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Künzel RG, Elgazzar M, Bain PA, Kirschbaum C, Papatheodorou S, Gelaye B. The association between maternal prenatal hair cortisol concentration and preterm birth: A systematic review and meta-analysis. Psychoneuroendocrinology 2024; 165:107041. [PMID: 38581747 DOI: 10.1016/j.psyneuen.2024.107041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The risk of preterm birth (PTB) increases when experiencing stress during pregnancy. Chronic stress has been associated with a dysregulation of the hypothalamic-pituitary-adrenal axis, for which hair cortisol concentration (HCC) is a promising biomarker. However, previous studies on the association between HCC and PTB yielded inconsistent results. This systematic review and meta-analysis synthesized previous studies on the association between maternal HCC before and during pregnancy and spontaneous PTB. METHODS Data was extracted from N = 11 studies with k = 19 effect sizes retrieved from PubMed, Embase, Web of Science, CINAHL and citation searching by hand in June 2023 and updated in October 2023. Standardized mean differences were calculated, and a random-effects three-level meta-analysis was conducted. Effect heterogeneity was assessed using Q and I2. RESULTS HCC during pregnancy was higher among PTB than term groups, but effects were not statistically significant (z = 0.11, 95% CI: - 0.28, 0.51, p = .54) and total heterogeneity was high (Q16 = 60.01, p < .001, I2Total = 92.30%). After leaving out two possible outlier studies in sensitivity analyses, HCC was lower among preterm compared to term delivering groups, although not statistically significant (z = - 0.06, 95% CI: - 0.20, 0.08, p = .39) but with a substantially reduced total heterogeneity (Q12 = 16.45, p = .17, I2Total = 42.15%). No moderators affected the estimates significantly, but an effect of trimester and gestational age at delivery is likely. CONCLUSION There is currently no evidence of prenatal HCC differences between PTB and term groups as effects were small, imprecise, and not significant. Low statistical power and methodological weaknesses of the small-scale studies challenge possible biological inferences from the small effects, but further research on HCC during pregnancy is highly encouraged.
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Affiliation(s)
- Richard G Künzel
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Katholische Universität Eichstätt-Ingolstadt, Ostenstr. 28a, Eichstätt 85072, Germany.
| | | | - Paul A Bain
- Countway Library, Harvard Medical School, 10 Shattuck St, Boston, MA 02115, USA
| | - Clemens Kirschbaum
- Technische Universität Dresden, Zellescher Weg 19, Dresden 01062, Germany
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; The Chester M. Pierce M.D. Division of Global Psychiatry, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
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Runkle JD, Sugg MM, Berry A, Reed C, Cowan K, Wertis L, Ryan S. Association of Psychiatric Emergency Visits and Warm Ambient Temperature during Pregnancy: A Time-Stratified Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67001. [PMID: 38829735 PMCID: PMC11166382 DOI: 10.1289/ehp13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Acute exposure to high ambient temperature and heat waves during the warm season has been linked with psychiatric disorders. Emerging research has shown that pregnant people, due to physiological and psychological changes, may be more sensitive to extreme heat, and acute exposure has been linked to increased risk of pregnancy complications; however, few studies have examined psychiatric complications. OBJECTIVE Our objective was to examine the association between acute exposure to warm ambient temperatures and emergency department (ED) visits for mental disorders during pregnancy. METHODS A time-stratified case-crossover design with conditional logistic regression was performed on ∼ 206,000 psychiatric ED visits for pregnant patients in North Carolina, from May to September 2016 to 2019. Daily average ambient temperature was the main exposure and was linked to daily visits by maternal zip code of residence for prenatal mood and anxiety disorders (PMAD), severe mental illness (SMI), mental disorder of pregnancy (MDP), suicidal thoughts (SUIC), and any psychiatric disorder (Any). Effect modification by trimester, residential segregation, economic segregation, urbanicity, and availability of greenspace was also investigated. RESULTS Each 5 ° C increase in same-day exposure to warm ambient temperature on case days was associated with an increase in incidence rate ratio (IRR) for any psychiatric disorder [IRR = 1.07; 95% confidence interval (CI): 1.01, 1.14] including anxiety (IRR = 1.14; 95% CI: 1.00, 1.30), bipolar disorder (IRR = 1.28; 95% CI: 0.98, 1.67), and suicidal thoughts (IRR = 1.28; 95% CI: 1.00, 1.65) compared to control days. In general, the associations were strongest for warm season temperatures on the same day of exposure or for temperatures averaged over the 3 or 6 d preceding the ED visit. The greatest risk of an incident ED admission for PMAD (RR = 1.20; 95% CI: 1.04, 1.39), particularly for anxiety (RR = 1.30; 95% CI: 1.07, 1.59), and any psychiatric disorder (RR = 1.17; 95% CI: 1.07, 1.28) occurred following cumulative exposure to hot temperatures the week before admission. Higher psychiatric burden from temperature was observed in urban areas and on extreme heat days. CONCLUSIONS For this pregnant population in the southeastern United States, short-term exposure to high ambient temperatures during the warm season was associated with a greater risk of ED visits for an array of psychiatric disorders. Findings show that climate-related increases in ambient temperature may contribute to psychiatric morbidity in pregnant people. https://doi.org/10.1289/EHP13293.
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Affiliation(s)
- Jennifer D. Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Margaret M. Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Anne Berry
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Charlie Reed
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Kristen Cowan
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Sophie Ryan
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
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Sears CG, Liu Y, Lanphear BP, Buckley JP, Meyer J, Xu Y, Chen A, Yolton K, Braun JM. Evaluating Mixtures of Urinary Phthalate Metabolites and Serum Per-/Polyfluoroalkyl Substances in Relation to Adolescent Hair Cortisol: The HOME Study. Am J Epidemiol 2024; 193:454-468. [PMID: 37846096 DOI: 10.1093/aje/kwad198] [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: 09/26/2022] [Revised: 08/08/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023] Open
Abstract
Results of toxicological studies indicate that phthalates and per-/polyfluoroalkyl substances (PFAS), 2 classes of endocrine-disrupting chemicals, may alter the functioning of the hypothalamic-pituitary-adrenocortical (HPA) axis. We evaluated the associations of urinary phthalate metabolites and serum PFAS during gestation and childhood with adolescent hair cortisol concentrations (pg/mg hair) at age 12 years, an integrative marker of HPA axis activity (n = 205 mother-child pairs; Cincinnati, Ohio; enrolled 2003-2006). We used quantile-based g-computation to estimate associations between mixtures of urinary phthalate metabolites or serum PFAS and hair cortisol. We also examined whether associations of individual phthalate metabolites or PFAS with cortisol varied by the timing of exposure. We found that a 1-quartile increase in all childhood phthalate metabolites was associated with 35% higher adolescent hair cortisol (phthalate mixture ψ = 0.13; 95% confidence interval: 0.03, 0.22); these associations were driven by monoethyl phthalate, monoisobutyl phthalate, and monobenzyl phthalate. We did not find evidence that phthalate metabolites during gestation or serum PFAS mixtures were related to adolescent hair cortisol concentrations. We found suggestive evidence that higher childhood concentrations of individual PFAS were related to higher and lower adolescent hair cortisol concentrations. Our results suggest that phthalate exposure during childhood may contribute to higher levels of chronic HPA axis activity.
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Juvinao-Quintero DL, Künzel RG, Larabure-Torrealva G, Duncan L, Kirschbaum C, Sanchez SE, Gelaye B. Correlates of preconception and pregnancy hair cortisol concentrations. RESEARCH SQUARE 2023:rs.3.rs-3349003. [PMID: 37790441 PMCID: PMC10543434 DOI: 10.21203/rs.3.rs-3349003/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Assessing factors that influence chronic stress biomarkers like hair cortisol concentrations (HCCs) in pregnancy is critical to prevent adverse pregnancy outcomes. Thus, we aimed to identify correlates of HCC preconception and during pregnancy. 2,581 pregnant women participated in the study. HCC was available at four time periods: pre-pregnancy (0-3 months preconception, n = 1,023), and in the first (1-12 weeks, n = 1,734), second (13-24 weeks, n = 1,534), and third (25-36 weeks, n = 835) trimesters. HCC was assessed using liquid chromatography tandem mass spectrometry (LC-MS/MS). Sociodemographic, pregnancy- and hair-related characteristics, and measures of psychosocial stress, were interrogated as potential correlates of HCC. Spearman correlations, paired t-tests, and ANOVA were used to assess differences in log-transformed values of HCC (logHCC) across maternal characteristics. Multivariable linear regressions were used to identify the correlates of HCCs after adjusting for confounders. Mean logHCC values increased across the four prenatal periods (P < 0.001). In multivariable analyses, pre-pregnancy BMI was consistently associated with all HCCs, while gestational age, economic hardship, hair dyeing, and depression, showed time-specific associations with HCC. In conclusion, this study showed evidence of factors influencing HCC levels before and during pregnancy. The most consistent association was seen with pre-pregnancy BMI. Depression was also associated with HCC concentrations.
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Affiliation(s)
| | - Richard G Künzel
- Department of Epidemiology, Harvard T.H. Chan School of Public Health
| | | | - Laramie Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | | | - Sixto E Sanchez
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Instituto de Investigacion
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health
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Cowell W, Kloog I, Just AC, Coull BA, Carroll K, Wright RJ. Ambient PM 2.5 exposure and salivary cortisol output during pregnancy in a multi-ethnic urban sample. Inhal Toxicol 2023; 35:101-108. [PMID: 35312378 PMCID: PMC10264094 DOI: 10.1080/08958378.2022.2051647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Evidence from murine research supports that fine particulate matter (PM2.5) may stimulate the hypothalamic-pituitary-adrenal axis, leading to elevated circulating glucocorticoid levels. Epidemiologic research examining parallel associations document similar associations. We examined these associations among a diverse sample of pregnant individuals exposed to lower levels of ambient PM2.5. MATERIALS AND METHODS Participants included pregnant individuals enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) pre-birth cohort. Daily residential PM2.5 exposure was estimated using a satellite-based spatial-temporal hybrid model. Maternal 3rd trimester salivary cortisol levels were used to calculate several features of the diurnal cortisol rhythm. We used multivariable linear regression to examine PM2.5 during the pre-conception period and during each trimester in relation to cortisol awakening rise (CAR), slope, and area under the curve relative to ground (AUCG). RESULTS AND DISCUSSION The average PM2.5 exposure level across pregnancy was 8.13 µg/m3. PM2.5 in each exposure period was positively associated with AUCG, a measure of total cortisol output across the day. We also observed an inverse association between PM2.5 in the 3rd trimester and diurnal slope, indicating a steeper decline in cortisol throughout the day with increasing exposure. We did not detect strong associations between PM2.5 and slope for the other exposure periods or between PM2.5 and CAR for any exposure period. CONCLUSIONS In this sample, PM2.5 exposure across the preconception and pregnancy periods was associated with increased cortisol output, even at levels below the U.S. National Ambient Air Quality Annual Standard for PM2.5 of 12.0 µg/m3.
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Affiliation(s)
- Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Allan C. Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Brent A. Coull
- Department of Biostatistics, Harvard TH Chan School of Public Health, Harvard University, Boston, MA
| | - Kecia Carroll
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
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Chiarello DI, Ustáriz J, Marín R, Carrasco-Wong I, Farías M, Giordano A, Gallardo FS, Illanes SE, Gutiérrez J. Cellular mechanisms linking to outdoor and indoor air pollution damage during pregnancy. Front Endocrinol (Lausanne) 2023; 14:1084986. [PMID: 36875486 PMCID: PMC9974835 DOI: 10.3389/fendo.2023.1084986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Pregnancies are a critical window period for environmental influences over the mother and the offspring. There is a growing body of evidence associating indoor and outdoor air pollution exposure to adverse pregnancy outcomes such as preterm birth and hypertensive disorders of pregnancy. Particulate matter (PM) could trigger oxi-inflammation and could also reach the placenta leading to placental damage with fetal consequences. The combination of strategies such as risk assessment, advise about risks of environmental exposures to pregnant women, together with nutritional strategies and digital solutions to monitor air quality can be effective in mitigating the effects of air pollution during pregnancy.
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Affiliation(s)
- Delia I. Chiarello
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
- *Correspondence: Delia I. Chiarello, ; Jaime Gutiérrez,
| | - Javier Ustáriz
- Department of Chemical and Bioprocess Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Reinaldo Marín
- Center for Biophysics and Biochemistry (CBB), Venezuelan Institute for Scientific Research (IVIC), Caracas, Venezuela
| | - Ivo Carrasco-Wong
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
| | - Marcelo Farías
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ady Giordano
- Inorganic Chemistry Department, Faculty of Chemistry and of Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe S. Gallardo
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián E. Illanes
- Reproductive Biology Program, Center for Biomedical Research and Innovation (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Jaime Gutiérrez
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
- *Correspondence: Delia I. Chiarello, ; Jaime Gutiérrez,
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Goriainova V, Awada C, Opoku F, Zelikoff JT. Adverse Effects of Black Carbon (BC) Exposure during Pregnancy on Maternal and Fetal Health: A Contemporary Review. TOXICS 2022; 10:toxics10120779. [PMID: 36548612 PMCID: PMC9781396 DOI: 10.3390/toxics10120779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/26/2022] [Accepted: 12/08/2022] [Indexed: 05/31/2023]
Abstract
Black carbon (BC) is a major component of ambient particulate matter (PM), one of the six Environmental Protection Agency (EPA) Criteria air pollutants. The majority of research on the adverse effects of BC exposure so far has been focused on respiratory and cardiovascular systems in children. Few studies have also explored whether prenatal BC exposure affects the fetus, the placenta and/or the course of pregnancy itself. Thus, this contemporary review seeks to elucidate state-of-the-art research on this understudied topic. Epidemiological studies have shown a correlation between BC and a variety of adverse effects on fetal health, including low birth weight for gestational age and increased risk of preterm birth, as well as cardiometabolic and respiratory system complications following maternal exposure during pregnancy. There is epidemiological evidence suggesting that BC exposure increases the risk of gestational diabetes mellitus, as well as other maternal health issues, such as pregnancy loss, all of which need to be more thoroughly investigated. Adverse placental effects from BC exposure include inflammatory responses, interference with placental iodine uptake, and expression of DNA repair and tumor suppressor genes. Taking into account the differences in BC exposure around the world, as well as interracial disparities and the need to better understand the underlying mechanisms of the health effects associated with prenatal exposure, toxicological research examining the effects of early life exposure to BC is needed.
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Torres Toda M, Estarlich M, Ballester F, De Castro M, Fernández-Somoano A, Ibarluzea J, Iñiguez C, Lertxundi A, Subiza-Perez M, Sunyer J, Tardón A, Foraster M, Dadvand P. Associations of residential greenspace exposure and fetal growth across four areas in Spain. Health Place 2022; 78:102912. [DOI: 10.1016/j.healthplace.2022.102912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/14/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022]
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9
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Gong Y, Sun P, Fu X, Jiang L, Yang M, Zhang J, Li Q, Chai J, He Y, Shi C, Wu J, Li Z, Yu F, Ba Y, Zhou G. The type of previous abortion modifies the association between air pollution and the risk of preterm birth. ENVIRONMENTAL RESEARCH 2022; 212:113166. [PMID: 35346659 DOI: 10.1016/j.envres.2022.113166] [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: 12/06/2021] [Revised: 02/05/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution and previous abortion have been reported to be related to preterm birth (PTB). But rare study examined the effect of air pollution on PTB risk among mothers with previous abortion. OBJECTIVE To estimate the effect of air pollution on PTB and the potential effect modification of previous abortion on such an association in rural part of Henan province (China). METHOD Based on National Free Preconception Health Examination Project (NFPHEP), information from the medical records of 57,337 mothers with previous abortion were obtained. An inverse distance-weighted model was used to estimate exposure levels of air pollutants. The effect of air pollution on the risk of PTB was estimated with a multiple logistic regression model. Stratified and interaction analyses were undertaken to explore the potential effect modification of previous abortion on this association. RESULTS The risk of PTB was positively associated with exposure to levels of nitrogen dioxide (NO2; OR: 1.03; 95%CI: 1.02-1.04)], and sulfur dioxide (SO2; 1.04; 1.02-1.07), and negatively associated with ozone (O3) exposure (0.97; 0.97-0.98) during the entire pregnancy. Besides, we observed a positive effect of carbon monoxide (CO) exposure during the third trimester of pregnancy on PTB (1.14; 1.01-1.29). The type of previous abortion could modify the effect of air pollution on the PTB risk (P-interaction < 0.05). Compared with mothers with previous induced abortion, mothers with previous spontaneous abortion carried a higher risk of PTB induced by NO2, CO, and O3. CONCLUSIONS The risk of PTB was positively associated with levels of NO2, SO2 and CO, and negatively associated with the O3 level. The types of previous abortion could modify the effect of air pollution on PTB. Mothers who had an abortion previously, especially spontaneous abortion, should avoid exposure to air pollution to improve their pregnancy outcome.
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Affiliation(s)
- Yongxiang Gong
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Panpan Sun
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Xiaoli Fu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Meng Yang
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Qinyang Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Yanan He
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Chaofan Shi
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Jingjing Wu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Zhiyuan Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
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10
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Li L, Yin W, Wang P, Ma S, Zhou M, Li P, Tao F, Zhu P. The role of cortisol in the association between prenatal air pollution and fetal growth: A prospective cohort study. ENVIRONMENTAL RESEARCH 2022; 212:113250. [PMID: 35427597 DOI: 10.1016/j.envres.2022.113250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/25/2022] [Accepted: 04/02/2022] [Indexed: 06/14/2023]
Abstract
Prenatal air pollutant exposure has been linked to impaired fetal growth. However, its special vulnerability windows and biological mechanisms remain unclear. A prospective birth cohort study including 7419 mother-newborn pairs was conducted from 2015 to 2020 to determine critical exposure windows and examine whether cortisol mediates the relationship between air pollutant exposure and fetal growth. Air pollutant data for PM2.5, PM10, SO2, and CO were obtained from the Hefei City Ecology and Environment Bureau. Data on fetal ultrasound measurements and birth size were collected. Maternal and cord blood samples were used for measuring cortisol. Prenatal air pollutant (PM2.5, PM10, SO2, and CO) exposure, particularly in the first trimester, was associated with reduced fetal size from later pregnancy to birth. An IQR increase in PM2.5 (β = 0.082, 95%CI: 0.029, 0.135), PM10 (β = 0.086, 95%CI: 0.036, 0.136), SO2 (β = 0.086, 95%CI: 0.028, 0.144), and CO (β = 0.063, 95%CI: 0.017, 0.109) exposure in the first trimester was associated with higher cord blood cortisol levels. Significant relationships were observed between air pollutant exposure in the first trimester and increased ratio of cord to maternal blood cortisol levels. Exposure to high levels of cord blood cortisol significantly reduced the Z scores of birth weight (β = -0.17, 95%CI: -0.23, -0.10), length (β = -0.09, 95%CI: -0.16, -0.03), and head circumference (β = -0.33, 95%CI: -0.42, -0.25). Mediation analysis showed that the association of air pollutant exposure in the first trimester with neonatal parameters mediated by cord blood cortisol was 20.62%. These results indicated that air pollutant exposure during pregnancy could reduce fetal growth by the increased fetal cortisol levels due to placental barrier impairment, with the critical window of exposure occurring in the first trimester.
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Affiliation(s)
- Lei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| | - Shuangshuang Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| | - Meiting Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| | - Pei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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11
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Pagalan L, Oberlander TF, Hanley GE, Rosella LC, Bickford C, Weikum W, Lanphear N, Lanphear B, Brauer M, van den Bosch M. The association between prenatal greenspace exposure and Autism spectrum disorder, and the potentially mediating role of air pollution reduction: A population-based birth cohort study. ENVIRONMENT INTERNATIONAL 2022; 167:107445. [PMID: 35921770 DOI: 10.1016/j.envint.2022.107445] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) incidence has increased in past decades. ASD etiology remains inconclusive, but research suggests genetic, epigenetic, and environmental contributing factors and likely prenatal origins. Few studies have examined modifiable environmental risk factors for ASD, and far fewer have examined protective exposures. Greenspace has been associated with positive child development, but very limited greenspace research has examined ASD risk or prenatal exposures. Only one ecological study in 2017 has evaluated the association between greenspace and ASD, observing protective benefits. Greenspace may have direct effects on ASD risk and indirect effects by reducing air pollution exposure, a growing suspected ASD risk factor. OBJECTIVES To measure the association between prenatal greenspace exposure and ASD risk and examine if reduced air pollution levels in areas of higher greenspace mediate this association. METHODS We linked a population-based birth cohort of all deliveries in Metro Vancouver, Canada, from 2004 to 2009, with follow-up to 2014. Diagnoses were based on Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised instruments. Greenspace was quantified as the average of the annual mean Normalized Difference Vegetation Index (NDVI) within a 250 m buffer of a residential postal code. Air pollutant exposures-particulate matter with a diameter less than 2.5 µm (PM2.5), nitric oxide (NO), and nitrogen dioxide (NO2)-were derived from previously developed and temporally adjusted land use regression models. We estimated air pollutant exposures as the mean concentration per month during pregnancy. We calculated odds ratios (ORs) using logistic regression per NDVI interquartile range (IQR) increase, adjusting for child sex, birth month and year, maternal age and birthplace, and neighborhood-level urbanicity and income. To estimate the health impact of greenspace on ASD at the population level, we used the logistic regression model and marginal standardization to derive risk differences (RDs). Lastly, to quantify the mediating effect of greenspace on ASD risk through air pollution reduction, we used marginal structural models and a potential outcomes framework to calculate marginal risk differences (RDs) to decompose the total effect of greenspace on ASD into natural direct and indirect effects. RESULTS Of 129,222 births, 1,921 (1.5 %) children were diagnosed with ASD. The adjusted OR for ASD per NDVI IQR (0.12) increase was 0.96 (95 % CI: 0.90, 1.02) in 250 m buffer zones and 0.94 (95 % CI: 0.89, 1.00) in 100 m buffer zones. On the additive scale, the adjusted RDs were null. Natural direct, natural indirect, and total effect RDs were null for PM2.5, NO, and NO2 mediation models. CONCLUSION Prenatal greenspace exposure was associated with reduced odds of ASD, but in the additive scale, this effect was null at the population level. No mediating effect was observed through reduced air pollution, suggesting that air pollution may act as a confounder rather than as a mediator.
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Affiliation(s)
- Lief Pagalan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Schwartz Reisman Institute for Technology and Society, University of Toronto, Ontario, Canada.
| | - Tim F Oberlander
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Sunny Hill Health Centre for Children, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
| | - Gillian E Hanley
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Celeste Bickford
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Whitney Weikum
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Sunny Hill Health Centre for Children, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
| | - Nancy Lanphear
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Matilda van den Bosch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Forest & Conservation Sciences, University of British Columbia, Vancouver, British Columbia, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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12
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Levhar M, Schonblum A, Arnon L, Michael Y, Sheelo LS, Eisner M, Hadar E, Meizner I, Wiznitzer A, Weller A, Koren L, Agay-Shay K. Residential greenness and hair cortisol levels during the first trimester of pregnancy. ENVIRONMENTAL RESEARCH 2022; 204:112378. [PMID: 34780787 DOI: 10.1016/j.envres.2021.112378] [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: 06/02/2021] [Revised: 10/24/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND AIM Studies have shown that increased maternal cortisol level is associated with child adverse health outcomes. Hair cortisol (HC) is suitable for assessing long-term circulating cortisol concentration. Only two previous studies reported beneficial associations between cortisol and residential greenness during pregnancy and no study focused on the first trimester. Our aim was to evaluate the association between residential greenness and first trimester HC levels among pregnant women in Israel. METHODS Women were recruited during second and third trimesters. Hair samples were collected from the scalp and retrospective HC levels during the first trimester were quantified for 217 women. HC levels were natural log transformed and outliers were excluded. Based on geocoded birth address, small area sociodemographic status (SES) and mean residential surrounding greenness were calculated using high-resolution satellite-based Normalised Difference Vegetation Index (NDVI) data at 100, 300 and 500-m buffers in a cross-sectional approach. In addition, longitudinal exposure to mean greenness during a week preconception and during the first trimester were calculated. Missing covariates were imputed and linearity of the associations were evaluated. Generalized linear models were used to estimate the crude and adjusted associations controlled for the relevant covariates. RESULTS After exclusion of outliers, for 211 women, crude and adjusted beneficial associations between exposure to higher mean NDVI and HC levels were observed for all the exposure measures. An increase in 1 interquartile range of greenness (100 m buffer) was associated with a statistically significant lower estimated natural log mean HC level (-0.27 95% CI: -0.44; -0.11). The associations were robust to adjustment for covariates. The findings were consistent for different buffers, for the longitudinal approach, when all observations were included in the analysis and slightly stronger associations were observed for women with addresses geocoded at the home or street level. For most of the exposure measures, stronger associations were observed among those of lower sociodemographic status. CONCLUSION Our findings that more greenness associated with reduced maternal cortisol levels measured in the hair during the first trimester, could have substantial implications for urban planners and public health professional. If our observations will be replicated, it may present a useful avenue for public-health intervention to promote health through the provision of greenness exposure during early pregnancy, specifically to disadvantage populations.
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Affiliation(s)
- Maya Levhar
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel; Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Anat Schonblum
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel; Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Liat Arnon
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yaron Michael
- Department of Geography and Environment, Bar-Ilan University, Ramat-Gan, Israel
| | - Liat Salzer Sheelo
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Eisner
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Israel Meizner
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Wiznitzer
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aron Weller
- Department of Psychology & Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Lee Koren
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Keren Agay-Shay
- Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
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13
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Verheyen VJ, Remy S, Govarts E, Colles A, Koppen G, Martin LR, Nielsen F, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, Loots I, De Decker A, Franken C, Den Hond E, Nelen V, De Henauw S, Covaci A, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Determinants of Chronic Biological Stress, Measured as Hair Cortisol Concentration, in a General Population of Adolescents: From Individual and Household Characteristics to Neighborhood Urbanicity. Front Public Health 2021; 9:669022. [PMID: 34888272 PMCID: PMC8650704 DOI: 10.3389/fpubh.2021.669022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/14/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic biological stress may adversely affect adolescents' physical and mental health, but insight in the personal and environmental factors that determine chronic stress is limited. We measured 3-month cumulative hair cortisol concentration (HCC) in 419 adolescents, participating in the Flemish Environment and Health Study. Adolescents' health and lifestyle characteristics, household and neighborhood socio-economic status as well as neighborhood urbanicity were assessed as potential determinants of HCC, using multiple linear regression models. We additionally explored heterogeneity of our results by sex. HCC were significantly higher in boys from densely populated neighborhoods, the association was not significant in girls. Accordingly, boys living outside cities had significantly lower HCC than boys, living in cities. HCC was significantly lower in adolescents with an optimal vitality, a measure of a positive mental health status. In adolescent girls, menarcheal status (pre-/postmenarche) was a significant determinant of HCC. Our findings are the first to suggest that residential urbanicity may have an impact on chronic biological stress in a general population of adolescent boys.
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Affiliation(s)
- Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | | | - Flemming Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Annelies De Decker
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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14
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Verheyen VJ, Remy S, Govarts E, Colles A, Rodriguez Martin L, Koppen G, Voorspoels S, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, De Decker A, Franken C, Den Hond E, Nelen V, Covaci A, Loots I, De Henauw S, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Urinary Polycyclic Aromatic Hydrocarbon Metabolites Are Associated with Biomarkers of Chronic Endocrine Stress, Oxidative Stress, and Inflammation in Adolescents: FLEHS-4 (2016-2020). TOXICS 2021; 9:toxics9100245. [PMID: 34678941 PMCID: PMC8537433 DOI: 10.3390/toxics9100245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants of public health concern. Multiple biological mechanisms have been hypothesized to contribute to PAHs-associated adverse health effects. Little is known about the impact of PAHs on endocrine stress and inflammation in adolescence. We examined 393 Flemish adolescents (14-15 years) cross-sectionally, measured urinary concentrations of hydroxylated naphthalene, fluorene, phenanthrene and pyrene metabolites, and calculated the sum of all measured metabolites. We determined hair cortisol concentration (HCC) as endocrine stress biomarker, leucocyte counts and neutrophil-lymphocyte ratio (NLR) in peripheral blood as inflammatory biomarkers, and urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) concentration as oxidative stress biomarker. Exposure-response associations were analyzed by multiple regression, adjusted for a priori selected covariates. A doubling of 1-hydroxypyrene concentration was associated with a factor of 1.13 (95% CI: 1.03, 1.24) increase in HCC and a factor of 1.07 (95% CI: 1.02, 1.13) increase in 8-oxodG. Doublings of 2- and 3-hydroxyphenanthrene concentrations were associated with a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.00, 1.12) increase in 8-oxodG, respectively. Doubling of 2-hydroxyphenanthrene and of the sum of 2- and 3-hydroxyfluorene was associated with, respectively, a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.01, 1.13) increase in NLR. Our results indicate the glucocorticoid pathway as a potential target for PAH exposure in adolescents and suggest oxidative stress, endocrine stress, and inflammation in adolescence as underlying mechanisms and early markers for PAH-related adverse health effects.
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Affiliation(s)
- Veerle J. Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Correspondence:
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Stefan Voorspoels
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium;
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium;
| | - Esmée M. Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Annelies De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Department of Radiotherapy and Experimental Cancerology, Ghent University, B-9000 Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Koning Albert II laan 20, bus 8, 1000 Brussels, Belgium;
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
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15
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Verheyen VJ, Remy S, Bijnens EM, Colles A, Govarts E, Martin LR, Koppen G, Bruckers L, Nielsen F, Vos S, Morrens B, Coertjens D, De Decker A, Franken C, Den Hond E, Nelen V, Covaci A, Loots I, De Henauw S, van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Long-term residential exposure to air pollution is associated with hair cortisol concentration and differential leucocyte count in Flemish adolescent boys. ENVIRONMENTAL RESEARCH 2021; 201:111595. [PMID: 34186082 DOI: 10.1016/j.envres.2021.111595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to air pollution and traffic noise are associated with adverse health outcomes in adolescents. Chronic endocrine stress and systemic inflammation have been hypothesized to underlie the adverse health effects. Simultaneous assessment of inflammation and chronic endocrine stress in epidemiological studies is lacking. The aim of the study was to investigate biomarkers of chronic endocrine stress and inflammation in relation to long-term residential exposure to air pollution and traffic noise in adolescents. METHODS In Flemish adolescents (14-15 years), we determined hair cortisol concentration (HCC) as a chronic stress biomarker in 3-cm scalp-near hair sections (n = 395), and leucocyte and leucocyte subtype counts (neutrophils, monocytes, lymphocytes) as inflammatory biomarkers in peripheral blood (n = 385). Daily particulate matter (PM2.5, PM10), nitrogen dioxide (NO2) and black carbon (BC) concentrations were modelled at the residential address and averaged over 3-month and 1-year periods prior to sampling. Residential traffic noise level was estimated and classified in 5 dB intervals. Sex-specific associations between residential exposures and effect biomarkers were studied using linear regression models, adjusted for a priori selected covariates. RESULTS In boys, HCC increased with a factor 1.30 (95% CI: 1.10, 1.54) for an increase in 1-year mean NO2 from the 25th to 75th percentile (p75/p25), after adjustment for age, BMI, personal and neighborhood socioeconomic status. The corresponding estimate for PM10 was 1.24 (95% CI: 1.02, 1.51). Total leucocyte count in boys, adjusted for the aforementioned covariates and recent health complaints, was positively associated with PM2.5, PM10, NO2 and BC. In particular, the neutrophil count increased with a factor 1.11 (95% CI: 1.03, 1.19) for a (p75/p25)-factor increase in 1-year mean BC, corresponding estimates for PM2.5, PM10 and NO2 were 1.10 (95% CI: 1.01, 1.19), 1.10 (95% CI: 1.01, 1.20) and 1.08 (95% CI: 1.00, 1.16). Lymphocyte count increased with a factor 1.05 (95% CI: 1.01, 1.10) for a (p75/p25)-factor increase in 1-year mean NO2. Similar results were observed for 3-month mean exposures. Results were robust to adjustment for recent air pollution exposure. In girls, air pollutants were not associated with HCC or differential leucocyte count. Residential traffic noise level was not associated with HCC or leucocyte counts in boys nor girls. CONCLUSIONS Long-term residential exposure to air pollutants was positively associated with chronic endocrine stress and inflammation in adolescent boys, not in girls. This study may contribute to a better understanding of the early pathophysiological changes that may underlie adverse health effects of air pollution exposure in adolescents.
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Affiliation(s)
- Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Flemming Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17A, 5000, Odense, Denmark
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Annelies De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Nicolas van Larebeke
- Analytical, Environmental and Geo- Chemistry, Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Koning Albert II laan 20, bus 8, 1000, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
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Can Residential Greenspace Exposure Improve Pain Experience? A Comparison between Physical Visit and Image Viewing. Healthcare (Basel) 2021; 9:healthcare9070918. [PMID: 34356296 PMCID: PMC8306991 DOI: 10.3390/healthcare9070918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 12/29/2022] Open
Abstract
Reducing the burden of pain via greenspace exposure is a rising research topic. However, insufficient evidence has been found in relation to the environmental effect itself. Residential greenspace, as a convenient but limited natural environment for urban dwellers, has benefits and services yet to be discovered. Therefore, the current study recruited 24 young adults to evaluate the effects of physical visit to, or image viewing of, residential greenspace on pain perception and related psychophysiological outcomes, via simulated pain. Pain threshold and tolerance were recorded via the level of pain stimuli, and pain intensity was evaluated using the Visual Analog Scale (VAS). The state scale of the State-Trait Anxiety Inventory (STAI-S) and two adjective pairs were employed to measure the state anxiety and subjective stress, respectively. Meanwhile, heart rate (HR), heart rate variability (HRV), and blood pressure (BP) were measured to investigate physiological responses. Besides, Scenic Beauty Estimation (SBE) was also employed to assess participants' preference regarding the experimental environments. The results revealed that visiting the greenspace significantly increased the pain threshold and tolerance, while no significant effect was observed for image viewing. On the other hand, no significant difference was observed in pain-related psychophysiological indices between the experimental settings, but significantly negative associations were found between the scores of SBE and subjective stress and state anxiety. In conclusion, the current study brings experimental evidence of improving pain experience via residential greenspace exposure, while the related psychophysiological benefits require further investigation.
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