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Fisher M, Weiler HA, Kuiper JR, Borghese M, Buckley JP, Shutt R, Ashley-Martin J, Subramanian A, Arbuckle TE, Potter BK, Little J, Morisset AS, Jukic AM. Vitamin D and Toxic Metals in Pregnancy - a Biological Perspective. CURR EPIDEMIOL REP 2024; 11:153-163. [PMID: 39156920 PMCID: PMC11329583 DOI: 10.1007/s40471-024-00348-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 08/20/2024]
Abstract
Purpose of Review To discuss the potential biological mechanisms between vitamin D and toxic metals and summarize epidemiological studies examining this association in pregnant women. Recent Findings We identified four plausible mechanisms whereby vitamin D and toxic metals may interact: nephrotoxicity, intestinal absorption of metals, endocrine disruption, and oxidative stress. Few studies have examined the association between vitamin D and toxic metals in pregnant women. North American studies suggest that higher vitamin D status early in pregnancy are associated with lower blood metals later in pregnancy. However, a trial of vitamin D supplementation in a pregnant population, with higher metal exposures and lower overall nutritional status, does not corroborate these findings. Summary Given ubiquitous exposure to many toxic metals, nutritional intervention could be a means for prevention of adverse outcomes. Future prospective studies are needed to establish a causal relationship and clarify the directionality of vitamin D and metals. Supplementary Information The online version contains supplementary material available at 10.1007/s40471-024-00348-0.
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Affiliation(s)
- Mandy Fisher
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON Canada
| | - Hope A. Weiler
- Nutrition Research Division, Health Products and Food Branch, Health Canada, Ottawa, ON Canada
| | - Jordan R. Kuiper
- Milken Institute School of Public Health, The George Washington University, Washington, DC USA
| | - Michael Borghese
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON Canada
| | - Jessie P. Buckley
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health Sciences, Chapel Hill, North Carolina USA
| | - Robin Shutt
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON Canada
| | | | - Anita Subramanian
- National Institute of Environmental Health Sciences (NIEHS), Duram, North Carolina USA
| | - Tye E. Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON Canada
| | - Beth K. Potter
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, ON Canada
| | - Julian Little
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, ON Canada
| | | | - Anne Marie Jukic
- National Institute of Environmental Health Sciences (NIEHS), Duram, North Carolina USA
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2
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Hu H. Lasting Adverse Effects of Low-Level Lead Exposure on Cognition and Heritable Susceptibilities. JAMA Netw Open 2023; 6:e2339446. [PMID: 37870837 DOI: 10.1001/jamanetworkopen.2023.39446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Affiliation(s)
- Howard Hu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
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3
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Jia Z, Zhang H, Yu L, Qiu F, Lv Y, Guan J, Gang H, Zuo J, Zheng T, Liu H, Xia W, Xu S, Li Y. Prenatal Lead Exposure, Genetic Factors, and Cognitive Developmental Delay. JAMA Netw Open 2023; 6:e2339108. [PMID: 37870833 PMCID: PMC10594149 DOI: 10.1001/jamanetworkopen.2023.39108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/04/2023] [Indexed: 10/24/2023] Open
Abstract
Importance Although the effects of lead (Pb) exposure on neurocognition in children have been confirmed, the individual associations of prenatal Pb exposure and its interaction with genetic factors on cognitive developmental delay (CDD) in children remain unclear. Objective To investigate the association of prenatal Pb exposure and its interaction with genetic factors with CDD risk. Design, Setting, and Participants Women in Wuhan, China, who had an expected delivery date between March 2014 and December 2017, were recruited for this prospective cohort study. Children were assessed for cognitive development at approximately 2 years of age (March 2016 to December 2019). Maternal venous blood, cord blood, and venous blood from children were collected in a longitudinal follow-up. Data analysis was performed from March 2022 to February 2023. Exposure Prenatal Pb exposure, and genetic risk for cognitive ability evaluated by polygenic risk score constructed with 58 genetic variations. Main Outcomes and Measures Cognitive developmental delay of children aged approximately 2 years was assessed using the Chinese revision of the Bayley Scale of Infant Development. A series of multivariable logistic regressions was estimated to determine associations between prenatal Pb exposure and CDD among children with various genetic backgrounds, adjusting for confounding variables. Results This analysis included 2361 eligible mother-child pairs (1240 boys [52.5%] and 1121 girls [47.5%]; mean [SD] ages of mothers and children, 28.9 [3.6] years and 24.8 [1.0] months, respectively), with 292 children (12.4%) having CDD. Higher maternal Pb levels were significantly associated with increased risk of CDD (highest vs lowest tertile: odds ratio, 1.55; 95% CI, 1.13-2.13), adjusting for demographic confounders. The association of CDD with maternal Pb levels was more evident among children with higher genetic risk (highest vs lowest tertile: odds ratio, 2.59; 95% CI, 1.48-4.55), adjusting for demographic confounders. Conclusions and Relevance In this cohort study, prenatal Pb exposure was associated with an increased risk of CDD in children, especially in those with a high genetic risk. These findings suggest that prenatal Pb exposure and genetic background may jointly contribute to an increased risk of CDD for children and indicate the possibility for an integrated strategy to assess CDD risk and improve children's cognitive ability.
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Affiliation(s)
- Zhenxian Jia
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | - Ling Yu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Qiu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yiqing Lv
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Guan
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huiqing Gang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingwen Zuo
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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4
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Ali Daoud Y, Tebby C, Beaudouin R, Brochot C. Development of a physiologically based toxicokinetic model for lead in pregnant women: The role of bone tissue in the maternal and fetal internal exposure. Toxicol Appl Pharmacol 2023; 476:116651. [PMID: 37549741 DOI: 10.1016/j.taap.2023.116651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
Epidemiological studies have shown associations between prenatal exposure to lead (Pb) and neurodevelopmental effects in young children. Prenatal exposure is generally characterized by measuring the concentration in the umbilical cord at delivery or in the maternal blood during pregnancy. To assess internal Pb exposure during prenatal life, we developed a pregnancy physiologically based pharmacokinetic (p-PBPK) model that to simulates Pb levels in blood and target tissues in the fetus, especially during critical periods for brain development. An existing Pb PBPK model was adapted to pregnant women and fetuses. Using data from literature, both the additional maternal bone remodeling, that causes Pb release into the blood, and the Pb placental transfers were estimated by Bayesian inference. Additional maternal bone remodeling was estimated to start at 21.6 weeks. Placental transfers were estimated between 4.6 and 283 L.day-1 at delivery with high interindividual variability. Once calibrated, the p-PBPK model was used to simulate fetal exposure to Pb. Internal fetal exposure greatly varies over the pregnancy with two peaks of Pb levels in blood and brain at the end of the 1st and 3rd trimesters. Sensitivity analysis shows that the fetal blood lead levels are affected by the maternal burden of bone Pb via maternal bone remodeling and by fetal bone formation at different pregnancy stages. Coupling the p-PBPK model with an effect model such as an adverse outcome pathway could help to predict the effects on children's neurodevelopment.
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Affiliation(s)
- Yourdasmine Ali Daoud
- Experimental toxicology and modeling unit (MIV/TEAM), Institut National de l'Environnement Industriel et des Risques, 60550 Verneuil-en-Halatte, France; Péritox, UMR-I 01, University of Picardie Jules Verne, 80025 Amiens, France
| | - Cleo Tebby
- Experimental toxicology and modeling unit (MIV/TEAM), Institut National de l'Environnement Industriel et des Risques, 60550 Verneuil-en-Halatte, France.
| | - Rémy Beaudouin
- Experimental toxicology and modeling unit (MIV/TEAM), Institut National de l'Environnement Industriel et des Risques, 60550 Verneuil-en-Halatte, France; Sebio, UMR-I 02, Institut National de l'Environnement Industriel et des Risques, 60550 Verneuil-en-Halatte, France
| | - Céline Brochot
- Experimental toxicology and modeling unit (MIV/TEAM), Institut National de l'Environnement Industriel et des Risques, 60550 Verneuil-en-Halatte, France; Certara UK Ltd, Simcyp Division, Sheffield, UK
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5
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Coyte RM, Darrah T, Olesik J, Barrett E, O'Connor TG, Brunner J, Love T, Perez-D'Gregorio R, Wang HZ, Aleksunes LM, Buckley B, Doherty C, Miller RK. Gadolinium during human pregnancy following administration of gadolinium chelate before pregnancy. Birth Defects Res 2023; 115:1264-1273. [PMID: 37334869 DOI: 10.1002/bdr2.2209] [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: 03/02/2023] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/21/2023]
Abstract
Gadolinium (Gd), a toxic rare earth element, has been shown to dissociate from chelating agents and bioaccumulate within tissues, raising concerns about the possibility of their remobilization during pregnancy with subsequent free Gd exposures to developing fetuses. Gd chelates are among the most commonly used magnetic resonance imaging (MRI) contrast agents. This investigation was undertaken after the detection of elevated Gd (800-1000× higher than the usual rare earth element levels) in preliminary unpublished studies from the placentae of subjects in the NIH ECHO/UPSIDE Rochester Cohort Study and unpublished studies from placentae analyzed in formalin-fixed placental specimens from Surgical Pathology at the University of Rochester. Fifteen pregnancies with elevated Gd were studied (12 first pregnancies and 3 second pregnancies). Maternal bloods were collected from all three trimesters, maternal, and cord (fetal) bloods at delivery as well as placental tissue. Breastmilk was also collected from selected mothers. It was determined that Gd was present in maternal bloods from all three trimesters, and in cord bloods and breastmilk in both first and second pregnancies. These results emphasize the need to fully appreciate the implications of pre-pregnancy exposure to Gd chelates and its potential effects on maternal and fetal health.
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Affiliation(s)
- Rachel M Coyte
- School of Earth Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Thomas Darrah
- School of Earth Sciences, The Ohio State University, Columbus, Ohio, USA
- Global Water Institute, The Ohio State University, Columbus, Ohio, USA
| | - John Olesik
- School of Earth Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Emily Barrett
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA
| | - Thomas G O'Connor
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Psychiatry, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA
- Department of Neuroscience, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA
| | - Jessica Brunner
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Rogelio Perez-D'Gregorio
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Henry Z Wang
- Department of Imaging Science, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Lauren M Aleksunes
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, New Jersey, USA
| | - Brian Buckley
- Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA
| | - Cathleen Doherty
- Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA
| | - Richard K Miller
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Pathology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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6
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Granitzer S, Widhalm R, Atteneder S, Fernandez MF, Mustieles V, Zeisler H, Hengstschläger M, Gundacker C. BDNF and KISS-1 Levels in Maternal Serum, Umbilical Cord, and Placenta: The Potential Role of Maternal Levels as Effect Biomarker. EXPOSURE AND HEALTH 2023:1-17. [PMID: 37360514 PMCID: PMC10225291 DOI: 10.1007/s12403-023-00565-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) and kisspeptin-1 (KISS-1) regulate placental development and fetal growth. The predictive value of maternal serum BDNF and KISS-1 concentrations for placental and umbilical cord levels has not yet been explored. The influence of prenatal lead (Pb) and cadmium (Cd) exposure and maternal iron status on BDNF and KISS-1 levels is also unclarified and of concern. In a pilot cross-sectional study with 65 mother-newborn pairs, we analyzed maternal and cord serum levels of pro-BDNF, mature BDNF, and KISS-1, BDNF, and KISS-1 gene expression in placenta, Pb and Cd in maternal and umbilical cord blood (erythrocytes), and placenta. We conducted a series of in vitro experiments using human primary trophoblast cells (hTCs) and BeWo cells to verify main findings of the epidemiological analysis. Strong and consistent correlations were observed between maternal serum levels of pro-BDNF, mature BDNF, and KISS-1 and corresponding levels in umbilical serum and placental tissue. Maternal red blood cell Pb levels were inversely correlated with serum and placental KISS-1 levels. Lower expression and release of KISS-1 was also observed in Pb-exposed BeWo cells. In vitro Pb exposure also reduced cellular BDNF levels. Cd-treated BeWo cells showed increased pro-BDNF levels. Low maternal iron status was positively associated with low BDNF levels. Iron-deficient hTCs and BeWo cells showed a consistent decrease in the release of mature BDNF. The correlations between maternal BDNF and KISS-1 levels, placental gene expression, and umbilical cord serum levels, respectively, indicate the strong potential of maternal serum as predictive matrix for BDNF and KISS-1 levels in placentas and fetal sera. Pb exposure and iron status modulate BDNF and KISS-1 levels, but a clear direction of modulations was not evident. The associations need to be confirmed in a larger sample and validated in terms of placental and neurodevelopmental function. Supplementary Information The online version contains supplementary material available at 10.1007/s12403-023-00565-w.
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Affiliation(s)
- Sebastian Granitzer
- Institute of Medical Genetics, Medical University of Vienna, Waehringer Strasse 10, 1090 Vienna, Austria
- Exposome Austria, Research Infrastructure and National EIRENE Hub, Vienna, Austria
| | - Raimund Widhalm
- Institute of Medical Genetics, Medical University of Vienna, Waehringer Strasse 10, 1090 Vienna, Austria
- Exposome Austria, Research Infrastructure and National EIRENE Hub, Vienna, Austria
| | - Simon Atteneder
- Institute of Medical Genetics, Medical University of Vienna, Waehringer Strasse 10, 1090 Vienna, Austria
| | - Mariana F. Fernandez
- Center for Biomedical Research (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), Granada, Spain
- Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Mustieles
- Center for Biomedical Research (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), Granada, Spain
- Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Harald Zeisler
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Markus Hengstschläger
- Institute of Medical Genetics, Medical University of Vienna, Waehringer Strasse 10, 1090 Vienna, Austria
| | - Claudia Gundacker
- Institute of Medical Genetics, Medical University of Vienna, Waehringer Strasse 10, 1090 Vienna, Austria
- Exposome Austria, Research Infrastructure and National EIRENE Hub, Vienna, Austria
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7
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Rocha T, Allotey J, Palacios A, Vogel JP, Smits L, Carroli G, Mistry H, Young T, Qureshi ZP, Cormick G, Snell KIE, Abalos E, Pena-Rosas JP, Khan KS, Larbi KK, Thorson A, Singata-Madliki M, Hofmeyr GJ, Bohren M, Riley R, Betran AP, Thangaratinam S. Calcium supplementation to prevent pre-eclampsia: protocol for an individual participant data meta-analysis, network meta-analysis and health economic evaluation. BMJ Open 2023; 13:e065538. [PMID: 37169508 PMCID: PMC10186423 DOI: 10.1136/bmjopen-2022-065538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Low dietary calcium intake is a risk factor for pre-eclampsia, a major contributor to maternal and perinatal mortality and morbidity worldwide. Calcium supplementation can prevent pre-eclampsia in women with low dietary calcium. However, the optimal dose and timing of calcium supplementation are not known. We plan to undertake an individual participant data (IPD) meta-analysis of randomised trials to determine the effects of various calcium supplementation regimens in preventing pre-eclampsia and its complications and rank these by effectiveness. We also aim to evaluate the cost-effectiveness of calcium supplementation to prevent pre-eclampsia. METHODS AND ANALYSIS We will identify randomised trials on calcium supplementation before and during pregnancy by searching major electronic databases including Embase, CINAHL, MEDLINE, CENTRAL, PubMed, Scopus, AMED, LILACS, POPLINE, AIM, IMSEAR, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform, without language restrictions, from inception to February 2022. Primary researchers of the identified trials will be invited to join the International Calcium in Pregnancy Collaborative Network and share their IPD. We will check each study's IPD for consistency with the original authors before standardising and harmonising the data. We will perform a series of one-stage and two-stage IPD random-effect meta-analyses to obtain the summary intervention effects on pre-eclampsia with 95% CIs and summary treatment-covariate interactions (maternal risk status, dietary intake, timing of intervention, daily dose of calcium prescribed and total intake of calcium). Heterogeneity will be summarised using tau2, I2 and 95% prediction intervals for effect in a new study. Sensitivity analysis to explore robustness of statistical and clinical assumptions will be carried out. Minor study effects (potential publication bias) will be investigated using funnel plots. A decision analytical model for use in low-income and middle-income countries will assess the cost-effectiveness of calcium supplementation to prevent pre-eclampsia. ETHICS AND DISSEMINATION No ethical approvals are required. We will store the data in a secure repository in an anonymised format. The results will be published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021231276.
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Affiliation(s)
- Thaís Rocha
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - John Allotey
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Alfredo Palacios
- Health Economics, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Joshua Peter Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Luc Smits
- Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - Hema Mistry
- Warwick Evidence, University of Warwick, Coventry, UK
| | - Taryn Young
- Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
| | - Zahida P Qureshi
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Gabriela Cormick
- Department of Health Technology Assessment and Health Economics, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Kym I E Snell
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, UK
| | - Edgardo Abalos
- Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina
| | | | - Khalid Saeed Khan
- Public Health, University of Granada Faculty of Medicine, Granada, Spain
| | | | - Anna Thorson
- Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Mandisa Singata-Madliki
- Effective Care Research Unit (ECRU), East London Hospital Complex, East London, South Africa
| | | | - Meghan Bohren
- Centre for Health Equity, University of Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Richard Riley
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, UK
| | - Ana Pilar Betran
- Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
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8
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Butt MS, Javed K, Tariq U. Co-supplementation of Zinc and Calcium Suppresses Bio-absorption of Lead in Sprague Dawley Rats. Biol Trace Elem Res 2023; 201:1317-1326. [PMID: 35399139 DOI: 10.1007/s12011-022-03233-3] [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: 02/23/2022] [Accepted: 04/04/2022] [Indexed: 02/07/2023]
Abstract
Lead (Pb) is a widespread environmental toxicant and its toxicity causes huge health impacts. The present study was conducted to examine the protective role of zinc (Zn) and calcium (Ca) supplements against bio-absorption of Pb in blood and organs including the liver and kidney. Hence, Sprague Dawley rats were divided in to five groups. G1 served as negative control and was provided with standard diet, G2 as positive control receiving standard diet + PbAc (20 mg/kg BW), G3 was provided with standard diet + PbAc (20 mg/kg BW) + ZnSO4 (20 mg/kg BW), G4 with standard diet + PbAc (20 mg/kg BW) + CaCO3 (7.5 g/kg BW) whereas G5 was fed on standard diet + PbAc (20 mg/kg BW) + ZnSO4 (20 mg/kg BW) + CaCO3 (7.5 g/kg BW). The salts were provided as solution, dissolved in 0.5 mL distilled water via orogastric tube. After 35 days, the overnight fasted rats were decapitated, and blood and organs were collected for analysis of levels of metals and liver and kidney function tests. The results depicted significant decrease in Pb concentration in blood and organs while increase in Zn and Ca absorption was observed as a result of Zn and Ca supplementation with Zn being better than Ca alone, specially however, combined effect of these supplements was more profound in improving liver and kidney stress biomarkers and maintained the normal architecture of renal and hepatic parenchyma. It was concluded that Zn and Ca co-supplementation hinder Pb absorption in blood, the liver, and kidney thus suggesting that their intake may protect from Pb toxicity.
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Affiliation(s)
- Masood Sadiq Butt
- Faculty of Food, Nutrition and Home Sciences, National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Komal Javed
- Faculty of Food, Nutrition and Home Sciences, National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
- Department of Human Nutrition and Dietetics, Riphah International University, Faisalabad, 38000, Pakistan
| | - Urwa Tariq
- Faculty of Food, Nutrition and Home Sciences, National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan.
- Department of Human Nutrition and Dietetics, Riphah International University, Faisalabad, 38000, Pakistan.
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Koendjbiharie AP, Hindori-Mohangoo AD, Zijlmans WCWR, Wickliffe JK, Shankar A, Covert HH, Lichtveld MY, Grünberg AW, Drury SS. The Single and Combined Effects of Prenatal Nonchemical Stressors and Lead Exposure on Neurodevelopmental Outcomes in Toddlers: Results from the CCREOH Environmental Epidemiologic Study in Suriname. CHILDREN (BASEL, SWITZERLAND) 2023; 10:287. [PMID: 36832416 PMCID: PMC9954975 DOI: 10.3390/children10020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers' neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers' gross motor scaled scores (β -0.13, 95% CI [-0.24--0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β -0.26, 95% CI [-0.49--0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β -0.74, 95% CI: [-1.41--0.01]).
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Affiliation(s)
- Aloysius Ph. Koendjbiharie
- Community Health Department, Regional Health Services, Paramaribo, Suriname
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
| | - Ashna D. Hindori-Mohangoo
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Wilco C. W. R. Zijlmans
- Faculty of Medical Science, Anton De Kom University, Paramaribo, Suriname
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Jeffrey K. Wickliffe
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Arti Shankar
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Hannah H. Covert
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Maureen Y. Lichtveld
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Antoon W. Grünberg
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - Stacy S. Drury
- Department of Psychiatry, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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10
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Li S, Yang C, Yi X, Wei R, Aschner M, Jiang Y, Ou S, Yao C. Effects of Sub-chronic Lead Exposure on Essential Element Levels in Mice. Biol Trace Elem Res 2023; 201:282-293. [PMID: 35133610 DOI: 10.1007/s12011-022-03137-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/23/2022] [Indexed: 01/11/2023]
Abstract
Lead (Pb), a corrosion-resistant heavy non-ferrous metal, is one of the most common environmental neurotoxic metals. The effects of Pb on other essential metal elements are contradictory. Therefore, this in vivo study addressed the effects of sub-chronic Pb exposure on the distribution of other divalent metals, exploring the relationships between Pb levels in blood, teeth, bones, hair, and brain tissues. Thirty-two healthy male C57BL/6 mice received intragastric administration (i.g.) with 0, 12.5, 25, and 50 mg/kg Pb acetate, once a day for 8 weeks. Levels of Pb and other metal elements [including iron(Fe), zinc (Zn), magnesium (Mg), copper (Cu), and calcium(Ca)] in the whole blood, teeth, the right thighbone, hair, and brain tissues (including cortex, hippocampus, striatum, and hypothalamus) were detected with inductively coupled plasma-mass spectrometry (ICP-MS). Pb levels in all detected organs were increased after Pb-exposed for 8 weeks. The results of relationship analysis between Pb levels in the tissues and lifetime cumulative Pb exposure (LCPE) showed that Pb levels in the blood, bone, and hair could indirectly reflect the Pb accumulation in the murine brain. These measures might serve as valuable biomarkers for chronic Pb exposure reflective of the accumulation of Pb in the central nervous system (CNS). Sub-chronic Pb exposure for 8 weeks altered Ca, Cu, Fe, and Zn levels, but no effects were noted on Mg levels in any of the analyzed tissues. Pb decreased Ca in teeth, Cu in thighbone and teeth, Zn in whole blood and hair, and Fe in hair. In contrast, Pb increased Ca levels in corpus striatum and hypothalamus, Cu levels in striatum, Zn levels in teeth, and Fe levels in hippocampus, thighbone, and teeth. The Pb-induced changes in metal ratios in various tissues may serve as valuable biomarkers for chronic Pb exposure as they are closely related to the accumulations of Pb in the murine CNS. The results suggest that altered distribution of several essential metal elements may be involved in Pb-induced neurotoxicity. Additional studies should address the interaction between Pb and essential metal elements in the CNS and other organs.
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Affiliation(s)
- Shaojun Li
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China.
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China.
| | - Chun Yang
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China
| | - Xiang Yi
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China
| | - Ruokun Wei
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Yueming Jiang
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China
| | - Shiyan Ou
- Teaching and Research Section of Hygienic Toxicology, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Rd, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China
| | - Chaocong Yao
- Cardiothoracic Vascular Surgery, Hezhou People's Hospital, No. 150 Xiyue Rd, Hezhou, Guangxi, People's Republic of China
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11
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Waeyeng D, Khamphaya T, Pouyfung P, Vattanasit U, Yimthiang S. Blood Lead Levels among Non-Occupationally Exposed Pregnant Women in Southern Thailand. TOXICS 2022; 10:599. [PMID: 36287879 PMCID: PMC9610693 DOI: 10.3390/toxics10100599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/25/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
Lead (Pb) is a heavy metal that is toxic to humans, especially children and pregnant women. In Thailand, guidelines exist to minimize lead exposure in pregnant women working in lead-related occupations. However, no guidelines exist for pregnant women who are not employed in these economic sectors. This cross-sectional study aimed to examine blood lead levels (BLLs) and related risk factors among 80 non-occupationally exposed pregnant women from the general population living in Nakhon Si Thammarat province, Southern Thailand. BLLs were determined by graphite furnace atomic absorption spectrophotometry. A validated questionnaire was adopted to interview participants which included demographic, consumer goods, supplement intake, and health factors. The mean BLL was 4.68 ± 1.55 µg/dL (95% CI 4.33-5.02) and 42.50% had BLLs ≥ 5 µg/dL. Higher education was the only demographic factor associated with BLLs ≥ 5 µg/dL (aOR 0.16, 95% CI 0.03-0.80, p = 0.027). Systolic blood pressure was also associated with BLLs ≥ 5 µg/dL (aOR 5.00, 95% CI 1.23-17.16, p = 0.023). However, consumer goods and supplement intake were not associated with BLLs. Our results indicate that pregnant women from the general population who were not in the risk exposure group had lead in their bodies. Except for education, demographics were not associated with pregnant women with BLLs. However, with health factors, even low BLLs had a small effect on systolic blood pressure. These data suggest a need for promoting health education and health interventions to prevent the dangers of lead exposure, especially for pregnant women and children.
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Affiliation(s)
- Donrawee Waeyeng
- Environmental, Safety Technology and Health Program, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Tanaporn Khamphaya
- Environmental, Safety Technology and Health Program, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Phisit Pouyfung
- Occupational Health and Safety Department, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Udomratana Vattanasit
- Environmental Health and Technology Department, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Supabhorn Yimthiang
- Environmental, Safety Technology and Health Program, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand
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12
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Ortíz-García SG, Torres-Sánchez LE, Muñoz-Rocha TV, Mercado-García A, Peterson KE, Hu H, Osorio-Yáñez C, Téllez-Rojo MM. Maternal urinary fluoride during pregnancy and birth weight and length: Results from ELEMENT cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156459. [PMID: 35660617 DOI: 10.1016/j.scitotenv.2022.156459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Epidemiological studies assessing prenatal fluoride exposure and anthropometry at birth are scarce, inconsistent and with methodological limitations. The aim of this study was to evaluate associations between maternal urinary fluoride (MUF) at each trimester of pregnancy and birth weight and length in 536 mother-child pairs in the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort study. MUF (mg/L) was measured using microdiffusion/fluoride-specific electrode from at least one trimester of pregnancy. Non-linear associations were assessed through segmented regression models (MUF and birth weight Z-score) and we used linear regression models for MUF and birth length Z-score. Models were adjusted for potential confounders including urinary creatinine concentrations as a covariate. Non-creatinine adjusted MUF levels at each trimester of pregnancy were 0.81, 0.86, and 0.82 mg/L, mean concentrations for first, second and third trimester, respectively. For birth weight, we identified a MUF breakpoint at 0.99, 0.68 and 0.58 mg/L, for first, second and third trimester of pregnancy, respectively. In the first trimester, an increase of 1 mg/L in MUF concentrations ≥0.99 mg/L was associated with an increase in weight Z-score at birth (β = 0.79; 95% CI: 0.10, 1.48; p = 0.02). Second trimester MUF (≥0.68 mg/L) was marginally associated with birth weight decrease (β = -0.25; 95% CI: -0.55, 0.04; p = 0.09) and third trimester MUF (≥0.58 mg/L) was significantly associated with birth weight decrease (β = -0.33; 95% CI: -0.63, -0.03; p = 0.03). We observed a linear and significant association between MUF and Z-score of length at birth only for the first trimester of pregnancy (β = 0.55; 95% CI: 0.07, 1.04; p < 0.02). Prenatal fluoride exposure was associated with birthweight z-score with different susceptibility windows. Our findings reinforce the hypothesis that maternal fluoride exposure may affect birth anthropometry.
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Affiliation(s)
| | | | | | | | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Howard Hu
- University of Washington, School of Public Health, Seattle, WA, USA
| | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INCICH, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de Mexico, Mexico.
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13
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Goodrich JM, Tang L, Carmona YR, Meijer JL, Perng W, Watkins DJ, Meeker JD, Mercado-García A, Cantoral A, Song PX, Téllez-Rojo MM, Peterson KE. Trimester-specific phthalate exposures in pregnancy are associated with circulating metabolites in children. PLoS One 2022; 17:e0272794. [PMID: 36040907 PMCID: PMC9426875 DOI: 10.1371/journal.pone.0272794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Prenatal phthalates exposures have been related to adiposity in peripuberty in a sex-specific fashion. Untargeted metabolomics analysis to assess circulating metabolites offers the potential to characterize biochemical pathways by which early life exposures influence the development of cardiometabolic risk during childhood and adolescence, prior to becoming evident in clinical markers. Methods Among mother-child dyads from the Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) birth cohort, we measured 9 phthalate metabolites and bisphenol A in maternal spot urine samples obtained during each trimester of pregnancy, corrected for urinary specific gravity and natural log-transformed. In 110 boys and 124 girls aged 8–14 years, we used a mass-spectrometry based untargeted metabolomics platform to measure fasting serum metabolites, yielding 572 annotated metabolites. We estimated the associations between trimester-specific urinary toxicants and each serum metabolite, among all children or stratified by sex and adjusting for child age, BMI z-score, and pubertal onset. We accounted for multiple comparisons using a 10% false discovery rate (q<0.1). Results Associations between exposures and metabolites were observed among all children and in sex-stratified analyses (q<0.1). First trimester MEP, MiBP, and MCPP were associated with decreased 2-deoxy-D-glucose among all children. Among girls, third trimester concentrations of MECPP, MEHHP, MEHP, and MCPP were associated with 15, 13, 1, and 10 metabolites, respectively, including decreased choline and increased acylcarnitines and saturated FAs (FA). Among boys, third trimester MIBP was positively associated with 9 features including long chain saturated FAs, and second trimester MBzP was inversely associated with thyroxine. Conclusions Metabolomics biomarkers may reflect sex- and exposure timing-specific responses to prenatal phthalate exposures manifesting in childhood that may not be detected using standard clinical markers of cardiometabolic risk.
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Affiliation(s)
- Jaclyn M. Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Lu Tang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Yanelli R. Carmona
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Jennifer L. Meijer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States of America
| | - Wei Perng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Adriana Mercado-García
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Peter X. Song
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Martha M. Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Karen E. Peterson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- * E-mail:
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14
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Goodman CV, Bashash M, Green R, Song P, Peterson KE, Schnaas L, Mercado-García A, Martínez-Medina S, Hernández-Avila M, Martinez-Mier A, Téllez-Rojo MM, Hu H, Till C. Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6-12 years in the ELEMENT cohort. ENVIRONMENTAL RESEARCH 2022; 211:112993. [PMID: 35276192 PMCID: PMC9890727 DOI: 10.1016/j.envres.2022.112993] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/13/2022] [Accepted: 02/19/2022] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Prenatal exposure to fluoride has been associated with adverse neurodevelopmental outcomes. However, the neuropsychological profile of fluoride's developmental neurotoxicity at low levels and the stability of this relationship across childhood has not been characterized. We investigated the longitudinal and domain specific effect of prenatal fluoride exposure on IQ among children ages 4, 5, and 6-12 years in the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort. METHODS We measured the average of maternal urinary fluoride at each trimester of pregnancy adjusted for creatinine (MUFCRE). Children were administered the McCarthy Scales of Children's Abilities at ages 4 (N = 386) and 5 (N = 308), and the Wechsler Abbreviated Scale of Intelligence at age 6-12 (N = 278). We used generalized estimating equation (GEE) models to estimate the population averaged effect of MUFCRE concentration on longitudinal General Cognitive Index (GCI)/Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ) scores (N = 348). We tested for possible interactions between MUFCRE and child sex as well as for MUFCRE and time point on children's IQ. All models controlled for relevant available covariates. RESULTS The mean/median MUFCRE concentration was 0.90/0.83 mg/L (SD = 0.39; IQR, 0.64-1.11 mg/L). A 0.5 mg/L increase in MUFCRE predicted an average 2.12-point decrease in GCI/FSIQ (95% CI: -3.49, -0.75) and 2.63-point decrease in PIQ (95% CI: -3.87, -1.40). MUFCRE was marginally associated with VIQ across time (B = -1.29, 95% CI: -2.60, 0.01). No interactions between MUFCRE and child sex or MUFCRE and time were observed. CONCLUSION The negative association between prenatal fluoride exposure and longitudinal IQ was driven by decrements in non-verbal intelligence (i.e. PIQ), suggesting that visual-spatial and perceptual reasoning abilities may be more impacted by prenatal fluoride exposure as compared to verbal abilities.
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Affiliation(s)
- Carly V Goodman
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Morteza Bashash
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Rivka Green
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Peter Song
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Karen E Peterson
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | | | | | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christine Till
- Faculty of Health, York University, Toronto, Ontario, Canada
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15
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Wang J, Yang Y, Zhang J, Liu N, Xi H, Liang H. Trends of Blood Lead Levels in US Pregnant Women: The National Health and Nutrition Examination Survey (2001–2018). Front Public Health 2022; 10:922563. [PMID: 35844875 PMCID: PMC9283785 DOI: 10.3389/fpubh.2022.922563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/08/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives This study investigates the trends of blood lead levels in US pregnant women based on the National Health and Nutrition Examination Survey from 2001 to 2018. Methods A total of 1,230 pregnant women were included in this study. The weighted logistic regression was applied to analyze the association between sociodemographic characteristics with high blood levels. We computed the blood lead levels for each survey period from 2001–2002 to 2017–2018. Moreover, we used the adjusted linear regression model to investigate the time-related change in blood lead level. The odds ratio (OR) with a 95% confidence interval (CI) was calculated accordingly. Results The mean blood lead was 0.73 ± 0.03 ug/dL, and high blood lead was observed in 2.53% of individuals. The Mexican Americans were more associated with high blood lead than the non-Hispanic white (OR, 1.072; 95% CI, 1.032-1.112). The mean blood lead level has decreased from 0.97 ug/dL in 2001–2002 to 0.46 ug/dL in 2013–2014. Afterward, a slight increase was observed with the mean blood lead of 0.55 ug/dL in 2015–2016 and 0.53 ug/dL in 2017-2018. In the adjusted linear regression model, each year's increase would lead to a 0.029 ug/dL decrease in blood lead (P < 0.001). However, no significant change was observed in the 2017–2018 cycle compared with 2009–2010 (P = 0.218). Conclusion This study summarized the trend of blood lead levels in US pregnant women over 2001–2018. Continued effort is still required to control lead sources better and protect this population from lead exposure.
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Affiliation(s)
- Jing Wang
- Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yujie Yang
- Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Juan Zhang
- Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Na Liu
- Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
- Na Liu
| | - Huifang Xi
- The First Affiliated Hospital of Shandong First Medical University, Jinan, China
- Huifang Xi
| | - Hong Liang
- Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Hong Liang
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16
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Zamora AN, Peterson KE, Téllez-Rojo MM, Cantoral A, Song PXK, Mercado-García A, Solano-González M, Fossee E, Jansen EC. Third-Trimester Maternal Dietary Patterns Are Associated with Sleep Health among Adolescent Offspring in a Mexico City Cohort. J Nutr 2022; 152:1487-1495. [PMID: 35218195 PMCID: PMC9178955 DOI: 10.1093/jn/nxac045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal diet during gestation has been linked to infant sleep; whether associations persist through adolescence is unknown. OBJECTIVES We explored associations between trimester-specific maternal diet patterns and measures of sleep health among adolescent offspring in a Mexico City birth cohort. METHODS Data from 310 mother-adolescent dyads were analyzed. Maternal diet patterns were identified by principal component analysis derived from FFQs collected during each trimester of pregnancy. Sleep duration, midpoint, and fragmentation were obtained from 7-d actigraphy data when adolescents were between 12 and 20 y old. Unstratified and sex-stratified association analyses were conducted using linear regression models, adjusted for potential confounders. RESULTS Mean ± SD age of offspring was 15.1 ± 1.9 y, and 52.3% of the sample was female. Three diet patterns were identified during each trimester of pregnancy: the Prudent Diet (PD), high in lean proteins and vegetables; the Transitioning Mexican Diet (TMD), high in westernized foods; and the High Meat & Fat Diet (HMFD), high in meats and fat products. Mean ± SD sleep duration was 8.5 ± 1.5 h/night. Most associations were found in the third trimester. Specifically, PD maternal adherence was associated with shorter sleep duration among offspring (-0.57 h; 95% CI: -0.98, -0.16 h, in the highest tertile compared with the lowest) and earlier sleep midpoint among females (-0.77 h; 95% CI: -1.3, -0.26 h). Adherence to the HMFD and TMD was nonlinearly associated with less fragmented sleep, with the latter only evident among females. CONCLUSIONS Findings indicate that maternal dietary patterns, especially during the third trimester of pregnancy, may have long-term impacts on offspring sleep.
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Affiliation(s)
- Astrid N Zamora
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha M Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | | | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adriana Mercado-García
- Center for Research on Nutrition and Health, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | - Maritsa Solano-González
- Center for Research on Nutrition and Health, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | - Erica Fossee
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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17
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Castiblanco-Rubio GA, Muñoz-Rocha TV, Téllez-Rojo MM, Ettinger AS, Mercado-García A, Peterson KE, Hu H, Cantoral A, Martínez-Mier EA. Dietary Influences on Urinary Fluoride over the Course of Pregnancy and at One-Year Postpartum. Biol Trace Elem Res 2022; 200:1568-1579. [PMID: 34176079 DOI: 10.1007/s12011-021-02799-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Dietary factors are known to influence urinary fluoride (UF) levels in nonpregnant people. Maternal UF is used as a biomarker of fluoride exposure; however, dietary influences on UF during pregnancy are unknown. We compared UF levels and assessed the associations between UF and five select dietary influences in pregnancy vs. one-year postpartum: dietary fluoride (F), calcium intake from diet (Ca-diet), calcium intake from supplements (Ca-sup), dietary acid load (AL), and table salt use (TS) in 421 women exposed to fluoridated salt in the Mexican diet. Spot UF (mg/L) was measured by microdiffusion/fluoride-specific electrode and dilution-corrected with specific gravity (SG). Dietary variables were estimated from a validated Food Frequency Questionnaire. Comparisons among UF in pregnancy vs. one-year postpartum were performed with non-parametric tests. Associations between dietary variables and UF were assessed using random effect models (for pregnancy) and linear regression (for one-year postpartum). SG-corrected UF (median, range) during pregnancy (0.77, 0.01-4.73 mg/L) did not significantly differ from one-year postpartum (0.75, 0.15-2.62 mg/L) but did increase every 10 gestational weeks, β = 0.05 (CI: 0.00-0.10). Different dietary influences on UF were identified at each state. Although Ca-diet and AL were not associated with UF in either state, Ca-sup decreased UF only during pregnancy, β = - 0.012 mg/L (CI: - 0.023-0.00). Reporting TS use was associated with 12% increase in UF only at one-year postpartum (p = 0.026). These results suggest different dietary influences on UF in the pregnant state, which need consideration when using UF as a biomarker of fluoride exposure.
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Affiliation(s)
- Gina A Castiblanco-Rubio
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St, Indianapolis, IN, 46202, USA.
| | - Teresa V Muñoz-Rocha
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Adrienne S Ettinger
- Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adriana Mercado-García
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St, Indianapolis, IN, 46202, USA
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18
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Shekhawat DS, Janu VC, Singh P, Sharma P, Singh K. Association of newborn blood lead concentration with neurodevelopment outcome in early infancy. J Trace Elem Med Biol 2021; 68:126853. [PMID: 34543780 DOI: 10.1016/j.jtemb.2021.126853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/24/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND In utero exposure to toxic metal substances can cause severe neurodevelopmental deficits in developing fetus and infant. METHODS We evaluated the association of newborn umbilical cord blood lead concentration with early neurodevelopmental performance (cognitive, receptive language, expressive language, fine motor, gross motor and social-emotional development). The Bayley Scale of Infants Developments-III (BSID-III) was used to perform neurodevelopment outcomes at an average age of 6.5 months. In this prospective study, total of 167 mother-child pairs were enrolled from Western Rajasthan, India. Association between risk factors of lead contamination and newborn umbilical cord blood lead levels was observed. Multivariate regression was performed to see the association of cord blood lead level with infant neurodevelopment outcome. RESULTS The obtained newborn umbilical cord blood lead concentration 5.0-10.5 μg/dL was negatively associated with the sub-scale score of gross motor development (β-coefficient with 95 % CI; -0.29 (-5.0-0.11), p = 0.04). However, no associations were found with the score of cognitive, language, gross motor, and social-emotional development. The umbilical cord blood lead concentration <5.0 μg/dL was also not associated with the BSID-III scores. The mother's regular intake of calcium supplements during the antenatal period was significantly associated with a lower umbilical cord blood lead level (p-value 0.031). CONCLUSION The data suggest that newborn umbilical cord blood lead concentration 0.5-10.5 μg/dL has a negative association with early gross motor development during infancy.
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Affiliation(s)
- Dolat Singh Shekhawat
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Vikash Chandra Janu
- WQMG/DEST Division, Defence Research and Development Organization, Jodhpur, 342011, India.
| | - Pratibha Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, 342005, India.
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19
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Lead (Pb) and neurodevelopment: A review on exposure and biomarkers of effect (BDNF, HDL) and susceptibility. Int J Hyg Environ Health 2021; 238:113855. [PMID: 34655857 DOI: 10.1016/j.ijheh.2021.113855] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/13/2022]
Abstract
Lead (Pb) is a ubiquitous environmental pollutant and a potent toxic compound. Humans are exposed to Pb through inhalation, ingestion, and skin contact via food, water, tobacco smoke, air, dust, and soil. Pb accumulates in bones, brain, liver and kidney. Fetal exposure occurs via transplacental transmission. The most critical health effects are developmental neurotoxicity in infants and cardiovascular effects and nephrotoxicity in adults. Pb exposure has been steadily decreasing over the past decades, but there are few recent exposure data from the general European population; moreover, no safe Pb limit has been set. Sensitive biomarkers of exposure, effect and susceptibility, that reliably and timely indicate Pb-associated toxicity are required to assess human exposure-health relationships in a situation of low to moderate exposure. Therefore, a systematic literature review based on PubMed entries published before July 2019 that addressed Pb exposure and biomarkers of effect and susceptibility, neurodevelopmental toxicity, epigenetic modifications, and transcriptomics was conducted. Finally included were 58 original papers on Pb exposure and 17 studies on biomarkers. The biomarkers that are linked to Pb exposure and neurodevelopment were grouped into effect biomarkers (serum brain-derived neurotrophic factor (BDNF) and serum/saliva cortisol), susceptibility markers (epigenetic markers and gene sequence variants) and other biomarkers (serum high-density lipoprotein (HDL), maternal iron (Fe) and calcium (Ca) status). Serum BDNF and plasma HDL are potential candidates to be further validated as effect markers for routine use in HBM studies of Pb, complemented by markers of Fe and Ca status to also address nutritional interactions related to neurodevelopmental disorders. For several markers, a causal relationship with Pb-induced neurodevelopmental toxicity is likely. Results on BDNF are discussed in relation to Adverse Outcome Pathway (AOP) 13 ("Chronic binding of antagonist to N-methyl-D-aspartate receptors (NMDARs) during brain development induces impairment of learning and memory abilities") of the AOP-Wiki. Further studies are needed to validate sensitive, reliable, and timely effect biomarkers, especially for low to moderate Pb exposure scenarios.
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20
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Jahir T, Pitchik HO, Rahman M, Sultana J, Shoab AKM, Nurul Huda TM, Byrd KA, Islam MS, Yeasmin F, Baker M, Yeasmin D, Nurunnahar S, Luby SP, Winch PJ, Forsyth JE. Making the invisible visible: Developing and evaluating an intervention to raise awareness and reduce lead exposure among children and their caregivers in rural Bangladesh. ENVIRONMENTAL RESEARCH 2021; 199:111292. [PMID: 33971132 PMCID: PMC8261827 DOI: 10.1016/j.envres.2021.111292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 06/09/2023]
Abstract
Lead exposure is harmful at any time in life, but pre-natal and early childhood exposures are particularly detrimental to cognitive development. In Bangladesh, multiple household-level lead exposures pose risks, including turmeric adulterated with lead chromate and food storage in lead-soldered cans. We developed and evaluated an intervention to reduce lead exposure among children and their caregivers in rural Bangladesh. We conducted formative research to inform theory-based behavioral recommendations. Lead exposure was one of several topics covered in the multi-component intervention focused on early child development. Community health workers (CHWs) delivered the lead component of the intervention during group sessions with pregnant women and mother-child dyads (<15 months old) in a cluster-randomized trial. We administered household surveys at baseline (control n = 301; intervention n = 320) and 9 months later at endline (control n = 279; intervention n = 239) and calculated adjusted risk and mean differences for primary outcomes. We conducted two qualitative assessments, one after 3 months and a second after 9 months, to examine the feasibility and benefits of the intervention. At endline, the prevalence of lead awareness was 52 percentage points higher in the intervention arm compared to the control (adjusted risk difference: 0.52 [95% CI 0.46 to 0.61]). Safe turmeric consumption and food storage practices were more common in the intervention versus control arm at endline, with adjusted risk differences of 0.22 [0.10 to 0.32] and 0.13 [0.00 to 0.19], respectively. Semi-structured interviews conducted with a subset of participants after the intervention revealed that the perceived benefit of reducing lead exposure was high because of the long-term negative impacts that lead can have on child cognitive development. The study demonstrates that a group-based CHW-led intervention can effectively raise awareness about and motivate lead exposure prevention behaviors in rural Bangladesh. Future efforts should combine similar awareness-raising efforts with longer-term regulatory and structural changes to systematically and sustainably reduce lead exposure.
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Affiliation(s)
- Tania Jahir
- Emerging Infections, Icddr,b, Dhaka, Bangladesh
| | | | | | | | - A K M Shoab
- Emerging Infections, Icddr,b, Dhaka, Bangladesh
| | | | | | - Md Saiful Islam
- Emerging Infections, Icddr,b, Dhaka, Bangladesh; School of Public Health and Community Medicine, UNSW, Sydney, Australia
| | | | - Musa Baker
- Emerging Infections, Icddr,b, Dhaka, Bangladesh
| | | | | | | | - Peter J Winch
- John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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21
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Zhang T, Ru YF, Wu B, Dong H, Chen L, Zheng J, Li J, Wang X, Wang Z, Wang X, Shen X, Wu J, Qian J, Miao M, Gu Y, Shi H. Effects of low lead exposure on sperm quality and sperm DNA methylation in adult men. Cell Biosci 2021; 11:150. [PMID: 34344450 PMCID: PMC8335892 DOI: 10.1186/s13578-021-00665-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
INSTRUCTION Lead (Pb) exposure is a risk factor for male infertility, but the epigenetic changes in sperm DNAattributable to lead exposure is poorly defined. METHODS In this study, we investigated whether low Pb exposure (< 10 µg/dL) affects the sperm quality. Blood, urine, and semen samples of 297 men of childbearing age were analyzed for all relevant parameters. Based on the blood Pb level (BLL), participants were allocated to RL (0-2.5 µg/dL), RM (2.5-5 µg/dL), and RH (5-10 µg/dL) groups. The 5-methylcytosine and 5-hydroxymethylcytosine patterns in the sperm DNA were identified using methylated DNA immunoprecipitation and hydroxymethylated DNA immunoprecipitation sequencing. RESULTS The non-progressive motility (NP) was significantly increased and associated with global hypomethylation of sperm DNA in the RH group compared with the RL group, indicating that aberrant sperm methylation due to low Pb exposure is possibly associated with reduced sperm motility. The hypomethylated promoter regions were primarily enriched in the calcium (Ca) homeostasis pathway. Further, the interaction between Ca and Pb was associated with sperm rapid progressive motility and asthenospermia risk, although no significant methylation abnormality was observed in those with BLL < 5 µg/dL. When BLL was > 5 µg/dL or when predicting NP, no significant Pb-Ca interaction was observed. DISCUSSION Overall, our results indicate that aberrant DNA methylation of the Ca homeostasis pathway, induced by low Pb exposure, is the potential cause for reduced sperm velocity.
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Affiliation(s)
- Tiancheng Zhang
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Yan Fei Ru
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, 310024, Zhejiang, China
| | - Bin Wu
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Haiyan Dong
- Shanghai Kelin Institute of clinical bioinformatics, Shanghai, China
| | - Liang Chen
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Jufen Zheng
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Jianhui Li
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Xin Wang
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Zhikai Wang
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Xuemei Wang
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Xiaorong Shen
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Jun Wu
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
| | - Jun Qian
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China.
| | - Maohua Miao
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China.
| | - Yihua Gu
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China.
| | - Huijuan Shi
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, China
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22
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Gleason KM, Valeri L, Shankar AH, Obrycki JF, Ibne Hasan MOS, Mostofa G, Quamruzzaman Q, Wright RO, Christiani DC, Bellinger DC, Mazumdar M. Stunting and lead: using causal mediation analysis to better understand how environmental lead exposure affects cognitive outcomes in children. J Neurodev Disord 2020; 12:39. [PMID: 33327931 PMCID: PMC7745460 DOI: 10.1186/s11689-020-09346-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many children in Bangladesh experience poor nutritional status and environmental lead exposure, both of which are associated with lower scores on neurodevelopmental assessments. Recent studies have suggested that part of lead's adverse effects on neurodevelopment are caused in part by lead's effect on growth. New statistical methods are now available to evaluate potential causal pathways in observational studies. This study used a novel statistical method to test the hypothesis that stunting, a measure of linear growth related to poor nutrition, is a mediator and/or an effect modifier of the lead exposure's adverse effect on cognitive development. METHODS Participants were 734 children from a longitudinal birth cohort established in rural Bangladesh to study the health effects of prenatal and early childhood environmental metal exposures. Lead exposure was estimated using umbilical cord blood samples obtained at birth and blood obtained via venipuncture at age 20-40 months. Stunting was determined using the World Health Organization's standards. Neurodevelopment was assessed at age 20-40 months years using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). We evaluated the effect of lead on stunting and whether the effect of lead on cognitive scores is modified by stunting status in multivariable regression analyses. We then conducted a novel 4-way mediation analysis that allows for exposure-mediator interaction to assess how much of the effect of lead on cognitive scores is explained by the pathway through stunting (mediation) and how much is explained by the interaction between lead and stunt (effect modification). RESULTS Stunting was not a mediator of the effect of lead in our analyses. Results suggested effect modification by stunting. In an area of Bangladesh with lower lead exposures (median umbilical cord blood lead concentration, 1.7 μg/dL), stunting modified the relationship between prenatal blood lead concentrations and cognitive score at age 2-3 years. A 1-unit increase in natural log cord blood lead concentration in the presence of stunting was associated with a 2.1-unit decrease in cognitive scores (β = - 2.10, SE = 0.71, P = 0.003). This interaction was not found in a second study site where lead exposures were higher (median umbilical cord blood lead concentration, 6.1 μg/dL, β = - 0.45, SE = 0.49, P = 0.360). CONCLUSIONS We used a novel method of mediation analysis to test whether stunting mediated the adverse effect of prenatal lead exposure on cognitive outcomes in Bangladesh. While we did not find that stunting acted as mediator of lead's effect on cognitive development, we found significant effect modification by stunting. Our results suggest that children with stunting are more vulnerable to the adverse effects of low-level lead exposure.
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Affiliation(s)
- Kelsey M Gleason
- Department of Medicine, Robert Larner M.D. College of Medicine, Burlington, VT, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA
| | - Anuraj H Shankar
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John F Obrycki
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | | | | | | | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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23
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Goodrich JM, Hector EC, Tang L, LaBarre JL, Dolinoy DC, Mercado-Garcia A, Cantoral A, Song PX, Téllez-Rojo MM, Peterson KE. Integrative Analysis of Gene-Specific DNA Methylation and Untargeted Metabolomics Data from the ELEMENT Cohort. Epigenet Insights 2020; 13:2516865720977888. [PMID: 33354655 PMCID: PMC7734565 DOI: 10.1177/2516865720977888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/04/2020] [Indexed: 12/18/2022] Open
Abstract
Epigenetic modifications, such as DNA methylation, influence gene expression and cardiometabolic phenotypes that are manifest in developmental periods in later life, including adolescence. Untargeted metabolomics analysis provide a comprehensive snapshot of physiological processes and metabolism and have been related to DNA methylation in adults, offering insights into the regulatory networks that influence cellular processes. We analyzed the cross-sectional correlation of blood leukocyte DNA methylation with 3758 serum metabolite features (574 of which are identifiable) in 238 children (ages 8-14 years) from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) study. Associations between these features and percent DNA methylation in adolescent blood leukocytes at LINE-1 repetitive elements and genes that regulate early life growth (IGF2, H19, HSD11B2) were assessed by mixed effects models, adjusting for sex, age, and puberty status. After false discovery rate correction (FDR q < 0.05), 76 metabolites were significantly associated with LINE-1 DNA methylation, 27 with HSD11B2, 103 with H19, and 4 with IGF2. The ten identifiable metabolites included dicarboxylic fatty acids (five associated with LINE-1 or H19 methylation at q < 0.05) and 1-octadecanoyl-rac-glycerol (q < 0.0001 for association with H19 and q = 0.04 for association with LINE-1). We then assessed the association between these ten known metabolites and adiposity 3 years later. Two metabolites, dicarboxylic fatty acid 17:3 and 5-oxo-7-octenoic acid, were inversely associated with measures of adiposity (P < .05) assessed approximately 3 years later in adolescence. In stratified analyses, sex-specific and puberty-stage specific (Tanner stage = 2 to 5 vs Tanner stage = 1) associations were observed. Most notably, hundreds of statistically significant associations were observed between H19 and LINE-1 DNA methylation and metabolites among children who had initiated puberty. Understanding relationships between subclinical molecular biomarkers (DNA methylation and metabolites) may increase our understanding of genes and biological pathways contributing to metabolic changes that underlie the development of adiposity during adolescence.
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Affiliation(s)
- Jaclyn M Goodrich
- Deptartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Emily C Hector
- Deptartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA.,Deptartment of Statistics, North Carolina State University, USA
| | - Lu Tang
- Deptartment of Biostatistics, University of Pittsburgh, USA
| | - Jennifer L LaBarre
- Deptartment of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Deptartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.,Deptartment of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Adriana Mercado-Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Peter Xk Song
- Deptartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Karen E Peterson
- Deptartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.,Deptartment of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
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Jukic AMZ, Zuchniak A, Qamar H, Ahmed T, Mahmud AA, Roth DE. Vitamin D Treatment during Pregnancy and Maternal and Neonatal Cord Blood Metal Concentrations at Delivery: Results of a Randomized Controlled Trial in Bangladesh. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:117007. [PMID: 33226277 PMCID: PMC7682582 DOI: 10.1289/ehp7265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/06/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Vitamin D improves absorption of calcium; however, in animal studies vitamin D also increases the absorption of toxic metals, such as lead and cadmium. OBJECTIVES We examined maternal and neonatal cord blood levels of lead, cadmium, manganese, and mercury after supplementation with vitamin D during pregnancy. METHODS The Maternal Vitamin D for Infant Growth trial was a randomized, placebo-controlled, multi-arm study of maternal vitamin D supplementation during pregnancy in Dhaka, Bangladesh (NCT01924013). Women were randomized during their second trimester to blinded weekly doses of placebo or 4,200, 16,800, or 28,000 IU of vitamin D3 throughout pregnancy. Each group had 118-239 maternal blood specimens and 100-201 cord blood samples analyzed. Metals were measured using inductively coupled plasma mass spectrometry. Unadjusted estimates from linear regression models were expressed as percentage differences. Cord blood cadmium was analyzed as detectable or undetectable with log-binomial regression. RESULTS Maternal cadmium, mercury, and manganese levels were nearly identical across groups. Maternal lead levels were 6.3%, 7.4%, and 6.0% higher in the treatment groups (4,200, 16,800, and 28,000 IU, respectively) vs. placebo; however, 95% confidence intervals (CIs) showed that differences from 4.1% lower to 20% higher were compatible with the data. In treatment groups (4,200, 16,800, 28,000 IU) vs. placebo, neonatal cord blood lead levels were 8.5% (95% CI: - 3.5 , 22), 16% (95% CI: 3.3, 30), and 11% (95% CI: 0.4, 23) higher and had higher risk of detectable cadmium, relative risk ( RR ) = 2.2 (95% CI: 1.3, 3.7), RR = 1.4 (95% CI: 0.8, 2.5), RR = 1.7 (95% CI: 1.0, 2.9). DISCUSSION Vitamin D supplementation from the second trimester of pregnancy did not influence maternal cadmium, mercury, or manganese levels at delivery. Vitamin D was associated with nonsignificant increases in maternal lead and with significant increases in cord blood lead and cadmium. These associations were not dose dependent. Given that there are no safe levels of metals in infants, the observed increases in cord blood lead and cadmium require further exploration. https://doi.org/10.1289/EHP7265.
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Affiliation(s)
- Anne Marie Z. Jukic
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina, USA
| | - Anna Zuchniak
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Huma Qamar
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mahmud
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Daniel E. Roth
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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McElroy KG, Iobst SE, DeVance-Wilson C, Ludeman E, Barr E. Systematic Review and Meta-Analysis of the Effect of Nutrients on Blood Lead Levels in Pregnancy. J Obstet Gynecol Neonatal Nurs 2020; 49:243-253. [PMID: 32259512 DOI: 10.1016/j.jogn.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To synthesize experimental and nonexperimental research on the relationship between nutrients and blood lead levels in pregnant women. We also performed a meta-analysis on a subgroup of studies on calcium and blood lead levels. DATA SOURCES PubMed, Embase, and CINAHL databases were searched in July 2019. STUDY SELECTION We included articles published in English in any year that reported the results of experimental or observational studies on the effect of nutrients on blood lead levels in pregnancy. DATA EXTRACTION Three nurse reviewers extracted data and appraised the studies using tools from the Joanna Briggs Institute. DATA SYNTHESIS AND META-ANALYSIS We included 28 studies from 16 countries. Study authors examined 14 distinct nutrients, with calcium being the most frequent. The metaregression included nine analyses of the effect of calcium on blood lead levels and showed a small but significant inverse relationship. The quality of evidence for the effect of calcium on lead levels was high. Eleven analyses were related to the effect of iron on blood lead levels. The quality of evidence was high, and we found mostly negative associations between iron intake and blood lead levels. The quality of evidence for the remaining nutrients was moderate, with few significant findings. CONCLUSION Targeted nutritional interventions may be beneficial for pregnant women with current lead exposure or a history of elevated lead levels, particularly those with calcium- or iron-deficient diets. More rigorously designed studies are needed in this area.
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Flannery BM, Dolan LC, Hoffman-Pennesi D, Gavelek A, Jones OE, Kanwal R, Wolpert B, Gensheimer K, Dennis S, Fitzpatrick S. U.S. Food and Drug Administration's interim reference levels for dietary lead exposure in children and women of childbearing age. Regul Toxicol Pharmacol 2020; 110:104516. [DOI: 10.1016/j.yrtph.2019.104516] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022]
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Levin R, Zilli Vieira CL, Mordarski DC, Rosenbaum MH. Lead seasonality in humans, animals, and the natural environment. ENVIRONMENTAL RESEARCH 2020; 180:108797. [PMID: 31761335 DOI: 10.1016/j.envres.2019.108797] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/13/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
Lead adversely impacts the health of humans, animals, and the natural environment. Higher lead burdens in warm weather occur in humans, domesticated and wild animals; land and water species; urban and rural, developed and pristine environments. The array of evidence suggests that lead seasonality is multifactorial within the natural world, including humans. Seasonally higher temperatures, solar radiation, humidity and anthropogenic pollution result in lower pH (acidification) in air, water and soil. Environmental acidification increases lead's bioavailability and mobility thus intensifying human, animal and plant exposures. In addition, lead seasonality in the biosphere is influenced by higher growth rates, slightly increased exposures, and more Vitamin D metabolism. Methodologically, we applied a One Health perspective to EPA's Integrated Science Assessments of Lead to review the published literature, supplemented with subsequent and related publications to assess data on the seasonality of lead exposure across species and through the earth's systems. Our integrated assessment suggests that: 1) 'Seasonality' is a multifactorial, terrestrial phenomenon affecting the natural world; human activities have exacerbated natural cyclicities that impact lead exposures across species. 2) To be sustainable, human lead remediation strategies must consider the total environment. 3) Global warming and climate change events may increase lead exposures and toxicity to all species throughout the natural environment.
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Affiliation(s)
- Ronnie Levin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Carolina L Zilli Vieira
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | | | - Marieke H Rosenbaum
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536, USA.
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Liu Y, Ettinger AS, Téllez-Rojo M, Sánchez BN, Zhang Z, Cantoral A, Hu H, Peterson KE. Prenatal Lead Exposure, Type 2 Diabetes, and Cardiometabolic Risk Factors in Mexican Children at Age 10-18 Years. J Clin Endocrinol Metab 2020; 105:dgz038. [PMID: 31608940 PMCID: PMC7037075 DOI: 10.1210/clinem/dgz038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/26/2019] [Indexed: 12/23/2022]
Abstract
CONTEXT Several cross-sectional studies have assessed the association of lead exposure with type 2 diabetes and cardiometabolic risk factors in adults; however, studies of such associations in childhood are rare. OBJECTIVE We assessed the prospective associations of prenatal exposure to lead with type 2 diabetes and cardiometabolic risk factors in children. DESIGN The Early Life Exposure in Mexico to Environmental Toxicants is a birth cohort study of pregnant women and their offspring. SETTING Public hospitals in Mexico City. PATIENTS OR OTHER PARTICIPANTS Women were recruited during pregnancy; their offspring were recruited for a follow-up visit at age 10 to 18 years (n = 369). MAIN OUTCOME MEASURES We measured fasting serum markers of type 2 diabetes and cardiometabolic risk factors in children, including fasting glucose, insulin, and lipids. The index of insulin resistance was calculated. RESULTS The geometric mean of maternal blood lead levels (BLLs) during pregnancy was 4.3 µg/dL (95% confidence interval [CI]): 4.0-4.6 µg/dL) in the entire sample. In boys, those with maternal BLLs ≥ 5 µg/dL (compared with those with BLLs < 5 µg/dL) had significantly lower z scores for total cholesterol (β = -0.41, 95% CI: -0.71, -0.12), high-density lipoprotein cholesterol (β = -0.32, 95% CI: -0.59, -0.05), and low-density lipoprotein cholesterol (β = -0.52, 95% CI: -0.81, -0.22), adjusting for covariates. No associations were detected in girls. CONCLUSIONS In our study, we found that higher prenatal exposure to lead was associated with lower levels of cholesterol in children following a sex-specific pattern. Further studies with a larger sample size that examine whether sex is a potential modifier are needed to confirm our findings.
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Affiliation(s)
- Yun Liu
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Martha Téllez-Rojo
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Zhenzhen Zhang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Alejandra Cantoral
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Howard Hu
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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Influence of post-partum BMI change on childhood obesity and energy intake. PLoS One 2019; 14:e0224830. [PMID: 31830761 PMCID: PMC6908440 DOI: 10.1371/journal.pone.0224830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/22/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Association between parent’s Body Mass Index (BMI) and their children, has been widely documented. Individual, familiar and structural factors play a role in this relation. We analyzed the association between maternal BMI change during the first year post-partum and their offspring’s growth-trajectories and energy intake in their first five years of life. Objective Compare growth-trajectories and children’s caloric intake according to post-partum mother´s BMI classification. Methods The anthropometric assessment was taken in 935 mother-child pairs along the study period. Mothers were classified into four groups according to their BMI-trajectories in the post-partum. Children’s weight for height z-scores (WHZ) was compared among groups using random-effects regression models. A longitudinal comparison of children’s caloric intake by the maternal group was carried out. Results At 42 months of age, infants from mothers that remained overweight during the first year post-partum had, on average, 0.61 SD higher WHZ than those from mothers who remained in a recommended BMI group (R-BMI) in the same period. At 60 months of age, children´s prevalence of obesity was almost twice in the maternal overweight group vs R-BMI group (14.2% and 7.3% respectively). Chances for a child of having an over caloric intake were 36.5% (95% IC: 6.6%, 74.8%) and significantly higher among children from overweight mothers than those from R-BMI mothers. The difference in children’s WHZ trajectory remained significant after adjusting for caloric intake, suggesting that contextual factors play a role in shaping children’s obesity. A concurrent ethnographic study with the study subjects provides suggestions as to what these factors might be, including changes in the food landscape. Conclusion Children from overweight mothers tended to have a more caloric diet yielding a higher propensity to obesity. Contextual factors such as food landscape might contribute to childhood obesity beyond having an overweight mother. Pregnancy and post-partum is a window of opportunity for interventions to decrease the incidence of children’s overweight.
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Dórea JG, Fenton SE. Estimating risk of neurotoxicity from early life exposure: Human milk is an appropriate matrix, but messages should not discourage breastfeeding. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 693:133665. [PMID: 31634993 DOI: 10.1016/j.scitotenv.2019.133665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/08/2019] [Accepted: 07/28/2019] [Indexed: 06/10/2023]
Affiliation(s)
- José G Dórea
- Faculty of Health Sciences, Universidade de Brasilia, 70919-970 Brasilia, DF, Brazil.
| | - Suzanne E Fenton
- Division of the National Toxicology Program (DNTP), NTP Laboratory, National Institute of Environmental Health Sciences (NIEHS), National Institute of Health (NIH), Research Triangle Park, NC 27709, USA
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Dórea JG. Environmental exposure to low-level lead (Pb) co-occurring with other neurotoxicants in early life and neurodevelopment of children. ENVIRONMENTAL RESEARCH 2019; 177:108641. [PMID: 31421445 DOI: 10.1016/j.envres.2019.108641] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
Lead (Pb) is a worldwide environmental contaminant that even at low levels influences brain development and affects neurobehavior later in life; nevertheless it is only a small fraction of the neurotoxicant (NT) exposome. Exposure to environmental Pb concurrent with other NT substances is often the norm, but their joint effects are challenging to study during early life. The aim of this review is to integrate studies of Pb-containing NT mixtures during the early life and neurodevelopment outcomes of children. The Pb-containing NT mixtures that have been most studied involve other metals (Mn, Al, Hg, Cd), metalloids (As), halogen (F), and organo-halogen pollutants. Co-occurring Pb-associated exposures during pregnancy and lactation depend on the environmental sources and the metabolism and half-life of the specific NT contaminant; but offspring neurobehavioral outcomes are also influenced by social stressors. Nevertheless, Pb-associated effects from prenatal exposure portend a continued burden on measurable neurodevelopment; they thus favor increased neurological health issues, decrements in neurobehavioral tests and reductions in the quality of life. Neurobehavioral test outcomes measured in the first 1000 days showed Pb-associated negative outcomes were frequently noticed in infants (<6 months). In older (preschool and school) children studies showed more variations in NT mixtures, children's age, and sensitivity and/or specificity of neurobehavioral tests; these variations and choice of statistical model (individual NT stressor or collective effect of mixture) may explain inconsistencies. Multiple exposures to NT mixtures in children diagnosed with 'autism spectrum disorders' (ASD) and 'attention deficit and hyperactivity disorders' (ADHD), strongly suggest a Pb-associated effect. Mixture potency (number or associated NT components and respective concentrations) and time (duration and developmental stage) of exposure often showed a measurable impact on neurodevelopment; however, net effects, reversibility and/or predictability of delays are insufficiently studied and need urgent attention. Nevertheless, neurodevelopment delays can be prevented and/or attenuated if public health policies are implemented to protect the unborn and the young child.
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Affiliation(s)
- José G Dórea
- Universidade de Brasília, Brasília, 70919-970, DF, Brazil.
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Astolfi ML, Protano C, Schiavi E, Marconi E, Capobianco D, Massimi L, Ristorini M, Baldassarre ME, Laforgia N, Vitali M, Canepari S, Mastromarino P. A prophylactic multi-strain probiotic treatment to reduce the absorption of toxic elements: In-vitro study and biomonitoring of breast milk and infant stools. ENVIRONMENT INTERNATIONAL 2019; 130:104818. [PMID: 31279184 DOI: 10.1016/j.envint.2019.05.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 05/26/2023]
Abstract
Potential exposure to toxic elements initially occurs during gestation and after birth via breast milk, which is the principal source of nutrients for infants during the first months of life. In this study, we evaluated whether maternal oral supplementation with a multi-strain probiotic product can protect infants from exposure to arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) via breast milk. In-vitro studies of the bacterial strains present in this probiotic product showed a high bacterial tolerance for As, Cd, Hg, and Pb, and good binding capacity for Cd, Hg, and Pb (72%, 81%, and 64%, respectively) within 1 h of contact. We evaluated concentrations (5 mg L-1 for Cd and Pb, and 2 mg L-1 for Hg) that largely exceeded the provisional tolerable weekly intake of these toxic elements via food or water applicable for human consumption. Changes in the levels of these elements in breast milk and newborn stools were evaluated in the control (orally supplemented with placebo) and experimental (orally supplemented with probiotic) groups at birth (t0), 15 days (t15), and 30 days (t30) after delivery. Elemental analysis of breast milk did not show significant differences between the control and experimental groups at different stages of lactation; however, stool samples obtained from newborns of mothers supplemented with the probiotic product showed that Cd levels were significantly reduced (by 26%) at t15 compared with the levels of the controls. Our data did not show an association between concentration of toxic elements in breast milk and that in newborn stools. Indeed, the concentration of Cd, Hg, and Pb in breast milk decreased during the lactation period, whereas the levels of these elements in newborn stools were stable over time. Although our in-vitro data indicate that the consortium of these probiotic strains can absorb toxic compounds, this study was limited by its small sample size and potential uncontrolled confounding effects, such as maternal diet and lifestyle. Therefore, we could not confirm whether prophylactic use of this probiotic product can reduce the absorption of toxic elements. The risk assessment in the studied population evidenced a margin of exposure (MOE) of 1, or between 1 and 10 for Pb, and lower than 50 for As. This poses a potential risk for breastfed infants, indicating that interventions aimed to avoid breastfeeding-related health risks remain a major challenge in public health.
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Affiliation(s)
- Maria Luisa Astolfi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy.
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisabetta Marconi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Daniela Capobianco
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Lorenzo Massimi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Martina Ristorini
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care Unit, University "Aldo Moro" of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care Unit, University "Aldo Moro" of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Silvia Canepari
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
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Early lead exposure and childhood adiposity in Mexico city. Int J Hyg Environ Health 2019; 222:965-970. [PMID: 31257186 DOI: 10.1016/j.ijheh.2019.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/30/2019] [Accepted: 06/13/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Prenatal and early childhood lead exposures have been associated with reduced weight in infants and young children, while studies that have examined such associations in children during peripubescence are rare. OBJECTIVES We investigated the associations of prenatal and early-life exposure to lead with indices of adiposity in peripubertal children living in Mexico City. METHODS Maternal bone lead (as a proxy for cumulative fetal exposure) was assessed at 1 month postpartum. Blood samples were obtained from children annually from 1 to 4 years. Multivariable linear regression models were used to examine the association between each lead biomarker and BMI z-score, waist circumference, sum of skinfolds and body fat percentage in 248 children aged 8-16 years. RESULTS After adjusting for covariates, maternal patella lead was associated with lower child BMI z-score (β = -0.02, 95% CI: 0.03, -0.01, p = 0.004), waist circumference (β = -0.12 cm, 95% CI: 0.22, -0.03, p = 0.01), sum of skinfolds (β = -0.29 mm, 95% CI: 0.50, -0.08, p = 0.007) and body fat percentage (β = -0.09%, 95% CI: 0.17, -0.01, p = 0.03). No significant associations were detected from the postnatal exposure period. CONCLUSIONS We observed a significant and inverse association of prenatal lead exposure with body composition in Mexican children, suggesting the potential role of early lead exposure in the fetal programming of child growth. Further research on the biological mechanisms underlying these associations is needed.
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Bowman A, Peterson KE, Dolinoy DC, Meeker JD, Sánchez BN, Mercado-Garcia A, Téllez-Rojo MM, Goodrich JM. Phthalate Exposures, DNA Methylation and Adiposity in Mexican Children Through Adolescence. Front Public Health 2019; 7:162. [PMID: 31275917 PMCID: PMC6593088 DOI: 10.3389/fpubh.2019.00162] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/03/2019] [Indexed: 01/16/2023] Open
Abstract
Phthalates are a class of endocrine disrupting chemicals with near ubiquitous exposure to populations around the world. Phthalates have been associated with children's adiposity in previous studies, though discrepancies exist across studies that may be due to timing of exposure or outcome assessment and population differences (i.e., genetics, other confounders). DNA methylation, an epigenetic modification involved in gene regulation, may mediate the effects of early life phthalate exposures on health outcomes. This study aims to evaluate the mediating effect of DNA methylation at growth-related genes on the association between phthalate exposure and repeat measures of adiposity (BMI-for-age z-score, waist circumference, and skinfolds thickness) in Mexican children. Urinary phthalate metabolite concentrations were quantified in mothers at each of the three trimesters of pregnancy and in children at the first peri-adolescent study visit. Blood leukocyte DNA methylation at H19 and HSD11B2 was quantified during the first peri-adolescent visit, and adiposity was measured at the first visit and again ~3 years later among participants (n = 109 boys, 114 girls) from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) project. Associations between phthalates or DNA methylation and repeat outcome measures were assessed separately in boys and girls using generalized estimating equation models including covariates (urinary specific gravity, maternal education, and child's age). Sobel tests were used to assess DNA methylation as a mediator in models adjusting for the same covariates. Associations between phthalates and adiposity varied by phthalate and timing of exposure. Early gestation MBP, MIBP, and MBzP were associated with adiposity among girls. For example, among girls first trimester maternal urine concentrations of MIBP were associated with increases in skinfold thickness, BMI-for-age, and waist circumference (p < 0.01). Second trimester and adolescent MBzP were associated with adiposity among boys in opposite directions. In girls, H19 methylation was positively associated with skinfold thickness. No significant mediation of phthalate exposure on adiposity by DNA methylation of H19 or HSD11B2 was observed (Sobel p > 0.05). However, the mediation analysis was underpowered to detect small to medium effect sizes, and the role of DNA methylation as a mediator between phthalates and outcomes merits further study.
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Affiliation(s)
- Alison Bowman
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Adriana Mercado-Garcia
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha M Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
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Taylor CM, Doerner R, Northstone K, Kordas K. Dietary Patterns Are Not Consistently Associated with Variability in Blood Lead Concentrations in Pregnant British Women. J Nutr 2019; 149:1027-1036. [PMID: 31149708 PMCID: PMC6543203 DOI: 10.1093/jn/nxz023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 01/30/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND During pregnancy lead crosses the placenta freely and can have adverse effects on the fetus, with the potential for lifelong impact on the child. Identification of dietary patterns and food groups in relation to measures of lead status could provide a more useful alternative to nutrient-specific advice to minimize fetal lead exposure. OBJECTIVES The aim of this study was to evaluate whether dietary patterns and food groups are associated with blood lead concentration (B-Pb) in pregnancy. DESIGN Whole blood samples were collected at a median of 11 wk gestation (IQR 9-13 wk) from women enrolled in the Avon Longitudinal Study of Parents and Children birth cohort study, and analyzed for lead. Dietary pattern scores were derived from principal components analysis of a food-frequency questionnaire (32 wk gestation). Associations of dietary pattern scores (quartiles), and of food groups (frequency of consumption), with the likelihood of B-Pb ≥5 µg/dL identified with adjusted logistic regression (n = 2167 complete cases). RESULTS There was a negative association between the "confectionery" dietary pattern and the likelihood of B-Pb ≥5 µg/dL (OR: 0.62; 95% CI: 0.41, 0.94) in an adjusted model. There were no associations with other dietary patterns. There was a positive association between the food group "all leafy green and green vegetables" and the likelihood of B-Pb ≥5 µg/dL (OR 1.45; 95% CI: 1.04, 2.01). Conversely, the food group "cakes and biscuits" was negatively associated (OR 0.63; 95% CI: 0.43, 0.93). After multiple imputation, there was a positive association of the "healthy" diet pattern and no association of the "confectionery" pattern. CONCLUSIONS We found limited evidence of an association between women's typical diet and B-Pb during pregnancy. Our findings do not indicate need to revise dietary guidance for pregnant women, who are advised to adopt a healthy diet in pregnancy, with a variety of foods consumed in moderation.
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Affiliation(s)
- Caroline M Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, UK
| | - Rita Doerner
- Bristol Medical School, University of Bristol, UK
| | | | - Katarzyna Kordas
- Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Curry SJ, Krist AH, Owens DK, Barry MJ, Cabana M, Caughey AB, Doubeni CA, Epling JW, Kemper AR, Kubik M, Landefeld CS, Mangione CM, Pbert L, Silverstein M, Simon MA, Tseng CW, Wong JB. Screening for Elevated Blood Lead Levels in Children and Pregnant Women: US Preventive Services Task Force Recommendation Statement. JAMA 2019; 321:1502-1509. [PMID: 30990556 DOI: 10.1001/jama.2019.3326] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Elevated blood lead levels in children are associated with neurologic effects such as behavioral and learning problems, lower IQ, hyperactivity, hearing problems, and impaired growth. In pregnant women, lead exposure can impair organ systems such as the hematopoietic, hepatic, renal, and nervous systems, and increase the risk of preeclampsia and adverse perinatal outcomes. Many of the adverse health effects of lead exposure are irreversible. OBJECTIVE To update the 2006 US Preventive Services Task Force (USPSTF) recommendation on screening for elevated blood lead levels in children and pregnant women. EVIDENCE REVIEW The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of elevated blood lead levels. In this update, an elevated blood lead level was defined according to the Centers for Disease Control and Prevention reference level of 5 μg/dL. FINDINGS The USPSTF found adequate evidence that questionnaires and other clinical prediction tools to identify asymptomatic children with elevated blood lead levels are inaccurate. The USPSTF found adequate evidence that capillary blood testing accurately identifies children with elevated blood lead levels. The USPSTF found inadequate evidence on the effectiveness of treatment of elevated blood lead levels in asymptomatic children 5 years and younger and in pregnant women. The USPSTF found inadequate evidence regarding the accuracy of questionnaires and other clinical prediction tools to identify asymptomatic pregnant women with elevated blood lead levels. The USPSTF found inadequate evidence on the harms of screening for or treatment of elevated blood lead levels in asymptomatic children and pregnant women. The USPSTF concluded that the current evidence is insufficient, and that the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children 5 years and younger and in pregnant women cannot be determined. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic pregnant persons. (I statement).
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Affiliation(s)
| | | | - Alex H Krist
- Fairfax Family Practice Residency, Fairfax, Virginia
- Virginia Commonwealth University, Richmond
| | - Douglas K Owens
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Stanford University, Stanford, California
| | | | | | | | | | | | | | | | | | | | - Lori Pbert
- University of Massachusetts Medical School, Worcester
| | | | | | - Chien-Wen Tseng
- University of Hawaii, Honolulu
- Pacific Health Research and Education Institute, Honolulu, Hawaii
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Cantor AG, Hendrickson R, Blazina I, Griffin J, Grusing S, McDonagh MS. Screening for Elevated Blood Lead Levels in Childhood and Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2019; 321:1510-1526. [PMID: 30990555 DOI: 10.1001/jama.2019.1004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Elevated blood lead level is associated with serious, often irreversible, health consequences. OBJECTIVE To synthesize evidence on the effects of screening, testing, and treatment for elevated blood lead level in pregnant women and children aged 5 years and younger in the primary care setting to inform the US Preventive Services Task Force. DATA SOURCES Cochrane CENTRAL and Cochrane Database of Systematic Reviews (through June 2018) and Ovid MEDLINE (1946 to June 2018); surveillance through December 5, 2018. STUDY SELECTION English-language trials and observational studies of screening for and treating elevated lead levels in asymptomatic children and pregnant women. DATA EXTRACTION AND SYNTHESIS Independent critical appraisal and data abstraction by 2 reviewers using predefined criteria. MAIN OUTCOMES AND MEASURES Elevated blood lead level, morbidity, mortality, clinical prediction tools, test accuracy, adverse events. RESULTS A total of 24 studies (N = 11 433) were included in this review. No studies evaluated the benefits or harms of screening vs no screening in children. More than 1 positive answer on the 5-item 1991 Centers for Disease Control and Prevention (CDC) screening questionnaire was associated with a pooled sensitivity of 48% (95% CI, 31.4% to 65.6%) and specificity of 58% (95% CI, 39.9% to 74.0%) for identifying children with a venous blood lead level greater than 10 μg/dL (5 studies [n = 2265]). Adapted versions of the CDC questionnaire did not demonstrate improved accuracy. Capillary blood lead testing demonstrated sensitivity of 87% to 91% and specificity greater than 90%, compared with venous measurement (4 studies [n = 1431]). Counseling and nutritional interventions or residential lead hazard control techniques did not reduce blood lead concentrations in asymptomatic children, but studies were few and had methodological limitations (7 studies [n = 1419]). One trial (n = 780) of dimercaptosuccinic acid (DMSA) chelation therapy found reduced blood lead levels in children at 1 week to 1 year but not at 4.5 to 6 years, while another trial (n = 39) found no effect at 1 and 6 months. Seven-year follow-up assessments showed no effect on neuropsychological development, a small deficit in linear growth (height difference, 1.17 cm [95% CI, 0.41 to 1.93]), and poorer cognitive outcomes reported as the Attention and Executive Functions subscore of the Developmental Neuropsychological Assessment (unadjusted difference, -1.8 [95% CI, -4.5 to 1.0]; adjusted P = .045) in children treated with DMSA chelation. Evidence was too limited to determine the accuracy of screening questionnaires or benefits and harms of treatment in pregnant women. CONCLUSIONS AND RELEVANCE Screening questionnaires were not accurate for identifying children with elevated blood lead levels. Chelating agents in children were not significantly associated with sustained effects on blood level levels but were associated with harms.
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Affiliation(s)
- Amy G Cantor
- Pacific Northwest Evidence-based Practice Center, Departments of Medical Informatics and Clinical Epidemiology, Family Medicine, and Obstetrics and Gynecology, Oregon Health & Science University, Portland
| | - Rob Hendrickson
- Department of Emergency Medicine, Oregon Health & Science University, Portland
| | - Ian Blazina
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | - Jessica Griffin
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | - Sara Grusing
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
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Ladele JI, Fajolu IB, Ezeaka VC. Determination of lead levels in maternal and umbilical cord blood at birth at the Lagos University Teaching Hospital, Lagos. PLoS One 2019; 14:e0211535. [PMID: 30730916 PMCID: PMC6366766 DOI: 10.1371/journal.pone.0211535] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 01/16/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lead toxicity is a cause of intellectual disability in children and majority of affected children live in developing countries. Its adverse effect on pregnancy outcome has also been documented. OBJECTIVES To assess the relationship between maternal blood lead levels and umbilical cord blood lead levels in their corresponding newborn infants; to determine factors associated with high blood lead levels and the pregnancy outcome in participants. MATERIALS AND METHODS This was a cross-sectional descriptive study carried out at a tertiary Teaching Hospital, Lagos, Nigeria. Four hundred and forty pregnant women and their respective newborns delivered at the study centre. Blood samples were obtained from the mothers and umbilical cord of the newborns at delivery and analysed by atomic absorption spectrophotometry. Socio-demographic and obstetric data was obtained by questionnaires administered to the mothers. The anthropometric measurements of the babies were taken at birth and clinical data recorded. Main outcome measures were blood lead levels in mother and baby pair, socio-demographic factors, birth weight, gestational age, length, occipito-frontal circumference. RESULTS The median maternal and umbilical blood lead level was 64.3μg/dl and 39.2μg/dl respectively. The levels were above 5μg/dl in 75.6% and 66.8% of mothers and umbilical cord respectively. There was a strong positive correlation between the maternal and umbilical cord blood lead levels (rs = 0.80). Use of calcium supplements during pregnancy was significantly associated with a lower maternal blood lead level (p = 0.010) while recent painting and renovation of residential accommodation were associated with a higher umbilical cord blood lead level (p = 0.025). There were no statistically significant associations between the maternal and umbilical cord blood lead levels and the gestational age and anthropometry of the newborns at birth. CONCLUSIONS The blood lead levels in newborns of women residing in Lagos, Nigeria are high and administration of antenatal calcium is associated with lower blood lead levels.
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Affiliation(s)
- Jejelola I. Ladele
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- * E-mail:
| | - Iretiola Bamikeolu Fajolu
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Department of Paediatrics, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Veronica Chinyere Ezeaka
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Department of Paediatrics, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Rodríguez-Carmona Y, Cantoral A, Trejo-Valdivia B, Téllez-Rojo MM, Svensson K, Peterson KE, Meeker JD, Schnaas L, Solano M, Watkins DJ. Phthalate exposure during pregnancy and long-term weight gain in women. ENVIRONMENTAL RESEARCH 2019; 169:26-32. [PMID: 30408750 PMCID: PMC6347540 DOI: 10.1016/j.envres.2018.10.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/11/2018] [Accepted: 10/13/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND Phthalates are known endocrine disruptors and peroxisome proliferator-activated receptor (PPAR) activators, potentially capable of promoting an obesogenic effect. Pregnant women are especially vulnerable to phthalate exposure due to physiological and metabolic changes during pregnancy, including those related to the metabolism of xenobiotics. Phthalate exposure during pregnancy has been associated with early gestational weight gain, however, its effect on long-term weight gain remains unclear. The aim of the present study was to evaluate the association between phthalate exposure during pregnancy and long-term changes in weight among women. METHODS Urinary phthalate concentrations, socioeconomic, anthropometry and information on diet and socioeconomic status were collected during pregnancy from 178 women from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort. Maternal body weight and diet information was also collected up to 5 times in the first year postpartum and twice during follow-up visits 5.2-10.7 years later. A path analysis was performed to assess associations between urinary phthalate metabolite levels during pregnancy and change in weight (kg) per year after delivery, including age, education, living with/without partner, parity, daily energy intake and breastfeeding duration. RESULTS The mean age at pregnancy was 27.3 ± 5.9 years and mean body mass index during the first postpartum year was 27.07 ± 4.22 kg/m2. On average, women gained 3.48 kg (0.52 ± 0.84 kg/year). A unit increase in log-transformed mono-3-carboxypropyl phthalate (MCPP) was associated with 0.33 kg (95% CI: 0.09, 0.56) higher weight gain per year, and mono-benzyl phthalate (MBzP) with 0.21 kg (95% CI: -0.38, -0.03) lower weight gain per year. CONCLUSION Exposure to certain phthalates during pregnancy may be associated with long-term weight change in women. More studies on the effects of phthalate exposure during pregnancy on women's long-term health are required.
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Affiliation(s)
| | - Alejandra Cantoral
- CONACYT, National Institute of Public Health, Center for Nutrition and Health Research, Av Universidad 655 Col. Sta. Ma. Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico.
| | - Belem Trejo-Valdivia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, USA
| | - Lourdes Schnaas
- Division of Research in Community Interventions, National Institute of Perinatology, Mexico City, Mexico
| | - Maritsa Solano
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, USA
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Khanjani N, Jafari M, Ahmadi Mousavi E. Breast milk contamination with lead and cadmium and its related factors in Kerman, Iran. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2018; 16:323-335. [PMID: 30729003 PMCID: PMC6277342 DOI: 10.1007/s40201-018-0320-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/30/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND Heavy metals may be carcinogenic and have serious health effects in humans. In this study, levels of lead (Pb) and cadmium (Cd) in human milk samples from Kerman, Iran were evaluated. METHODS One-hundred breast milk samples were collected from mothers visiting 20 maternal and child care centers. Demographic, diet and smoking data was collected for each mother. Samples were analyzed by Graphite Furnace Atomic Absorption Spectrometry. Statistical analysis was done in Minitab15, through non-parametric methods, Spearman's correlation and chi-square. RESULTS The mean ± sd of Pb and Cd was 53.6 ± 64.9 and 8.01 ± 15.5 μg/L respectively. The median (25-75 percentiles) of Pb and Cd was 34.00 (4.00-81.75) and 5.00 (4.00-7.00) μg/L; 6 and 17% of infants were receiving higher than recommended levels of lead and cadmium respectively. Mothers who took fat off their meat before eating and mothers who had a vaginal delivery had higher levels of Cd than others (p value = 0.04, 0.002). Non-primiparous mothers and those who consumed more yogurt had higher levels of Pb (p value = 0.011, 0.025). CONCLUSION Lead and cadmium contamination was considerable among mothers' in Kerman, Iran. There is a need for decreasing the current levels in food, air, water and other consumer products such as cosmetics.
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Affiliation(s)
- Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Majideh Jafari
- Department of Health Education, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Effat Ahmadi Mousavi
- Department of Biology, School of Science, Shahid Bahonar University, Kerman, Iran
- School of Science, International Center of Science, High Technology and Environmental Sciences, Mahan, Kerman, Iran
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Horton MK, Hsu L, Claus Henn B, Margolis A, Austin C, Svensson K, Schnaas L, Gennings C, Hu H, Wright R, Rojo MMT, Arora M. Dentine biomarkers of prenatal and early childhood exposure to manganese, zinc and lead and childhood behavior. ENVIRONMENT INTERNATIONAL 2018; 121:148-158. [PMID: 30205321 PMCID: PMC6373872 DOI: 10.1016/j.envint.2018.08.045] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Metal exposure alters neurodevelopmental outcomes; little is known about critical windows of susceptibility when exposure exerts the strongest effect. OBJECTIVE To examine associations between dentine biomarkers of manganese (Mn), zinc (Zn) and lead (Pb) and later childhood behaviors. METHODS Subjects enrolled in a longitudinal birth cohort study in Mexico City provided naturally shed deciduous teeth. We estimated weekly prenatal and postnatal dentine Mn, Zn and Pb concentrations in teeth using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) and measured behavior at ages 8-11 years of age using the Behavior Assessment System for Children, 2nd edition (BASC-2). We used distributed lag models and lagged weighted quantile sum regression to identify the role of individual and combined dentine biomarkers of Mn, Zn and Pb on behavioral outcomes controlling for maternal education and gestational age. RESULTS Among the 133 subjects included in this study, prenatal and early postnatal dentine Mn appeared protective against childhood behavioral problems, specifically hyperactivity and attention. Postnatal dentine Mn was associated with increased reporting of internalizing problems, specifically anxiety. At 6 months, a 1-unit increase (unit = 1 SD of log concentration) in Mn was associated with a 0.18-unit (unit = 1 SD of BASC-2 score) increase in internalizing symptoms score and a 0.25-unit increase in anxiety. Postnatal Pb was associated with increasing anxiety symptoms; at 12 months, a 1-unit increase in Pb was associated with a 0.4 unit increase in anxiety symptoms. When examined as a metal mixture, we observed two potential windows of susceptibility to increased anxiety symptoms: the first window (0-8 months) appeared driven by Mn, the second window (8-12 months) was driven by the metal mixture and dominated by Pb. A 1-unit increase in the mixture index was associated with a 0.7-unit increase in SD of anxiety symptoms. CONCLUSIONS Childhood behaviors may demonstrate postnatal windows of susceptibility to individual and mixed metal concentrations measured in deciduous teeth. Prenatal dentine Mn may be protective, while excessive early postnatal Mn may increase risk for adverse behaviors. In combination, higher concentrations of Mn, Zn and Pb may have an adverse impact on behavior.
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Affiliation(s)
- Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, United States of America
| | - Amy Margolis
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center, 1051 Riverside Drive New York, New York 10032, United States of America
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatología, Montes Urales 800, Lomas Virreyes, Mexico City CP 11000, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6(th) floor, Toronto M5T 3M7, Canada
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health (Mexico), Universidad 655, Cuernavaca 62100, Mexico.
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
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Li YM, Shen YD, Li YJ, Xun GL, Liu H, Wu RR, Xia K, Zhao JP, Ou JJ. Maternal dietary patterns, supplements intake and autism spectrum disorders: A preliminary case-control study. Medicine (Baltimore) 2018; 97:e13902. [PMID: 30593205 PMCID: PMC6314746 DOI: 10.1097/md.0000000000013902] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was first to investigate associations between maternal dietary patterns and autism spectrum disorders (ASDs) and second to investigate association between maternal supplement intake and ASD.We used a case-control study design to enroll typically developing (TD) children and children with ASD, and data were derived from the Autism Clinical and Environmental Database (ACED).Three seventy four children with AUTISM and 354 age matched TD children were included. The multivariate logistic regression model revealed that maternal unbalanced dietary patterns before conception had a significant increased risk of ASD in offspring (mostly meat: adjusted OR, 4.010 [95% CI, 1.080, 14.887]; mostly vegetable: adjusted OR, 2.234 [95% CI, 1.009, 4.946]); maternal supplementation of calcium during pregnancy preparation was associated with decreased ASD risk (adjusted OR, 0.480 [95% CI, 0.276, 0.836]).This study provided preliminary evidence that maternal unbalanced dietary patterns may be a risk factor for ASD and supplementation of calcium during pregnancy preparation may be inversely associated with ASD in offspring.
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Affiliation(s)
- Ya-Min Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University
| | - Yi-Dong Shen
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, the China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province
| | - Yong-Jiang Li
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan
| | - Guang-Lei Xun
- Shandong Mental Health Center, 49 East Wenhua Road, Jinan, Shandong
| | - Huaqing Liu
- Beijing Huilongguan Hospital, Changping District, Beijing
| | - Ren-Rong Wu
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, the China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province
| | - Kun Xia
- The State Key Laboratory of Medical Genetics, No. 110 Xiangya Road, Changsha, Hunan, PR China
| | - Jing-Ping Zhao
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, the China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province
| | - Jian-Jun Ou
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, the China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province
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Malin AJ, Busgang SA, Cantoral AJ, Svensson K, Orjuela MA, Pantic I, Schnaas L, Oken E, Baccarelli AA, Téllez-Rojo MM, Wright RO, Gennings C. Quality of Prenatal and Childhood Diet Predicts Neurodevelopmental Outcomes among Children in Mexico City. Nutrients 2018; 10:E1093. [PMID: 30111728 PMCID: PMC6115750 DOI: 10.3390/nu10081093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 12/11/2022] Open
Abstract
Adequate nutrition is important for neurodevelopment. Although nutrients are ingested in combination, the impact of specific nutrients within the context of a nutrient mixture has not been studied with respect to health, such as neurodevelopment. Therefore, we examined the impact of prenatal and childhood nutrient mixtures on neurodevelopmental outcomes. Participants included mother⁻child pairs in the Programming Research in Obesity, Growth, Environment, and Social Stress (PROGRESS) prospective birth cohort in Mexico City. We assessed prenatal and child micro- and macronutrient profiles among 65 and 329 children, respectively, via food frequency questionnaires. Neurodevelopmental outcomes of 4⁻6-year-old children were measured using the McCarthy Scales of Children's Abilities (MSCA). We conducted weighted quantile sum (WQS) regression analyses to calculate indices reflecting "good" and "poor" prenatal and childhood nutrition. After adjusting for maternal education, socioeconomic status, the Home Observation for Measurement of the Environment (HOME) score, and total caloric intake, the good prenatal and childhood nutrition indices predicted more favorable neurodevelopment, while both poor nutrition indices predicted poorer neurodevelopment. These associations were stronger in prenatal than childhood models. Monounsaturated fats predicted various neurodevelopmental abilities relatively strongly in both models. Prenatal and childhood consumption of combinations of beneficial nutrients may contribute to more favorable neurodevelopment.
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Affiliation(s)
- Ashley J Malin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY 10029, USA.
| | - Stefanie A Busgang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY 10029, USA.
| | - Alejandra J Cantoral
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca 62100, Mexico.
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY 10029, USA.
| | - Manuela A Orjuela
- Columbia Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA.
| | - Ivan Pantic
- Instituto Nacional de Perinatología, Montes Urales 800, Lomas Virreyes, Ciudad de México C.P. 11000, Mexico.
| | - Lourdes Schnaas
- Instituto Nacional de Perinatología, Montes Urales 800, Lomas Virreyes, Ciudad de México C.P. 11000, Mexico.
| | - Emily Oken
- Division of Chronic Disease Research across the Life course, Department of Population Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
- Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Dr #401, Boston, MA 02215, USA.
| | - Andrea A Baccarelli
- Columbia Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA.
| | - Martha M Téllez-Rojo
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca 62100, Mexico.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY 10029, USA.
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY 10029, USA.
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Parnia A, Chakravartty D, Wiseman CLS, Archbold J, Copes R, Zawar N, Chen SX, Cole DC. Environmental factors associated with blood lead among newcomer women from South and East Asia in the Greater Toronto Area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 624:558-566. [PMID: 29268227 DOI: 10.1016/j.scitotenv.2017.11.336] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Newcomers bring with them histories of environmental exposure in their home countries and may have different sources of lead (Pb) exposure compared to other residents of their adopted country. AIMS To describe past and current factors associated with Pb exposure and blood Pb among South and East Asian newcomer women of reproductive age in the Greater Toronto Area (GTA), Ontario, Canada. METHODS In collaboration with public health units and community organizations a community-based research model was utilized by recruiting peer researchers to assist in all aspects of the study. Blood samples were taken and phone interviews were conducted. Canadian Health Measures Survey (CHMS) cycles 1, 2, and 3 data was used to contextualize the distribution blood Pb levels. Multiple regression was applied to log-transformed blood lead measurements, using a hierarchical model building process. RESULTS In total, 211 participants were recruited from Bangladesh, China, India, Pakistan and Sri Lanka. The distribution of the blood Pb varied by country of origin, and higher blood Pb values were found above 75th percentile compared to the CHMS. Distal factors significantly influencing blood Pb concentrations related to life history, such as duration of stay in Canada (RR=0.91; 95% CI 0.86-0.97), living near agricultural fields (RR=0.78; 95% CI 0.62-0.93), and country of origin. Proximal factors with significant contribution were use of cosmetics, traditional remedies, and smoking cigarettes. RECOMMENDATIONS Different past and current exposures may be important in various newcomer populations, informing international stakeholders, public health agencies, and primary care practitioners to adapt health education and exposure reduction programs to consider pre- and post-migration factors.
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Affiliation(s)
- Abtin Parnia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Dolon Chakravartty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Clare L S Wiseman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
| | | | - Ray Copes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Public Health Ontario, Toronto, Canada
| | - Noureen Zawar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Shirley X Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
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Yan J, Gao Z, Wang J, Ma W, Ying X, Zhou C, Yan C. Family environmental and dietary implications for low-level prenatal lead exposure in Wujiang City, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:12780-12787. [PMID: 29473138 DOI: 10.1007/s11356-017-1102-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/19/2017] [Indexed: 06/08/2023]
Abstract
To explore the potential environmental and dietary factors during pregnancy affecting low-level prenatal lead exposure, we conducted a longitudinal study in Wujiang City, China. A total of 1976 mother-infant pairs were included from 2009 to 2010. An interviewed questionnaire was conducted and cord blood samples were collected. The geometric means of cord blood lead level was 30.3 μg/L (95% CI, 29.8-30.8) with 99.24% below 100 μg/L. Maternal age, passive smoking, and living in the countryside were significantly associated with cord blood lead concentrations. Multiple logistic models showed that some family environmental factors including using firewood and electricity as kitchen fuel were positively correlated with increased cord blood lead levels. Among dietary sources recorded in this study, meat consumption (> 3 times/week), fish consumption (1-3 times/week), vegetables consumption (> 1 times/day), and fruit intake (> 1 times/day) had inverse relationship with cord blood lead levels. In general, our findings may have important implications for family environmental and dietary direction during pregnancy to decrease prenatal lead exposure.
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Affiliation(s)
- Jin Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Zhenyan Gao
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ju Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Wenjuan Ma
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xiaolan Ying
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Cancan Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
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46
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BaSalamah MA, Abdelghany AH, El-Boshy M, Ahmad J, Idris S, Refaat B. Vitamin D alleviates lead induced renal and testicular injuries by immunomodulatory and antioxidant mechanisms in rats. Sci Rep 2018; 8:4853. [PMID: 29556070 PMCID: PMC5859277 DOI: 10.1038/s41598-018-23258-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/08/2018] [Indexed: 11/09/2022] Open
Abstract
This study measured the effects of vitamin D (VD) supplementation on the underlying molecular pathways involved in renal and testicular damage induced by lead (Pb) toxicity. Thirty two adult male Wistar rats were divided equally into four groups that were treated individually or simultaneously, except the negative control, for four weeks with lead acetate in drinking water (1,000 mg/L) and/or intramuscular VD (1,000 IU/kg; 3 days/week). Pb toxicity markedly reduced serum VD and Ca2+, induced substantial renal and testicular injuries with concomitant significant alterations in the expression of VD metabolising enzymes, its receptor and binding protein, and the calcium sensing receptor. Pb also significantly promoted lipid peroxidation and pro-inflammatory cytokines (IL-4 and TNF-α) in the organs of interest concomitantly with declines in several anti-oxidative markers (glutathione, glutathione peroxidase and catalase) and the anti-inflammatory cytokine, IL-10. The co-administration of VD with Pb markedly mitigated renal and testicular injuries compared with positive controls. This was associated with restoration of the expression of VD related molecules, promotion of anti-oxidative and anti-inflammatory markers, but tissue Pb concentrations were unaffected. In conclusion, this report is the first to reveal potential protective effects for VD against Pb-induced renal and testicular injuries via anti-inflammatory and anti-oxidative mechanisms.
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Affiliation(s)
- Mohammad A BaSalamah
- Pathology Department, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah, Saudi Arabia
| | - Abdelghany Hassan Abdelghany
- Department of Anatomy, Faculty of Medicine, Alexandria University, Alexandria, Egypt.,Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box, 7607, Makkah, Saudi Arabia
| | - Mohamed El-Boshy
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box, 7607, Makkah, Saudi Arabia.,Department of Clinical Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Jawwad Ahmad
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box, 7607, Makkah, Saudi Arabia
| | - Shakir Idris
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box, 7607, Makkah, Saudi Arabia
| | - Bassem Refaat
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box, 7607, Makkah, Saudi Arabia.
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Claus Henn B, Austin C, Coull BA, Schnaas L, Gennings C, Horton MK, Hernández-Ávila M, Hu H, Téllez-Rojo MM, Wright RO, Arora M. Uncovering neurodevelopmental windows of susceptibility to manganese exposure using dentine microspatial analyses. ENVIRONMENTAL RESEARCH 2018; 161:588-598. [PMID: 29247915 PMCID: PMC5965684 DOI: 10.1016/j.envres.2017.12.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/01/2017] [Accepted: 12/03/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Associations between manganese (Mn) and neurodevelopment may depend on dose and exposure timing, but most studies cannot measure exposure variability over time well. OBJECTIVE We apply temporally informative tooth-matrix biomarkers to uncover windows of susceptibility in early life when Mn is associated with visual motor ability in childhood. We also explore effect modification by lead (Pb) and child sex. METHODS Participants were drawn from the ELEMENT (Early Life Exposures in MExico and NeuroToxicology) longitudinal birth cohort studies. We reconstructed dose and timing of prenatal and early postnatal Mn and Pb exposures for 138 children by analyzing deciduous teeth using laser ablation-inductively coupled plasma-mass spectrometry. Neurodevelopment was assessed between 6 and 16 years of age using the Wide Range Assessment of Visual Motor Abilities (WRAVMA). Mn associations with total WRAVMA scores and subscales were estimated with multivariable generalized additive mixed models. We examined Mn interactions with Pb and child sex in stratified models. RESULTS Levels of dentine Mn were highest in the second trimester and declined steeply over the prenatal period, with a slower rate of decline after birth. Mn was positively associated with visual spatial and total WRAVMA scores in the second trimester, among children with lower (< median) tooth Pb levels: one standard deviation (SD) increase in ln-transformed dentine Mn at 150 days before birth was associated with a 0.15 [95% CI: 0.04, 0.26] SD increase in total score. This positive association was not observed at high Pb levels. In contrast to the prenatal period, significant negative associations were found in the postnatal period from ~ 6 to 12 months of age, among boys only: one SD increase in ln-transformed dentine Mn was associated with a 0.11 [95% CI: - 0.001, - 0.22] to 0.16 [95% CI: - 0.04, - 0.28] SD decrease in visual spatial score. CONCLUSIONS Using tooth-matrix biomarkers with fine scale temporal profiles of exposure, we found discrete developmental windows in which Mn was associated with visual-spatial abilities. Our results suggest that Mn associations are driven in large part by exposure timing, with beneficial effects found for prenatal levels and toxic effects found for postnatal levels.
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Affiliation(s)
- Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lourdes Schnaas
- Division of Research on Community Interventions, National Institute of Perinatology, Mexico City, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mauricio Hernández-Ávila
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Howard Hu
- University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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48
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Shaffer RM, Gilbert SG. Reducing occupational lead exposures: Strengthened standards for a healthy workforce. Neurotoxicology 2017; 69:181-186. [PMID: 29128313 DOI: 10.1016/j.neuro.2017.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/16/2022]
Abstract
Outdated federal and state occupational lead standards leave workers and their families vulnerable to the adverse effects of lead. Standards should be updated to reflect the best available scientific and medical evidence, which documents harm to multiple organ systems even at low levels of exposure. This commentary will review the inadequacies of existing policies, highlight susceptible populations, and briefly summarize state revision efforts to date. Federal policies must be strengthened to protect all workers and their families from this well-documented hazard.
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Affiliation(s)
- Rachel M Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington Seattle School of Public Health, 4225 Roosevelt Way NE Suite 100, University of Washington, Seattle, WA, 98105, United States
| | - Steven G Gilbert
- Department of Environmental and Occupational Health Sciences, University of Washington Seattle School of Public Health, 4225 Roosevelt Way NE Suite 100, University of Washington, Seattle, WA, 98105, United States; Institute of Neurotoxicology and Neurological Disorders (INND), 3711 47th Place NE, Seattle, WA, 98105, United States.
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49
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Bashash M, Thomas D, Hu H, Martinez-Mier EA, Sanchez BN, Basu N, Peterson KE, Ettinger AS, Wright R, Zhang Z, Liu Y, Schnaas L, Mercado-García A, Téllez-Rojo MM, Hernández-Avila M. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6-12 Years of Age in Mexico. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:097017. [PMID: 28937959 PMCID: PMC5915186 DOI: 10.1289/ehp655] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants. OBJECTIVE Our aim was to estimate the association of prenatal exposure to fluoride with offspring neurocognitive development. METHODS We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6-12 y old, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children's Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6-12. RESULTS We had complete data on 299 mother-child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models we found that an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI: -5.42, -0.87) and 2.50 (95% CI -4.12, -0.59) lower offspring GCI and IQ scores, respectively. CONCLUSIONS In this study, higher prenatal fluoride exposure, in the general range of exposures reported for other general population samples of pregnant women and nonpregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6-12 y. https://doi.org/10.1289/EHP655.
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Affiliation(s)
- Morteza Bashash
- Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
| | - Deena Thomas
- University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
| | - E Angeles Martinez-Mier
- Indiana University School of Dentistry, Indiana University-Purdue University Indianapolis , Indianapolis, Indiana, USA
| | - Brisa N Sanchez
- University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University , Montreal, Quebec, Canada
| | - Karen E Peterson
- University of Michigan School of Public Health , Ann Arbor, Michigan, USA
- Center for Human Growth and Development, University of Michigan , Ann Arbor, Michigan, USA
- Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
| | | | - Robert Wright
- Icahn School of Medicine at Mount Sinai , New York, New York, USA
| | - Zhenzhen Zhang
- University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - Yun Liu
- University of Michigan School of Public Health , Ann Arbor, Michigan, USA
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50
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Yang TC, Peterson KE, Meeker JD, Sánchez BN, Zhang Z, Cantoral A, Solano M, Tellez-Rojo MM. Bisphenol A and phthalates in utero and in childhood: association with child BMI z-score and adiposity. ENVIRONMENTAL RESEARCH 2017; 156:326-333. [PMID: 28390300 PMCID: PMC5482500 DOI: 10.1016/j.envres.2017.03.038] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To assess the relationship between in utero and concurrent child urinary exposures to bisphenol A (BPA) and phthalates with BMI z-score, waist circumference, and sum of triceps and subscapular skinfold thickness in Mexican children. METHODS Among participants (N=249) from the Early Life Exposure in Mexico to ENvironmental Toxicants study, we evaluated associations between maternal third trimester and concurrent urinary BPA and individual and summed phthalates metabolites (∑Di(2-ethylhexyl phthalate), ∑high molecular weight, ∑low molecular weight) with measures of weight status and adiposity in children aged 8-14 years. Linear regressions with specific-gravity corrected and natural log-transformed urinary concentrations were estimated, adjusting for covariates. Effect modification by sex was explored. RESULTS Prenatal urinary exposure to monobenzyl phthalate (MBzP) was inversely associated with child's BMI z-score (β=-0.21, 95%CI: -0.41, -0.02) and child urinary exposure to mono(2-ethylhexyl)phthalate (MEHP) was inversely associated with waist circumference (β=-1.85, 95%CI: -3.36, -0.35) and sum of skinfold thicknesses (β=-2.08, 95%CI: -3.80, -0.37) after adjusting for confounders. In the childhood exposure period, sex modified the relationships with BPA, MEHP, MBzP, monoethyl phthalate (MEP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP). In girls, increased BPA exposure was positively associated with sum of skinfold thickness (β=3.47, 95%CI: 0.05, 6.40) while increased MEHP was inversely associated with sum of skinfold thicknesses in boys (β=-2.95, 95%CI: -5.08, -0.82); these results remained in sensitivity analyses after excluding children who had initiated pubertal development (Tanner stage >1 for pubic hair). We did not observe relationships between summed phthalates metabolites at any exposure period with outcome measures. CONCLUSION Our results identified associations between urinary BPA and phthalates metabolites with measures of weight status and adiposity that differed by timing of exposure, sex, and pubertal status. Additional studies are needed to explore how associations may differ between those who are pre- and post-pubertal.
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Affiliation(s)
- Tiffany C Yang
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Department of Health Sciences, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Center for Human Growth and Development, University of Michigan, 300 North Ingalls St., Ann Arbor, MI 48109, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Zhenzhen Zhang
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Alejandra Cantoral
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Maritsa Solano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Martha M Tellez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
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