjusting for age, sex, race, median household income, and rural/urban residence, there were significant 11%, 15%, and 17% increases in estimated rates of hospitalization for asthma, ARI, and COPD, respectively, among individuals > 10 years of age living in a ZIP code containing a fuel-fired power plant compared with one that had no power plant. Living in a ZIP code with a fuel-fired power plant was not significantly associated with hospitalization for asthma or ARI among children < 10 years of age. Living in a ZIP code with a hazardous waste site was associated with hospitalization for all outcomes in both age groups, and joint effect estimates were approximately additive for living in a ZIP code that contained a fuel-fired power plant and a hazardous waste site.

CONCLUSIONS

Our results are consistent with the hypothesis that exposure to air pollution from fuel-fired power plants and volatile compounds coming from hazardous waste sites increases the risk of hospitalization for respiratory diseases.

The role of residence near hazardous waste sites containing benzene in the development of hematologic cancers in upstate New York

OBJECTIVES

Epidemiologic studies suggest an association between environmental exposure to benzene and hematologic cancers, but the relationship is not firmly established. The aim of this study was to assess the potential association between residence near hazardous waste sites containing benzene and hospitalization discharge rates for persons having hematologic cancers.

MATERIALS AND METHODS

We determined the number of hospital discharges of people with hematologic cancers in New York State except for New York City for the years 1993 to 2008.Descriptive statistics and negative binomial regression models were used to compare the rates of hospitalization of residents in zip codes containing hazardous waste sites containing benzene to the rates of discharges from residents in zip codes without waste sites.

RESULTS

When adjusting for potential confounders we found a 15% increase in the rate of hospitalization for chronic lymphatic leukemia (CLL) [rate ratio (RR): 1.15; 95% confidence interval (CI): 1.00-1.33], a 22% increase in the rate of discharges for total leukemia (RR: 1.22; 95% CI: 1.04-1.43) and a 17% increase in the rate of discharges for total lymphoma (RR: 1.17; 95% CI: 1.02-1.35) in the benzene exposed sites. We found greater effects of exposure in African Americans compared to Caucasians, females compared to males and people with higher socioeconomic status (SES) compared to those with lower SES for several of the diseases studied.

CONCLUSIONS

After controlling for major confounders we found statistically significant increases in discharge rates for several hematologic cancers in persons residing in zip codes containing benzene waste sites. These results provide additional support for a relationship between environmental exposure to benzene and risk of hematologic cancers.

Geospatial patterns of hospitalization rates for stroke with comorbid hypertension in relation to environmental sources of persistent organic pollutants: results from a 12-year population-based study

PURPOSE

Recent evidence indicates that exposure to persistent organic pollutants (POPs) is emerging as an important risk factor for atherosclerosis-related diseases, including stroke. Hypertension (HTN) is a major risk factor for stroke, and some studies suggest that exposure to POPs is also a risk factor for HTN. We hypothesized that POPs increase the environmental burden of stroke with comorbid HTN.

METHODS

A population-based study of hospitalization rates for stroke with comorbid HTN in populations presumably exposed to POPs, based on the zip code of residence, was conducted. Data on hospitalizations for stroke with comorbid HTN were obtained from the New York Statewide Planning and Research Cooperative System for 1993-2004. Relative risks, with 95% confidence intervals (RR, 95% CI), of hospitalization were estimated by multiple Poisson regression analysis.

RESULTS

RR of hospitalization for stroke with comorbid HTN was 13.4% higher in populations residing in zip codes containing or abutting environmental sources of POPs (RR = 1.134; 95% CI, 1.036-1.241; p = 0.006). Also, hospitalization rates were significantly higher in males than in females (RR = 1.397; 95% CI, 1.357-1.437; p < 0.001), in African Americans than in Caucasians (RR = 3.902; 95% CI, 3.617-4.208; p < 0.001), and in older age groups (p for trend < 0.001). These statistically significant findings of the effect of demographic factors are highly consistent with the current knowledge of stroke and serve as indirect quality indicators for our model.

CONCLUSIONS

Results of our study support the hypothesis that exposure to POPs increases the environmental burden of both stroke and HTN.

Increased hospitalizations for ischemic stroke with comorbid diabetes and residential proximity to sources of organic pollutants: a 12-year population-based study

BACKGROUND

Evidence is emerging that exposure to persistent organic pollutants (POP) is a risk factor for atherosclerosis-related diseases and for diabetes mellitus (DM). We hypothesized that residential proximity to sources of POP will be associated with an increase in hospitalization rates for ischemic stroke (IS) with comorbid DM (IS-DM).

METHODS

We examined IS-DM hospitalization rates in the New York State (exclusive of New York City) during a 12-year period. POP exposure status was assessed based on residency in a zip code containing or abutting environmental sources of POP. Adjusted relative risks (RR) of IS-DM hospitalization were estimated by multivariate Poisson regression.

RESULTS

A statistically significant 10% increase in IS-DM hospitalization rates was observed in populations environmentally exposed to POP (adjusted RR 1.10, 95% confidence interval, CI, 1.01-1.20; p = 0.031). IS-DM hospitalization rates were also higher in males (adjusted RR 1.34, 95% CI 1.30-1.39; p < 0.001), in blacks (adjusted RR 4.54, 95% CI 4.16-4.94; p < 0.001) and in older age groups (p for trend <0.001).

CONCLUSIONS

Residential proximity to sources of POP is associated with an increase in RR of IS-DM hospitalization. Our findings support the hypothesis of POP being a risk factor for IS. Further studies are warranted.

Residential proximity to environmental sources of persistent organic pollutants and first-time hospitalizations for myocardial infarction with comorbid diabetes mellitus: a 12-year population-based study

OBJECTIVES

Environmental exposure to persistent organic pollutants (POPs) has been associated with an increased risk of both acute myocardial infarction (AMI) and diabetes mellitus (DM). A study of first-time hospitalizations for AMI with DM as a comorbidity in populations presumed to be exposed or not exposed on the basis of residence near POPs sites was conducted to investigate whether exposure to POPs increases the environmental burden of disease.

MATERIALS AND METHODS

We examined the association between residential proximity to environmental sources of POPs and hospitalization rates for first-time AMI with comorbid DM in 31,428 patients aged 25-74 years, using the New York Statewide Planning and Research Cooperative System data for a 12-year period (1993-2004). Environmental exposure status was assessed based on the zip code of residence. Adjusted relative risks (RR) of AMI hospitalization were estimated by multivariate Poisson regression.

RESULTS

Hospitalization rates for first-time AMI with comorbid DM were significantly greater in populations living near POPs sites (adjusted RR = 1.169, 95% CI: 1.014-1.347, p < 0.05). These rates were also significantly higher in African Americans than in Caucasians (adjusted RR = 1.902, 95% CI: 1.659-2.180, p < 0.001), in males (adjusted RR = 1.767, 95% CI: 1.695-1.843, p < 0.001), and for older ages (p for trend < 0.001). These findings, consistent with established non-modifiable risk factors, support the plausibility of our model.

CONCLUSIONS

Residential proximity to environmental sources of POPs is associated with a significant increase in hospitalization rates for first-time AMI with comorbid DM, compared to respective rates in populations not exposed to POPs.

NADPH oxidase and lipid raft-associated redox signaling are required for PCB153-induced upregulation of cell adhesion molecules in human brain endothelial cells

Exposure to persistent organic pollutants, such as polychlorinated biphenyls (PCBs), can lead to chronic inflammation and the development of vascular diseases. Because cell adhesion molecules (CAMs) of the cerebrovascular endothelium regulate infiltration of inflammatory cells into the brain, we have explored the molecular mechanisms by which ortho-substituted polychlorinated biphenyls (PCBs), such as PCB153, can upregulate CAMs in brain endothelial cells. Exposure to PCB153 increased expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), as well as elevated adhesion of leukocytes to brain endothelial cells. These effects were impeded by inhibitors of EGFR, JAKs, or Src activity. In addition, pharmacological inhibition of NADPH oxidase or disruption of lipid rafts by cholesterol depleting agents blocked PCB153-induced phosphorylation of JAK and Src kinases and upregulation of CAMs. In contrast, silencing of caveolin-1 by siRNA interference did not affect upregulation of ICAM-1 and VCAM-1 in brain endothelial cells stimulated by PCB153. Results of the present study indicate that lipid raft-dependent NADPH oxidase/JAK/EGFR signaling mechanisms regulate the expression of CAMs in brain endothelial cells and adhesion of leukocytes to endothelial monolayers. Due to its role in leukocyte infiltration, induction of CAMs may contribute to PCB-induced cerebrovascular disorders and neurotoxic effects in the CNS.

Developmental exposure to polychlorinated biphenyls influences stroke outcome in adult rats

BACKGROUND

The "developmental origins of adult disease" hypothesis was originally derived from evidence linking low birth weight to cardiovascular diseases including stroke. Subsequently, it has been expanded to include developmental exposures to environmental contaminants as risk factors for adult onset disease.

OBJECTIVE

Our goal in this study was to test the hypothesis that developmental exposure to poly-chlorinated biphenyls (PCBs) alters stroke outcome in adults.

METHODS

We exposed rats to the PCB mixture Aroclor 1254 (A1254) at 0.1 or 1 mg/kg/day in the maternal diet throughout gestation and lactation. Focal cerebral ischemia was induced at 6-8 weeks of age via middle cerebral artery occlusion, and infarct size was measured in the cerebral cortex and striatum at 22 hr of reperfusion. PCB congeners were quantified in brain tissue by gas chromatography with microelectron capture detection, and cortical and striatal expression of Bcl2 and Cyp2C11 were quantified by quantitative reverse transcriptase-polymerase chain reaction.

RESULTS

Developmental exposure to A1254 significantly decreased striatal infarct in females and males at 0.1 and 1 mg/kg/day, respectively. Predominantly ortho-substituted PCB congeners were detected above background levels in brains of adult females and males exposed to A1254 at 1 but not 0.1 mg/kg/day. Effects of developmental A1254 exposure on Bcl2 and Cyp2C11 expression did not correlate with effects on infarct volume.

CONCLUSION

Our data provide proof of principle that developmental exposures to environmental contaminants influence the response of the adult brain to ischemic injury and thus represent potentially important determinants of stroke susceptibility.

Environmental vascular risk factors: new perspectives for stroke prevention

Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade. In this update we review the following: lower education and poor socioeconomic status (probable surrogates for exposure to traditional high-risk behaviors such as smoking, poor nutrition, lack of prenatal control, absence of preventive medical and dental care, and non-compliance of treatment of conditions such as hypertension); depression, stress and affective disorders; obstructive sleep apnea; passive smoking and environmental pollution; infections, in particular periodontal diseases that increase C-reactive protein (CRP); raised body mass index (obesity); exercise, and diet. The possible role of high-fructose corn syrup in the epidemic of obesity in the USA is reviewed. Protective diets include higher consumption of fish, olive oil, grains, fruits and vegetables (Mediterranean diet), as well as probiotic bacteria in yogurt and dairy products. Careful attention should be given to the patient's environment looking for modifiable factors. The effects of clean environmental air and water, adequate diet and appropriate nutrition, healthy teeth, exercise, and refreshing sleep in the prevention of stroke and cardiovascular disease appear to be quite compelling. Although some of these modifiable risk factors lack evidence-based information, judicious clinical sense should be used to counteract the potentially damaging effects of adverse environmental vascular risk factors.

Increased rate of hospitalization for diabetes and residential proximity of hazardous waste sites

BACKGROUND

Epidemiologic studies suggest that there may be an association between environmental exposure to persistent organic pollutants (POPs) and diabetes.

OBJECTIVE

The aim of this study was to test the hypothesis that residential proximity to POP-contaminated waste sites result in increased rates of hospitalization for diabetes.

METHODS

We determined the number of hospitalized patients 25-74 years of age diagnosed with diabetes in New York State exclusive of New York City for the years 1993-2000. Descriptive statistics and negative binomial regression were used to compare diabetes hospitalization rates in individuals who resided in ZIP codes containing or abutting hazardous waste sites containing POPs ("POP" sites); ZIP codes containing hazardous waste sites but with wastes other than POPs ("other" sites); and ZIP codes without any identified hazardous waste sites ("clean" sites).

RESULTS

Compared with the hospitalization rates for diabetes in clean sites, the rate ratios for diabetes discharges for people residing in POP sites and "other" sites, after adjustment for potential confounders were 1.23 [95% confidence interval (CI), 1.15-1.32] and 1.25 (95% CI, 1.16-1.34), respectively. In a subset of POP sites along the Hudson River, where there is higher income, less smoking, better diet, and more exercise, the rate ratio was 1.36 (95% CI, 1.26-1.47) compared to clean sites.

CONCLUSIONS

After controlling for major confounders, we found a statistically significant increase in the rate of hospitalization for diabetes among the population residing in the ZIP codes containing toxic waste sites.

Exposure to persistent organic pollutants and hypertensive disease

Previous research suggests that exposure to persistent organic pollutants (POPs) increases the risk of chronic diseases such as hypertension. We identified the zip codes of more than 800 waste sites contaminated with POPs and other pollutants, based on which we classified zip codes of upstate New York into three groups: "POPs sites", zip codes containing hazardous waste sites with POPs; "other waste sites", zip codes containing hazardous waste sites but not with POPs; and "clean sites", zip codes without any known hazardous waste sites. Age, gender, race, and zip code of residence of patients diagnosed with hypertension (ICD-9 codes 401-404) were identified using the New York Statewide Planning and Research Cooperative System (SPARCS) for the years 1993-2000. A generalized linear model, the negative binomial model, was used to assess the effect of living in a zip code with a hazardous waste site on the discharge rate of hypertension. After control for the aforementioned covariates, we found a statistically significant elevation of 19.2% (95% CI = 8.5%, 31%) in hypertension discharge rate for "POPs sites" and a 10% elevation in discharge rates for "other waste sites" as compared to "clean sites". In a subset of "POPs sites" where people have higher income, smoke less, exercise more and have healthier diets, there was still a 13.9% elevation of hypertension discharge rate as compared to "clean sites". The results support the hypothesis that living near hazardous waste sites, particularly sites containing POPs, may constitute a risk of exposure and of developing hypertension.

ClcR-based biosensing system in the detection of cis-dihydroxylated (chloro-)biphenyls

Polychlorinated biphenyls (PCBs) are a group of organic pollutants that are persistent when released into the environment. Among the metabolites of PCBs, dihydroxylated PCBs are also considered as toxic compounds. Various studies have shown that dihydroxylated PCBs affect the reproductive, immune, nervous, and endocrine systems. Detection of these chemicals in environmental and biological samples could provide first-hand information about their levels and lead to a better understanding of their role in toxicity. To that end, we developed a sensing system for the detection of dihydroxylated PCBs based on the clc operon. The Pseudomonas putida clc operon encodes a catabolic pathway for degradation of chlorocatechols, which are major metabolites of a large number of chlorinated compounds. In P. putida, the expression of these genes is regulated by a protein encoded by the gene clcR located upstream from the clcABD genes. We demonstrate here for the first time that dihydroxy PCBs can also induce the clc operon. Our sensing system employs P. putida bacteria harboring a plasmid in which the reporter gene, lacZ, is under the control of the regulatory protein ClcR. Consequently, when exposed to dihydroxy PCBs, the bacteria express beta-galactosidase in an amount related to the concentration of the corresponding dihydroxy PCB. Various dihydroxylated PCBs, differing in the number and position of chlorines and in the position of hydroxyls, were tested for their ability to induce expression of beta-galactosidase. Detection limits as low as 1 x 10(-6) mol L(-1) were obtained for various dihydroxylated PCBs.