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Mellon N, Robbins B, van Bruggen R, Zhang Y. A systematic review and meta-analysis of the preclinical and clinical results of low-field magnetic stimulation in cognitive disorders. Rev Neurosci 2024; 35:619-625. [PMID: 38671560 PMCID: PMC11297417 DOI: 10.1515/revneuro-2024-0023] [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: 02/01/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
Cognitive disorders such as major depressive disorder and bipolar disorder severely compromise brain function and neuronal activity. Treatments to restore cognitive abilities can have severe side effects due to their intense and excitatory nature, in addition to the fact that they are expensive and invasive. Low-field magnetic stimulation (LFMS) is a novel non-invasive proposed treatment for cognitive disorders. It repairs issues in the brain by altering deep cortical areas with treatments of low-intensity magnetic stimulation. This paper aims to summarize the current literature on the effects and results of LFMS in cognitive disorders. We developed a search strategy to identify relevant studies utilizing LFMS and systematically searched eight scientific databases. Our review suggests that LFMS could be a viable and effective treatment for multiple cognitive disorders, especially major depressive disorder. Additionally, longer, more frequent, and more personalized LFMS treatments tend to be more efficacious.
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Affiliation(s)
- Nicholas Mellon
- Faculty of Medicine and Dentistry, The University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Brett Robbins
- Faculty of Medicine and Dentistry, The University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Rebekah van Bruggen
- Faculty of Medicine and Dentistry, The University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Yanbo Zhang
- Faculty of Medicine and Dentistry, The University of Alberta, Edmonton, AB, T6G 2E1, Canada
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2
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Rafiee A, Faridi S, Sly PD, Stone L, Kennedy LP, Mahabee-Gittens EM. Asthma and decreased lung function in children exposed to perfluoroalkyl and polyfluoroalkyl substances (PFAS): An updated meta-analysis unveiling research gaps. ENVIRONMENTAL RESEARCH 2024; 262:119827. [PMID: 39182754 DOI: 10.1016/j.envres.2024.119827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND AND OBJECTIVE Associations between exposure to per- and polyfluoroalkyl substances (PFAS) and pediatric asthma and reduced lung function in children are mixed and inconclusive. The study objective was to examine the extant research on exposure to PFAS and the diagnosis of asthma or decreased lung function in children <17 years of age to highlight what is known and to identify research gaps for future investigations. METHODS The present review was registered on the PROSPER database (CRD42023407172). We systematically searched several bibliographic databases (Scopus, Embase, Web of Science (core Collection), Medline, and CINAHL) along with grey literature sources in January 2023 to find relevant studies before this date. The National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) tool was applied to assess the risk of bias (RoB) assessment. We used a random-effects meta-analysis to assess the associations. From 12 observational epidemiological studies (out of 513) explored for qualitative analyses, 4 studies were included in quantitative analyses. RESULTS The meta-analysis revealed a significant association between exposures to perfluorooctanoate (PFOA) with the prevalence of children's asthma [Odds Ratios (OR) = 1.162 (95% CI: 1.004-1.321)] whereas the association for perfluorooctane sulfonate (PFOS) was not statistically significant [OR = 1.03 (95%CI: 0.806-1.265]. The narrative synthesis results of the four included studies that examined the effects of PFAS exposure on lung function did not demonstrate significant associations between exposure to PFAS and decreased lung function. The RoB for most included studies was assessed as probably low without serious limitations. However, two studies were at high risk of biases. CONCLUSION Our findings suggest that children who are exposed to PFOA are at a higher risk of developing asthma as well as the association between exposure to PFOS with impaired lung function. Large longitudinal studies with homogeneous PFAS exposures and standardized outcome measures are needed to ascertain these outcomes with improved certainty as well as toxicological studies to investigate the underlying mechanisms.
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Affiliation(s)
- Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sasan Faridi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lynsey P Kennedy
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Symeonides C, Aromataris E, Mulders Y, Dizon J, Stern C, Barker TH, Whitehorn A, Pollock D, Marin T, Dunlop S. An Umbrella Review of Meta-Analyses Evaluating Associations between Human Health and Exposure to Major Classes of Plastic-Associated Chemicals. Ann Glob Health 2024; 90:52. [PMID: 39183960 PMCID: PMC11342836 DOI: 10.5334/aogh.4459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024] Open
Abstract
Background: Epidemiological research investigating the impact of exposure to plastics, and plastic-associated chemicals, on human health is critical, especially given exponentially increasing plastic production. In parallel with increasing production, academic research has also increased exponentially both in terms of the primary literature and ensuing systematic reviews with meta-analysis. However, there are few overviews that capture a broad range of chemical classes to present a state of play regarding impacts on human health. Methods: We undertook an umbrella review to review the systematic reviews with meta-analyses. Given the complex composition of plastic and the large number of identified plastic-associated chemicals, it was not possible to capture all chemicals that may be present in, and migrate from, plastic materials. We therefore focussed on a defined set of key exposures related to plastics. These were microplastics, due to their ubiquity and potential for human exposure, and the polymers that form the matrix of consumer plastics. We also included plasticisers and flame retardants as the two classes of functional additive with the highest concentration ranges in plastic. In addition, we included bisphenols and per- and polyfluoroalkyl substances (PFAS) as two other major plastic-associated chemicals with significant known exposure through food contact materials. Epistemonikos and PubMed were searched for systematic reviews with meta-analyses, meta-analyses, and pooled analyses evaluating the association of plastic polymers, particles (microplastics) or any of the selected groups of high-volume plastic-associated chemicals above, measured directly in human biospecimens, with human health outcomes. Results: Fifty-two systematic reviews were included, with data contributing 759 meta-analyses. Most meta-analyses (78%) were from reviews of moderate methodological quality. Across all the publications retrieved, only a limited number of plastic-associated chemicals within each of the groups searched had been evaluated in relevant meta-analyses, and there were no meta-analyses evaluating polymers, nor microplastics. Synthesised estimates of the effects of plastic-associated chemical exposure were identified for the following health outcome categories in humans: birth, child and adult reproductive, endocrine, child neurodevelopment, nutritional, circulatory, respiratory, skin-related and cancers. Bisphenol A (BPA) is associated with decreased anoclitoral distance in infants, type 2 diabetes (T2D) in adults, insulin resistance in children and adults, polycystic ovary syndrome, obesity and hypertension in children and adults and cardiovascular disease (CVD); other bisphenols have not been evaluated. Phthalates, the only plasticisers identified, are associated with spontaneous pregnancy loss, decreased anogenital distance in boys, insulin resistance in children and adults, with additional associations between certain phthalates and decreased birth weight, T2D in adults, precocious puberty in girls, reduced sperm quality, endometriosis, adverse cognitive development and intelligence quotient (IQ) loss, adverse fine motor and psychomotor development and elevated blood pressure in children and asthma in children and adults. Polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) but not other flame retardants, and some PFAS were identified and are all associated with decreased birth weight. In general populations, PCBs are associated with T2D in adults and endometriosis, bronchitis in infants, CVD, non-Hodgkin's lymphoma (NHL) and breast cancer. In PCB-poisoned populations, exposure is associated with overall mortality, mortality from hepatic disease (men), CVD (men and women) and several cancers. PBDEs are adversely associated with children's cognitive development and IQ loss. PBDEs and certain PFAS are associated with changes in thyroid function. PFAS exposure is associated with increased body mass index (BMI) and overweight in children, attention deficit hyperactive disorder (ADHD) in girls and allergic rhinitis. Potential protective associations were found, namely abnormal pubertal timing in boys being less common with higher phthalate exposure, increased high-density lipoprotein (HDL) with exposure to mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and reduced incidence of chronic lymphocytic lymphoma (a subtype of NHL) with PCB exposure. Conclusions: Exposure to plastic-associated chemicals is associated with adverse outcomes across a wide range of human health domains, and every plastic-associated chemical group is associated with at least one adverse health outcome. Large gaps remain for many plastic-associated chemicals. Recommendations: For research, we recommend that efforts are harmonised globally to pool resources and extend beyond the chemicals included in this umbrella review. Priorities for primary research, with ensuing systematic reviews, could include micro- and nanoplastics as well as emerging plastic-associated chemicals of concern such as bisphenol analogues and replacement plasticisers and flame retardants. With respect to chemical regulation, we propose that safety for plastic-associated chemicals in humans cannot be assumed at market entry. We therefore recommend that improved independent, systematic hazard testing for all plastic-associated chemicals is undertaken before market release of products. In addition because of the limitations of laboratory-based testing for predicting harm from plastic in humans, independent and systematic post-market bio-monitoring and epidemiological studies are essential to detect potential unforeseen harms.
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Affiliation(s)
- Christos Symeonides
- Minderoo Foundation, Perth, Western Australia, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Janine Dizon
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Cindy Stern
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Timothy Hugh Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ashley Whitehorn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tania Marin
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sarah Dunlop
- Minderoo Foundation, Perth, Western Australia, Australia
- School of Biological Sciences, The University of Western Australia, Perth, Australia
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Chang CJ, Ish JL, Chang VC, Daniel M, Jones RR, White AJ. Exposure to per- and polyfluoroalkyl substances and breast cancer risk: a systematic review and meta-analysis of epidemiologic studies. Am J Epidemiol 2024; 193:1182-1196. [PMID: 38400646 PMCID: PMC11299034 DOI: 10.1093/aje/kwae010] [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: 06/28/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
We synthesized the epidemiologic evidence on the associations between per- and polyfluoroalkyl substances (PFAS) exposure and breast cancer risk. Our systematic review and meta-analysis included 18 and 11 articles, respectively, covering studies up to February 2023. The summary relative risks (RRs) estimated by random-effects meta-analyses did not support an association between PFAS and overall breast cancer risk (eg, a natural log (ln)-unit increase in serum/plasma concentrations [ng/mL] for perfluorooctanoate [PFOA] RR = 0.95; 95% CI, 0.77-1.18; perfluorooctane sulfonate [PFOS] RR = 0.98; 95% CI, 0.87-1.11). However, when limiting to studies that assessed exposures prior to a breast cancer diagnosis, we observed a positive association with PFOA (a ln-unit increase, RR = 1.16; 95% CI, 0.96-1.40). We also observed some possible heterogeneous associations by tumor estrogen and progesterone receptor status among postmenopausal breast cancer cases. No meaningful changes were observed after excluding the studies with high risk of bias (Tier 3). Based on the evaluation tool developed by the National Toxicology Program, given the heterogeneity across studies and the variability in timing of exposure measurements, the epidemiologic evidence needed to determine the association between PFAS exposure and breast cancer remains inadequate. Our findings support the need for future studies with improved study designs to determine this association.
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Affiliation(s)
- Che-Jung Chang
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, United States
| | - Jennifer L Ish
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, United States
| | - Vicky C Chang
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, United States
| | - Meklit Daniel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, United States
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, United States
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, United States
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Johnson EE, Kenny RPW, Adesanya AM, Richmond C, Beyer F, Calderon C, Rankin J, Pearce MS, Toledano M, Craig D, Pearson F. The effects of radiofrequency exposure on adverse female reproductive outcomes: A systematic review of human observational studies with dose-response meta-analysis. ENVIRONMENT INTERNATIONAL 2024; 190:108816. [PMID: 38880062 DOI: 10.1016/j.envint.2024.108816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 05/24/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND To inform radiofrequency electromagnetic field (RF-EMF) exposure guidelines the World Health Organization (WHO) is bringing together evidence on RF-EMF in relation to health outcomes prioritised for evaluation by experts in this field. Given this, a network of topic experts and methodologists have conducted a series of systematic reviews collecting, assessing, and synthesising data of relevance to these guidelines. Here we present a systematic review of the effect of RF-EMF exposure on adverse pregnancy outcomes in human observational studies which follows the WHO handbook for guideline development and the COSTER conduct guidelines. METHODS We conducted a broad, sensitive search for potentially relevant records within the following bibliographic databases: MEDLINE; Embase; and the EMF Portal. Grey literature searches were also conducted through relevant databases (including OpenGrey), organisational websites and via consultation of RF-EMF experts. We included quantitative human observational studies on the effect of RF-EMF exposure in adults' preconception or pregnant women on pre-term birth, small for gestational age (SGA; associated with intrauterine growth restriction), miscarriage, stillbirth, low birth weight (LBW) and congenital anomalies. In blinded duplicate, titles and abstracts then full texts were screened against eligibility criteria. A third reviewer gave input when consensus was not reached. Citation chaining of included studies was completed. Two reviewers' data extracted and assessed included studies for risk of bias using the Office of Health Assessment and Translation (OHAT) tool. Random effects meta-analyses of the highest versus the lowest exposures and dose-response meta-analysis were conducted as appropriate and plausible. Two reviewers assessed the certainty in each body of evidence using the OHAT GRADE tool. RESULTS We identified 18 studies in this review; eight were general public studies (with the general public as the population of interest) and 10 were occupational studies (with the population of interest specific workers/workforces). General public studies. From pairwise meta-analyses of general public studies, the evidence is very uncertain about the effects of RF-EMF from mobile phone exposure on preterm birth risk (relative risk (RR) 1.14, 95% confidence interval (CI): 0.97-1.34, 95% prediction interval (PI): 0.83-1.57; 4 studies), LBW (RR 1.14, 95% CI: 0.96-1.36, 95% PI: 0.84-1.57; 4 studies) or SGA (RR 1.13, 95% CI: 1.02-1.24, 95% PI: 0.99-1.28; 2 studies) due to very low-certainty evidence. It was not feasible to meta-analyse studies reporting on the effect of RF-EMF from mobile phone exposure on congenital anomalies or miscarriage risk. The reported effects from the studies assessing these outcomes varied and the studies were at some risk of bias. No studies of the general public assessed the impact of RF-EMF exposure on stillbirth. Occupational studies. In occupational studies, based on dose-response meta-analyses, the evidence is very uncertain about the effects of RF-EMF amongst female physiotherapists using shortwave diathermy on miscarriage due to very low-certainty evidence (OR 1.02 95% CI 0.94-1.1; 2 studies). Amongst offspring of female physiotherapists using shortwave diathermy, the evidence is very uncertain about the effects of RF-EMF on the risk of congenital malformations due to very low-certainty evidence (OR 1.4, 95% CI 0.85 to 2.32; 2 studies). From pairwise meta-analyses, the evidence is very uncertain about the effects of RF-EMF on the risk of miscarriage (RR 1.06, 95% CI 0.96 to 1.18; very low-certainty evidence), pre-term births (RR 1.19, 95% CI 0.32 to 4.37; 3 studies; very low-certainty evidence), and low birth weight (RR 2.90, 95% CI: 0.69 to 12.23; 3 studies; very low-certainty evidence). Results for stillbirth and SGA could not be pooled in meta-analyses. The results from the studies reporting these outcomes were inconsistent and the studies were at some risk of bias. DISCUSSION Most of the evidence identified in this review was from general public studies assessing localised RF-EMF exposure from mobile phone use on female reproductive outcomes. In occupational settings, each study was of heterogenous whole-body RF-EMF exposure from radar, short or microwave diathermy, surveillance and welding equipment and its effect on female reproductive outcomes. Overall, the body of evidence is very uncertain about the effect of RF-EMF exposure on female reproductive outcomes. Further prospective studies conducted with greater rigour (particularly improved accuracy of exposure measurement and using appropriate statistical methods) are required to identify any potential effects of RF-EMF exposure on female reproductive outcomes of interest.
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Affiliation(s)
| | - Ryan P W Kenny
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Adenike M Adesanya
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Catherine Richmond
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Fiona Beyer
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | | | - Judith Rankin
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Mark S Pearce
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | | | - Dawn Craig
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Fiona Pearson
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
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Pw Kenny R, Evelynne Johnson E, Adesanya AM, Richmond C, Beyer F, Calderon C, Rankin J, Pearce MS, Toledano M, Craig D, Pearson F. The effects of radiofrequency exposure on male fertility: A systematic review of human observational studies with dose-response meta-analysis. ENVIRONMENT INTERNATIONAL 2024; 190:108817. [PMID: 38880061 DOI: 10.1016/j.envint.2024.108817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 05/24/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND The World Health Organization (WHO) is bringing together evidence on radiofrequency electromagnetic field (RF-EMF) exposure in relation to health outcomes, previously identified as priorities for research and evaluation by experts in the field, to inform exposure guidelines. A suite of systematic reviews have been undertaken by a network of topic experts and methodologists to collect, assess and synthesise data relevant to these guidelines. Following the WHO handbook for guideline development and the COSTER conduct guidelines, we systematically reviewed the evidence on the potential effects of RF-EMF exposure on male fertility in human observational studies. METHODS We conducted a broad and sensitive search for potentially relevant records within the following bibliographic databases: MEDLINE; Embase; Web of Science and EMF Portal. We also conducted searches of grey literature through relevant databases including OpenGrey, and organisational websites and consulted RF-EMF experts. We hand searched reference lists of included study records and for citations of these studies. We included quantitative human observational studies on the effect of RF-EMF exposure in adult male participants on infertility: sperm concentration; sperm morphology; sperm total motility; sperm progressive motility; total sperm count; and time to pregnancy. Titles and abstracts followed by full texts were screened in blinded duplicate against pre-set eligibility criteria with consensus input from a third reviewer as required. Data extraction from included studies was completed by two reviewers, as was risk of bias assessment using the Office of Health Assessment and Translation (OHAT) tool. We conducted a dose-response meta-analysis as possible and appropriate. Certainty of the evidence was assessed by two reviewers using the OHAT GRADE tool with input from a third reviewer as required. RESULTS We identified nine studies in this review; seven were general public studies (with the general public as the population of interest) and two were occupational studies (with specific workers/workforces as the population of interest). General public studies. Duration of phone use: The evidence is very uncertain surrounding the effects of RF-EMF on sperm concentration (10/6 mL) (MD (mean difference) per hour of daily phone use 1.6 106/mL, 95 % CI -1.7 to 4.9; 3 studies), sperm morphology (MD 0.15 percentage points of deviation of normal forms per hour, 95 % CI -0.21 to 0.51; 3 studies), sperm progressive motility (MD -0.46 percentage points per hour, 95 % CI -1.04 to 0.13; 2 studies) and total sperm count (MD per hour -0.44 106/ejaculate, 95 % CI -2.59 to 1.7; 2 studies) due to very low-certainty evidence. Four additional studies reported on the effect of mobile phone use on sperm motility but were unsuitable for pooling; only one of these studies identified a statistically significant effect. All four studies were at risk of exposure characterisation and selection bias; two of confounding, selective reporting and attrition bias; three of outcome assessment bias and one used an inappropriate statistical method. Position of phone: There may be no or little effect of carrying a mobile phone in the front pocket on sperm concentration, total count, morphology, progressive motility or on time to pregnancy. Of three studies reporting on the effect of mobile phone location on sperm total motility and, or, total motile count, one showed a statistically significant effect. All three studies were at risk of exposure characterisation and selection bias; two of confounding, selective reporting and attrition bias; three of outcome assessment bias and one used inappropriate statistical method. RF-EMF Source: One study indicates there may be little or no effect of computer or other electric device use on sperm concentration, total motility or total count. This study is at probably high risk of exposure characterisation bias and outcome assessment bias. Occupational studies. With only two studies of occupational exposure to RF-EMF and heterogeneity in the population and exposure source (technicians exposed to microwaves or seamen exposed to radar equipment), it was not plausible to statistically pool findings. One study was at probably or definitely high risk of bias across all domains, the other across domains for exposure characterisation bias, outcome assessment bias and confounding. DISCUSSION The majority of evidence identified was assessing localised RF-EMF exposure from mobile phone use on male fertility with few studies assessing the impact of phone position. Overall, the evidence identified is very uncertain about the effect of RF-EMF exposure from mobile phones on sperm outcomes. One study assessed the impact of other RF-EMF sources on male fertility amongst the general public and two studies assessed the impact of RF-EMF exposure in occupational cohorts from different sources (radar or microwave) on male fertility. Further prospective studies conducted with greater rigour (in particular, improved accuracy of exposure measurement and appropriate statistical method use) would build the existing evidence base and are required to have greater certainty in any potential effects of RF-EMF on male reproductive outcomes. Prospero Registration: CRD42021265401 (SR3A).
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Affiliation(s)
- Ryan Pw Kenny
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | | | - Adenike M Adesanya
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Catherine Richmond
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Fiona Beyer
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | | | - Judith Rankin
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Mark S Pearce
- Maternal & Child Health Group, Population Health Sciences Institute, Newcastle University, UK.
| | | | - Dawn Craig
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
| | - Fiona Pearson
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, UK.
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Taylor KW, Howdeshell KL, Singh A, Walker VR, Wang A, Boyles AE, Beverly BE, Rooney AA. Comment on "Evidence Synthesis of Observational Studies in Environmental Health: Lessons Learned from a Systematic Review on Traffic-Related Air Pollution". ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:88001. [PMID: 39136588 PMCID: PMC11321289 DOI: 10.1289/ehp15644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024]
Affiliation(s)
- Kyla W. Taylor
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Kembra L. Howdeshell
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Anisha Singh
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Vickie R. Walker
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Amy Wang
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Abee E. Boyles
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Brandiese E.J. Beverly
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Andrew A. Rooney
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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Doerr B, Botham P, Clare G, Gott D, Gowers A, Guercio V, Gunter Kuhnle, Loizou G, Lovell DP, Pearce N, Rushton L, Toledano M, Wallace HM, Boobis AR. A UK framework for the assessment and integration of different scientific evidence streams in chemical risk assessment. Regul Toxicol Pharmacol 2024; 151:105652. [PMID: 38839030 DOI: 10.1016/j.yrtph.2024.105652] [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: 02/19/2024] [Revised: 05/10/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Few methods are available for transparently combining different evidence streams for chemical risk assessment to reach an integrated conclusion on the probability of causation. Hence, the UK Committees on Toxicity (COT) and on Carcinogenicity (COC) have reviewed current practice and developed guidance on how to achieve this in a transparent manner, using graphical visualisation. METHODS/APPROACH All lines of evidence, including toxicological, epidemiological, new approach methodologies, and mode of action should be considered, taking account of their strengths/weaknesses in their relative weighting towards a conclusion on the probability of causation. A qualitative estimate of the probability of causation is plotted for each line of evidence and a combined estimate provided. DISCUSSION/CONCLUSIONS Guidance is provided on integration of multiple lines of evidence for causation, based on current best practice. Qualitative estimates of probability for each line of evidence are plotted graphically. This ensures a deliberative, consensus conclusion on likelihood of causation is reached. It also ensures clear communication of the influence of the different lines of evidence on the overall conclusion on causality. Issues on which advice from the respective Committees is sought varies considerably, hence the guidance is designed to be sufficiently flexible to meet this need.
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Affiliation(s)
- Barbara Doerr
- Chemical Risk Assessment, Food Standards Agency, London, England, UK.
| | - Phil Botham
- Syngenta, Jealott's Hill, Berkshire, England, UK
| | - Gill Clare
- Independent Consultant, Suffolk, England, UK
| | - David Gott
- Chemical Risk Assessment, Food Standards Agency, London, England, UK
| | - Alison Gowers
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Radiation, Chemical and Environmental Hazards, UK Health Security Agency, Chilton, England, UK
| | - Valentina Guercio
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Radiation, Chemical and Environmental Hazards, UK Health Security Agency, Chilton, England, UK
| | - Gunter Kuhnle
- Department of Food and Nutritional Sciences, University of Reading, England, UK
| | - George Loizou
- Health and Safety Executive Science and Research Centre, Buxton, England, UK
| | - David P Lovell
- Population Health Research Institute (PHRI), St George's Medical School, University of London, Cranmer Terrace, Tooting, London, SW17 0RE, UK
| | - Neil Pearce
- London School of Hygiene and Tropical Medicine, England, UK
| | | | - Mireille Toledano
- Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, England, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, England, UK
| | - Heather M Wallace
- School of Medicine, Medical Science and Nutrition, Institute of Medical Sciences, Aberdeen, Scotland, UK
| | - Alan R Boobis
- Faculty of Medicine, Imperial College London, England, UK
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9
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Pan K, Xu J, Xu Y, Wang C, Yu J. The association between endocrine disrupting chemicals and nonalcoholic fatty liver disease: A systematic review and meta-analysis. Pharmacol Res 2024; 205:107251. [PMID: 38862070 DOI: 10.1016/j.phrs.2024.107251] [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: 04/21/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide. Epidemiological studies have reported that exposure of the population to environmental endocrine-disrupting chemicals (EDCs) is associated with NAFLD. However, EDCs are of different types, and there are inconsistencies in the relevant evidence and descriptions, which have not been systematically summarized so far. Therefore, this study aimed to determine the association between population exposure to EDCs and NAFLD. Three databases, including PubMed, Web of science, and Embase were searched, and 27 articles were included in this study. Methodological quality, heterogeneity, and publication bias of the included studies were assessed using the Newcastle-Ottawa scale, I2 statistics, Begg's test, and Egger's test. The estimated effect sizes of the included studies were pooled and evaluated using the random-effects model (I2 > 50 %) and the fixed-effects model ( I2 < 50 %). The pooled-estimate effect sizes showed that population exposure to Phthalates (PAEs) (OR = 1.18, 95 % CI:1.03-1.34), cadmium (Cd) (OR = 1.37, 95 % CI:1.09-1.72), and bisphenol A (OR = 1.43, 95 % CI:1.24-1.65) were positively correlated with the risk of NAFLD. Exposure to mercury (OR =1.46, 95 % CI:1.17-1.84) and Cd increased the risk of "elevated alanine aminotransferase". On the contrary, no significant association was identified between perfluoroalkyl substances (OR =0.99, 95 % CI:0.93-1.06) and NAFLD. However, female exposure to perfluorooctanoic acid (OR =1.82, 95 % CI:1.01-3.26) led to a higher risk of NAFLD than male exposure. In conclusion, this study revealed that EDCs were risk factors for NAFLD. Nonetheless, the sensitivity analysis results of some of the meta-analyses were not stable and demonstrated high heterogeneity. The evidence for these associations is limited, and more large-scale population-based studies are required to confirm these findings.
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Affiliation(s)
- Kai Pan
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China
| | - Jie Xu
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China
| | - Yuzhu Xu
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China
| | - Chengxing Wang
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China
| | - Jie Yu
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China.
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10
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More S, Bampidis V, Benford D, Bragard C, Hernandez‐Jerez A, Bennekou SH, Koutsoumanis K, Lambré C, Machera K, Mennes W, Mullins E, Nielsen SS, Schlatter J, Schrenk D, Turck D, Younes M, Fletcher T, Greiner M, Ntzani E, Pearce N, Vinceti M, Vrijheid M, Georgiadis M, Gervelmeyer A, Halldorsson TI. Scientific Committee guidance on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments. EFSA J 2024; 22:e8866. [PMID: 38974922 PMCID: PMC11224774 DOI: 10.2903/j.efsa.2024.8866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
EFSA requested its Scientific Committee to prepare a guidance document on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments. The guidance document provides an introduction to epidemiological studies and illustrates the typical biases, which may be present in different epidemiological study designs. It then describes key epidemiological concepts relevant for evidence appraisal. This includes brief explanations for measures of association, exposure assessment, statistical inference, systematic error and effect modification. The guidance then describes the concept of external validity and the principles of appraising epidemiological studies. The customisation of the study appraisal process is explained including tailoring of tools for assessing the risk of bias (RoB). Several examples of appraising experimental and observational studies using a RoB tool are annexed to the document to illustrate the application of the approach. The latter part of this guidance focuses on different steps of evidence integration, first within and then across different streams of evidence. With respect to risk characterisation, the guidance considers how evidence from human epidemiological studies can be used in dose-response modelling with several different options being presented. Finally, the guidance addresses the application of uncertainty factors in risk characterisation when using evidence from human epidemiological studies.
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Akhigbe RE, Oyedokun PA, Akhigbe TM, Adenike S, Oladipo AA, Hughes JR. Does pyrethroid exposure lower human semen quality? a systematic review and meta-analysis. FRONTIERS IN TOXICOLOGY 2024; 6:1395010. [PMID: 38919453 PMCID: PMC11196980 DOI: 10.3389/ftox.2024.1395010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/13/2024] [Indexed: 06/27/2024] Open
Abstract
Background: Pyrethroids are natural organic compounds extracted from flowers of pyrethrums and commonly used as domestic and commercial insecticides. Although it is effective in insect and parasitic control, its associated toxicity, including spermotoxicity, remains a challenge globally. Currently, the available reports on the effect of pyrethroids on semen quality are conflicting, hence an evaluation of its detrimental effect is pertinent. This study conducts a detailed systematic review and meta-analysis of the effects of pyrethroids on sperm quality. Materials and methods: The present study was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a pre-defined strategic protocol, an internet search was done using combined text words. The criteria for eligibility were selected based on Population, Exposure, Comparator, Outcome, and Study Designs (PECO) framework, and relevant data were collected. Appraisal was done using The Office of Health Assessment and Translation (OHAT) tool for the evaluation of the Risk of Bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group guidelines for the certainty of evidence. A quantitative meta-analysis was conducted with the Review Manager (RevMan). Results: Only 12 out of the 4, 050 studies screened were eligible for inclusion in this study. The eligible studies were from China (4), Japan (3), Poland (3), and United States (2). All the eligible studies were cross-sectional. A total of 2, 050 male subjects were included in the meta-analysis. Pyrethroid exposure significantly reduced sperm motility. Region-stratified subgroup analyses revealed that pyrethroid significantly reduced sperm motility among men in Poland and United States, and decreased sperm count among men in Japan. Pyrethroid exposure also reduced sperm concentration among men in Poland but increased sperm concentration among men in the United States. Conclusion: Although the study revealed inconsistent evidence on the detrimental effect of pyrethroids on semen quality, the findings showed that pyrethroids have deleterious potentials on sperm motility, count, and concentration. Studies focusing on the assessment of semen quality in pyrethroid-exposed men, especially at specific varying levels of exposure, and employing prospective cohort studies or controlled cross-sectional designs are recommended.
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Affiliation(s)
- Roland Eghoghosoa Akhigbe
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - Precious Adeoye Oyedokun
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - Tunmise Maryanne Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Breeding and Genetics Unit, Department of Agronomy, Osun State University, Osogbo, Nigeria
| | - Suliat Adenike
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - Ayoola Abimbola Oladipo
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
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12
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Benke G, Abramson MJ, Brzozek C, McDonald S, Kelsall H, Sanagou M, Zeleke BM, Kaufman J, Brennan S, Verbeek J, Karipidis K. The effects of radiofrequency exposure on cognition: A systematic review and meta-analysis of human observational studies. ENVIRONMENT INTERNATIONAL 2024; 188:108779. [PMID: 38821015 DOI: 10.1016/j.envint.2024.108779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 05/22/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND We aimed to assess evidence of long-term effects of exposure to radiofrequency (RF) electromagnetic fields (EMF) on indicators of cognition, including domains of learning and memory, executive function, complex attention, language, perceptual motor ability and social cognition, and of an exposure-response relationship between RF-EMF and cognition. METHODS We searched PubMed, Embase, PsycInfo and the EMF-Portal on September 30, 2022 without limiting by date or language of publication. We included cohort or case-control studies that evaluated the effects of RF exposure on cognitive function in one or more of the cognitive domains. Studies were rated for risk of bias using the OHAT tool and synthesised using fixed effects meta-analysis. We assessed the certainty of the evidence using the GRADE approach and considered modification by OHAT for assessing evidence of exposures. RESULTS We included 5 studies that reported analyses of data from 4 cohorts with 4639 participants consisting of 2808 adults and 1831 children across three countries (Australia, Singapore and Switzerland) conducted between 2006 and 2017. The main source of RF-EMF exposure was mobile (cell) phone use measured as calls per week or minutes per day. For mobile phone use in children, two studies (615 participants) that compared an increase in mobile phone use to a decrease or no change were included in meta-analyses. Learning and memory. There was little effect on accuracy (mean difference, MD -0.03; 95% CI -0.07 to 0.02) or response time (MD -0.01; 95% CI -0.04 to 0.02) on the one-back memory task; and accuracy (MD -0.02; 95%CI -0.04 to 0.00) or response time (MD -0.01; 95%CI -0.04 to 0.03) on the one card learning task (low certainty evidence for all outcomes). Executive function. There was little to no effect on the Stroop test for the time ratio ((B-A)/A) response (MD 0.02; 95% CI -0.01 to 0.04, very low certainty) or the time ratio ((D-C)/C) response (MD 0.00; 95% CI -0.06 to 0.05, very low certainty), with both tests measuring susceptibility to interference effects. Complex attention. There was little to no effect on detection task accuracy (MD 0.02; 95% CI -0.04 to 0.08), or response time (MD 0.02;95% CI 0.01 to 0.03), and little to no effect on identification task accuracy (MD 0.00; 95% CI -0.04 to 0.05) or response time (MD 0.00;95% CI -0.01 to 0.02) (low certainty evidence for all outcomes). No other cognitive domains were investigated in children. A single study among elderly people provided very low certainty evidence that more frequent mobile phone use may have little to no effect on the odds of a decline in global cognitive function (odds ratio, OR 0.81; 95% CI 0.42 to 1.58, 649 participants) or a decline in executive function (OR 1.07; 95% CI 0.37 to 3.05, 146 participants), and may lead to a small, probably unimportant, reduction in the odds of a decline in complex attention (OR 0.67;95%CI 0.27 to 1.68, 159 participants) and a decline in learning and memory (OR 0.75; 95% CI 0.29 to 1.99, 159 participants). An exposure-response relationship was not identified for any of the cognitive outcomes. DISCUSSION This systematic review and meta-analysis found only a few studies that provided very low to low certainty evidence of little to no association between RF-EMF exposure and learning and memory, executive function and complex attention. None of the studies among children reported on global cognitive function or other domains of cognition. Only one study reported a lack of an effect for all domains in elderly persons but this was of very low certainty evidence. Further studies are needed to address all types of populations, exposures and cognitive outcomes, particularly studies investigating environmental and occupational exposure in adults. Future studies also need to address uncertainties in the assessment of exposure and standardise testing of specific domains of cognitive function to enable synthesis across studies and increase the certainty of the evidence. OTHER This review was partially funded by the WHO radioprotection programme and prospectively registered on PROSPERO CRD42021257548.
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Affiliation(s)
- Geza Benke
- Monash University, Melbourne, Australia.
| | | | | | | | | | | | | | | | | | - Jos Verbeek
- University Medical Centers Amsterdam, Amsterdam, the Netherlands.
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13
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Patwary MM, Sakhvidi MJZ, Ashraf S, Dadvand P, Browning MHEM, Alam MA, Bell ML, James P, Astell-Burt T. Impact of green space and built environment on metabolic syndrome: A systematic review with meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:170977. [PMID: 38360326 DOI: 10.1016/j.scitotenv.2024.170977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through August 30, 2023, examining the association of green space and built environment with metabolic syndrome. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 18 studies that met the inclusion criteria and were included in our review. Most were from China (n = 5) and the USA (n = 5), and most used a cross-sectional study design (n = 8). Nine studies (50 %) reported only green space exposures, seven (39 %) reported only built environment exposures, and two (11 %) reported both built environment and green space exposures. Studies reported diverse definitions of green space and the built environment, such as availability, accessibility, and quality, particularly around participants' homes. The outcomes focused on metabolic syndrome; however, studies applied different definitions of metabolic syndrome. Meta-analysis results showed that an increase in normalized difference vegetation index (NDVI) within a 500-m buffer was associated with a lower risk of metabolic syndrome (odds ratio [OR] = 0.90, 95%CI = 0.87-0.93, I2 = 22.3 %, n = 4). A substantial number of studies detected bias for exposure classification and residual confounding. Overall, the extant literature shows a 'limited' strength of evidence for green space protecting against metabolic syndrome and an 'inadequate' strength of evidence for the built environment associated with metabolic syndrome. Studies with more robust study designs, better controlled confounding factors, and stronger exposure measures are needed to understand better what types of green spaces and built environment features influence metabolic syndrome.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Michelle L Bell
- Yale School of the Environment, Yale University, New Haven, CT, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
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14
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Bosch-Capblanch X, Esu E, Oringanje CM, Dongus S, Jalilian H, Eyers J, Auer C, Meremikwu M, Röösli M. The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A systematic review of human experimental studies. ENVIRONMENT INTERNATIONAL 2024; 187:108612. [PMID: 38640611 DOI: 10.1016/j.envint.2024.108612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the population. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF. OBJECTIVES To systematically assess the effects of exposure to RF-EMF on self-reported non-specific symptoms in human subjects and to assess the accuracy of perceptions of presence or absence of RF-EMF exposure. METHODS Eligibility criteria: experimental studies carried out in the general population and in individuals with idiopathic environmental intolerance attributed to EMF (IEI-EMF), in any language. INFORMATION SOURCES Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos, Embase and EMF portal, searched till April 2022. Risk of Bias (ROB): we used the RoB tool developed by OHAT adapted to the topic of this review. SYNTHESIS OF RESULTS we synthesized studies using random effects meta-analysis and sensitivity analyses, where appropriate. RESULTS Included studies: 41 studies were included, mostly cross over trials and from Europe, with a total of 2,874 participants. SYNTHESIS OF RESULTS considering the primary outcomes, we carried out meta-analyses of 10 exposure-outcomes pairs. All evidence suggested no or small non-significant effects of exposure on symptoms with high (three comparisons), moderate (four comparisons), low (one comparison) and very low (two comparisons) certainty of evidence. The effects (standard mean difference, where positive values indicate presence of symptom being exposed) in the general population for head exposure were (95% confidence intervals) 0.08 (-0.07 to 0.22) for headache, -0.01 (-0.22 to 0.20) for sleeping disturbances and 0.13 (-0.51 to 0.76) for composite symptoms; and for whole-body exposure: 0.09 (-0.35 to 0.54), 0.00 (-0.15 to 0.15) for sleeping disturbances and -0.05 (-0.17 to 0.07) for composite symptoms. For IEI-EMF individuals SMD ranged from -0.19 to 0.11, all of them with confidence intervals crossing the value of zero. Further, the available evidence suggested that study volunteers could not perceive the EMF exposure status better than what is expected by chance and that IEI-EMF individuals could not determine EMF conditions better than the general population. DISCUSSION Limitations of evidence: experimental conditions are substantially different from real-life situations in the duration, frequency, distance and position of the exposure. Most studies were conducted in young, healthy volunteers, who might be more resilient to RF-EMF than the general population. The outcomes of interest in this systematic review were symptoms, which are self-reported. The available information did not allow to assess the potential effects of exposures beyond acute exposure and in elderly or in chronically ill people. It cannot be ruled out that a real EMF effect in IEI-EMF groups is masked by a mix with insensitive subjects. However, studies on symptoms reporting and/or field perceptions did not find any evidence that there were particularly vulnerable individuals in the IEI-EMF group, although in open provocation studies, when volunteers were informed about the presence or absence of EMF exposure, such differences were consistently observed. INTERPRETATION available evidence suggests that acute RF-EMF below regulatory limits does not cause symptoms and corresponding claims in the everyday life are related to perceived and not to real EMF exposure status.
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Affiliation(s)
- Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Ekpereonne Esu
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Chioma Moses Oringanje
- Department of Biology, College of Art & Sciences, Xavier University, Cincinnati, OH 45247, USA.
| | - Stefan Dongus
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Hamed Jalilian
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - John Eyers
- Independent Consultant & Senior Research Fellow, 3ie, c/o LIDC, 20 Bloomsbury Square, London WC1A 2NS, United Kingdom.
| | - Christian Auer
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Martin Meremikwu
- Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
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15
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Qiao JC, Sun LJ, Zhang MY, Gui SY, Wang XC, Hu CY. Association between ambient particulate matter exposure and mitochondrial DNA copy number: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171423. [PMID: 38442762 DOI: 10.1016/j.scitotenv.2024.171423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Ambient particulate matter (PM) has been recognized as inducing oxidative stress, which could contribute to mitochondrial damage and dysfunction. However, studies investigating the association between ambient PM and mitochondria, particularly mitochondrial DNA copy number (mtDNA-CN), have yielded inconsistent results. METHODS We conducted comprehensive literature searches to identify observational studies published before July 17, 2023, examining the association between ambient PM exposure and mtDNA-CN. Meta-analysis using random effects model was employed to calculate the pooled effect estimates for general individual exposures, as well as for prenatal exposure with specific trimester. Additionally, the quality and level of evidence for each exposure-outcome pair was evaluated. RESULTS A total of 10 studies were included in the systematic review and meta-analysis. The results indicated that general individual exposure to PM2.5 (β = -0.084, 95 % CI: -0.521, 0.353; I2 = 93 %) and PM10 (β = 0.035, 95 % CI: -0.129, 0.199; I2 = 95 %) did not significantly affect mtDNA-CN. Prenatal exposure to PM2.5 (β = 0.023, 95 % CI: -0.087, 0.133; I2 = 0 %) and PM10 (β = 0.006, 95 % CI: -0.135; 0.147; I2 = 51 %) were also not significantly associated with mtDNA-CN in offspring. The level of evidence for each tested exposure-outcome pair was assessed as "inadequate." CONCLUSIONS The findings of this systematic review and meta-analysis indicate that there is an "inadequate" strength of evidence for the association between general individual or prenatal exposure to ambient PM and mtDNA-CN. Future research necessitates studies with more rigorous design, enhanced control of confounding factors, and improved measures of exposure to substantiate our findings.
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Affiliation(s)
- Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Liang-Jie Sun
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Meng-Yue Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
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16
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Bline AP, Ellis LB, Pelch KE, Lam J, Sen S, Zlatnik M, Varshavsky J. The effect of per and polyfluoroalkyl substance (PFAS) exposure on gestational diabetes mellitus and its subclinical risk factors: A systematic review and meta-analysis protocol. ENVIRONMENT INTERNATIONAL 2024; 188:108711. [PMID: 38754246 DOI: 10.1016/j.envint.2024.108711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/30/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Multiple lines of evidence suggest that exposure to per- and polyfluoroalkyl substances (PFAS) may alter glucose homeostasis, particularly during pregnancy, and may affect risk for developing gestational diabetes mellitus (GDM). While previous systematic reviews have been conducted on this topic, they did not assess internal validity of the included studies and their search strategies were narrowly focused. OBJECTIVE The objective of this study is to assess the effect of higher PFAS exposure (defined by individual compounds or mixtures measured before or during pregnancy) on GDM and subclinical measures of impaired glucose homeostasis (measured during pregnancy) compared to lower PFAS exposure in pregnant. METHODS We developed our systematic review protocol in accordance with the Navigation Guide. Peer-reviewed journal and grey literature searches were piloted in to identify relevant studies and refine our search terms and strategy. We also piloted the study screening criteria and data extraction form in DistillerSR, and refined our protocol accordingly. The risk of bias assessment protocol was adapted from Navigation Guide guidance and will be piloted and performed in DistillerSR. Pending the identification of comparable studies, quantitative meta-analyses will be performed where possible. Study results that cannot be quantitatively synthesized will be included in a narrative synthesis. The quality and strength of the body of evidence will be evaluated using Navigation Guide methodology, which is informed by guidance from the Cochrane Collaboration and Grading of Recommendations Assessment, Development and Evaluation (GRADE). We also made refinements to the quality of evidence considerations based on guidance from the National Institute of Environmental Health Sciences (NIEHS) Office of Health Assessment and Translation (OHAT). FUNDING This work was supported by the Systematizing Data on Per- and Polyfluoroalkyl Substances and Health Northeastern University TIER 1 Award.
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Affiliation(s)
- Abigail P Bline
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Silent Spring Institute, Newton, MA, United States.
| | - Lauren B Ellis
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Department of Health Sciences, Northeastern University, Boston, MA, United States.
| | - Katherine E Pelch
- Natural Resources Defense Council, San Francisco, CA, United States.
| | - Juleen Lam
- Department of Public Health, California State University, East Bay, Hayward, CA, United States.
| | - Saunak Sen
- College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
| | - Marya Zlatnik
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States.
| | - Julia Varshavsky
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Department of Health Sciences, Northeastern University, Boston, MA, United States; Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States.
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17
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Mourino N, Varela-Lema L, Ruano-Ravina A, Peiteado C, Candal-Pedreira C, Rey-Brandariz J, Torres-Cadavid E, García G, Pérez-Ríos M. Occupational exposure to endotoxins and small cell lung cancer: a systematic review with meta-analysis. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2024; 27:91-105. [PMID: 38369511 DOI: 10.1080/10937404.2024.2316151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
The relationship of occupational exposure to endotoxins with different histologic subtypes of lung cancer has not been established. Our objective was to conduct a systematic review with meta-analysis to assess the effect of exposure to endotoxins on the development of small cell lung cancer (SCLC). A bibliographic search was conducted using MEDLINE, Embase, CENTRAL, and Web of Science databases until December 2022, including all cohort and/or case-control studies that examined occupational exposure to endotoxins and SCLC. Risk of bias was assessed using the U.S. Office of Health Assessment and Translation tool. A random effects model was applied, publication bias were assessed, and a sensitivity analysis was conducted. Four papers were selected for meta-analysis purposes. A total of 144 incident cases of SCLC and 897 population or hospital controls were included. Occupational exposure to endotoxins was considered for textile/leather industry and agricultural sector workers exposed to endotoxins originating from wool, cotton, or leather dust. Except for one study, all investigations were classified as having a low probability of risk of biases. The results of the meta-analysis were not statistically significant (pooled OR: 0.86; 95% CI:0.69-1.08). In addition, neither between-study heterogeneity (I2=0%;p=0.92) nor publication bias was observed (p=0.49). The results of the sensitivity analysis, after including five studies that assessed the risk of SCLC among textile industry and crop/livestock farm workers (not specifically exposed to endotoxins), showed a negative statistically non-significant association and low between-study heterogeneity (pooled OR: 0.90; 95% CI:0.79-1.02; I2=22%;p=0.23). Subjects exposed to occupational exposure to endotoxins seem to exhibit a negative association with the development of SCLC, although the results are not conclusive.
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Affiliation(s)
- Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristina Peiteado
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Eliana Torres-Cadavid
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Guadalupe García
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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18
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Shen C, Zhang K, Shi J, Yang J, Wang Y, Li Z, Dai H, Yang W. Association between brominated flame retardants and risk of endocrine-related cancer: A systematic review and meta-analysis. Toxicol Lett 2024; 394:11-22. [PMID: 38387762 DOI: 10.1016/j.toxlet.2024.02.002] [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: 06/14/2023] [Revised: 01/17/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND The incidence of endocrine-related cancer, which includes tumors in major endocrine glands such as the breast, thyroid, pituitary, and prostate, has been increasing year by year. Various studies have indicated that brominated flame retardants (BFRs) are neurotoxic, endocrine-toxic, reproductive-toxic, and even carcinogenic. However, the epidemiological relationship between BFR exposure and endocrine-related cancer risk remains unclear. METHODS We searched the PubMed, Google Scholar, and Web of Science databases for articles evaluating the association between BFR exposure and endocrine-related cancer risk. The odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were used to assess the association. Statistical heterogeneity among studies was assessed with the Q-test and I2 statistics. Begg's test was performed to evaluate the publication bias. RESULTS We collected 15 studies, including 6 nested case-control and 9 case-control studies, with 3468 cases and 4187 controls. These studies assessed the risk of breast cancer, thyroid cancer, and endocrine-related cancers in relation to BFR levels. Our findings indicate a significant association between BFR exposure in adipose tissue and an increased risk of breast cancer. However, this association was not observed for thyroid cancer. Generally, BFR exposure appears to elevate the risk of endocrine-related cancers, with a notable increase in risk linked to higher levels of BDE-28, a specific polybrominated diphenyl ether congener. CONCLUSIONS In conclusion, although this meta-analysis has several limitations, our results suggest that BFR exposure is a significant risk factor for breast cancer, and low-brominated BDE-28 exposure could significantly increase the risk of endocrine-related cancers. Further research is essential to clarify the potential causal relationships between BFRs and endocrine-related cancers, and their carcinogenic mechanisms.
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Affiliation(s)
- Chengchen Shen
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Kui Zhang
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Jingyi Shi
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Jingxuan Yang
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Yu Wang
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Zhuo Li
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Hao Dai
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Wenxing Yang
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
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19
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Michel SKF, Atmakuri A, von Ehrenstein OS. Systems for rating bodies of evidence used in systematic reviews of air pollution exposure and reproductive and children's health: a methodological survey. Environ Health 2024; 23:32. [PMID: 38539160 PMCID: PMC10976715 DOI: 10.1186/s12940-024-01069-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Translating findings from systematic reviews assessing associations between environmental exposures and reproductive and children's health into policy recommendations requires valid and transparent evidence grading. METHODS We aimed to evaluate systems for grading bodies of evidence used in systematic reviews of environmental exposures and reproductive/ children's health outcomes, by conducting a methodological survey of air pollution research, comprising a comprehensive search for and assessment of all relevant systematic reviews. To evaluate the frameworks used for rating the internal validity of primary studies and for grading bodies of evidence (multiple studies), we considered whether and how specific criteria or domains were operationalized to address reproductive/children's environmental health, e.g., whether the timing of exposure assessment was evaluated with regard to vulnerable developmental stages. RESULTS Eighteen out of 177 (9.8%) systematic reviews used formal systems for rating the body of evidence; 15 distinct internal validity assessment tools for primary studies, and nine different grading systems for bodies of evidence were used, with multiple modifications applied to the cited approaches. The Newcastle Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, neither developed specifically for this field, were the most commonly used approaches for rating individual studies and bodies of evidence, respectively. Overall, the identified approaches were highly heterogeneous in both their comprehensiveness and their applicability to reproductive/children's environmental health research. CONCLUSION Establishing the wider use of more appropriate evidence grading methods is instrumental both for strengthening systematic review methodologies, and for the effective development and implementation of environmental public health policies, particularly for protecting pregnant persons and children.
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Affiliation(s)
- Sophie K F Michel
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
| | - Aishwarya Atmakuri
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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20
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Woodruff TJ. Health Effects of Fossil Fuel-Derived Endocrine Disruptors. N Engl J Med 2024; 390:922-933. [PMID: 38446677 DOI: 10.1056/nejmra2300476] [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: 03/08/2024]
Affiliation(s)
- Tracey J Woodruff
- From the Program on Reproductive Health and the Environment, Environmental Research and Translation for Health Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco
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21
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Stacy C, Amélie C, Blanche W, Audrey R, Margaux S, Simon P, Julien J, Matteo R, Andreas K, Christophe R, Martine V, Mark N, Rémy S, Karine A. A plausibility database summarizing the level of evidence regarding the hazards induced by the exposome on children health. Int J Hyg Environ Health 2024; 256:114311. [PMID: 38271818 DOI: 10.1016/j.ijheh.2023.114311] [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: 06/03/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024]
Abstract
Childhood diseases correspond to major public health issues. A large number of studies using different approaches provide evidence regarding effects of environmental exposures, encompassed in the exposome, on children's health. We aimed to summarize the overall level of evidence (LoE) from all streams of evidence regarding exposome effects on child health. For 88 selected chemical and urban factors, we retrieved the conclusions of agency reports or literature reviews published between 2015 and 2021 regarding effects on child health, including cardiovascular, metabolic, neurodevelopmental, respiratory and other health outcomes. Adapted versions of PRISMA flowchart and AMSTAR-2 tool were used to select and assess the quality of the systematic reviews retrieved from PubMed and SCOPUS databases. For each factor-outcome pair, conclusions in three streams of evidence (epidemiological, toxicological and mechanistic, the latter corresponding to in vitro and in silico approaches) were translated into stream-specific LoEs and then combined into an overall LoE ranging from "very unlikely" to "very likely". The 88 environmental factors were implied in 611 factor-outcome pairs. Forty-four pairs (7%), corresponding to 16 factors, had a very likely overall LoE (≥80%); 127 pairs (21%), corresponding to 49 factors, had a likely or more overall LoE (≥60%). For 81 pairs (13%), no evidence was available in agency reports or published reviews, while for 275 pairs (45%), corresponding to 68 factors, the overall LoE was very unlikely (<20%). Exposure factors with the greatest number of associated health outcomes with a high overall LoE were HCB, PCBs, temperature (8 outcomes), PFOA (7 outcomes), PFOS, cotinine (6 outcomes), arsenic, lead (5 outcomes), bisphenols A and S, PFNA and PM2.5 (4 outcomes), DDT, DDE and DDD, PFHxA, PFDA, green space, UV radiation (3 outcomes). We developed an approach to extract and summarize the existing evidence about effects of environmental factors on health. The plausibility database built for children's health can be used to identify research gaps, conduct quantitative risk assessment studies. It could be expanded to consider a larger fraction of the exposome and other age groups and should be updated on a regular basis.
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Affiliation(s)
- Colzin Stacy
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Crépet Amélie
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Methodology and Studies Unit, Maisons-Alfort, France
| | | | - Rocabois Audrey
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Sanchez Margaux
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Air Risk Assessment Unit, Maisons-Alfort, France
| | - Perreau Simon
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Jean Julien
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Food Risk Assessment Unit, Maisons-Alfort, France
| | - Redaelli Matteo
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Air Risk Assessment Unit, Maisons-Alfort, France
| | - Kortenkamp Andreas
- Centre for Pollution Research and Policy, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Rousselle Christophe
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Vrijheid Martine
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nieuwenhuijsen Mark
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Slama Rémy
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.
| | - Angeli Karine
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
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22
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Benchikh I, Ziani K, Gonzalez Mateos A, Khaled BM. Non-acute exposure of neonicotinoids, health risk assessment, and evidence integration: a systematic review. Crit Rev Toxicol 2024; 54:194-213. [PMID: 38470098 DOI: 10.1080/10408444.2024.2310593] [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: 06/15/2023] [Accepted: 01/18/2024] [Indexed: 03/13/2024]
Abstract
Neonicotinoid pesticides are utilized against an extensive range of insects. A growing body of evidence supports that these neuro-active insecticides are classified as toxicants in invertebrates. However, there is limited published data regarding their toxicity in vertebrates and mammals. the current systematic review is focused on the up-to-date knowledge available for several neonicotinoid pesticides and their non-acute toxicity on rodents and human physiology. Oral lethal dose 50 (LD50) of seven neonicotinoids (i.e. imidacloprid, acetamiprid, clothianidin, dinotefuran, thiamethoxam, thiacloprid, and nitenpyram) was initially identified. Subsequently, a screening of the literature was conducted to collect information about non-acute exposure to these insecticides. 99 studies were included and assessed for their risk of bias and level of evidence according to the Office of Health and Translation (OHAT) framework. All the 99 included papers indicate evidence of reproductive toxicity, hepatotoxicity, nephrotoxicity, neurotoxicity, immunotoxicity, and oxidative stress induction with a high level of evidence in the health effect of rodents and a moderate level of evidence for human health. The most studied type of these insecticides among 99 papers was imidacloprid (55 papers), followed by acetamiprid (22 papers), clothianidin (21 papers), and thiacloprid (11 papers). While 10 of 99 papers assessed the relationship between clothianidin, thiamethoxam, dinotefuran, and nitenpyram, showing evidence of liver injury, dysfunctions of oxidative stress markers in the reproductive system, and intestinal toxicity. This systematic review provides a comprehensive overview of the potential risks caused by neonicotinoid insecticides to humans and rodents with salient health effects. However, further research is needed to better emphasize and understand the patho-physiological mechanisms of these insecticides, taking into account various factors that can influence their toxicity.
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Affiliation(s)
- Imen Benchikh
- Laboratory of Applied Hydrology and Environment, Department of Biology, Faculty of Natural Sciences and Life, Belhadj Bouchaib University, Ain Témouchent, Algeria
- Laboratoire de Nutrition, Pathologie, Agro-Biotechnologie et Santé (Lab-NuPABS), Department of Biology, Faculty of Natural Sciences and Life, Djillali Liabès University, Sidi-Bel-Abbès, Algeria
| | - Kaddour Ziani
- Laboratory of Biotoxicology, Pharmacognosy and Biological Valorization of Plants, Department of Biology, University of Saida-Dr. Taher Moulay, Saida, Algeria
| | - Antonio Gonzalez Mateos
- Department of Physiology, Cell Biology and Communication Research Group, University of Extremadura, Caceres, Spain
| | - Boumediène Méghit Khaled
- Laboratoire de Nutrition, Pathologie, Agro-Biotechnologie et Santé (Lab-NuPABS), Department of Biology, Faculty of Natural Sciences and Life, Djillali Liabès University, Sidi-Bel-Abbès, Algeria
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23
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Bui TT, Aasa J, Abass K, Ågerstrand M, Beronius A, Castro M, Escrivá L, Galizia A, Gliga A, Karlsson O, Whaley P, Yost E, Rudén C. Applying a modified systematic review and integrated assessment framework (SYRINA) - a case study on triphenyl phosphate. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024; 26:380-399. [PMID: 38205707 PMCID: PMC10879963 DOI: 10.1039/d3em00353a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
This work presents a case study in applying a systematic review framework (SYRINA) to the identification of chemicals as endocrine disruptors. The suitability and performance of the framework is tested with regard to the widely accepted World Health Organization definition of an endocrine disruptor (ED). The endocrine disrupting potential of triphenyl phosphate (TPP), a well-studied flame retardant reported to exhibit various endocrine related effects was assessed. We followed the 7 steps of the SYRINA framework, articulating the research objective via Populations, Exposures, Comparators, Outcomes (PECO) statements, performed literature search and screening, conducted study evaluation, performed data extraction and summarized and integrated the evidence. Overall, 66 studies, consisting of in vivo, in vitro and epidemiological data, were included. We concluded that triphenyl phosphate could be identified as an ED based on metabolic disruption and reproductive function. We found that the tools used in this case study and the optimizations performed on the framework were suitable to assess properties of EDs. A number of challenges and areas for methodological development in systematic appraisal of evidence relating to endocrine disrupting potential were identified; significant time and effort were needed for the analysis of in vitro mechanistic data in this case study, thus increasing the workload and time needed to perform the systematic review process. Further research and development of this framework with regards to grey literature (non-peer-reviewed literature) search, harmonization of study evaluation methods, more consistent evidence integration approaches and a pre-defined method to assess links between adverse effect and endocrine activity are recommended. It would also be advantageous to conduct more case studies for a chemical with less data than TPP.
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Affiliation(s)
- Thuy T Bui
- Department of Environmental Science, Stockholm University, Sweden.
| | | | - Khaled Abass
- Department of Environmental Health Sciences, College of Health Sciences, University of Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research (SIMR), University of Sharjah, United Arab Emirates
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, University of Oulu, Finland
| | | | | | - Mafalda Castro
- Section for Environmental Chemistry and Physics, University of Copenhagen, Denmark
| | - Laura Escrivá
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, Spain
| | - Audrey Galizia
- United States Environmental Protection Agency, Center for Public Health and Environmental Assessment, USA
| | - Anda Gliga
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Oskar Karlsson
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, Sweden
| | - Paul Whaley
- Lancaster Environment Centre, Lancaster University, UK
| | - Erin Yost
- United States Environmental Protection Agency, Center for Public Health and Environmental Assessment, USA
| | - Christina Rudén
- Department of Environmental Science, Stockholm University, Sweden.
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24
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Stephens J, Moorhouse AJ, Craenen K, Schroeder E, Drenos F, Anderson R. A systematic review of human evidence for the intergenerational effects of exposure to ionizing radiation. Int J Radiat Biol 2024; 100:1330-1363. [PMID: 38335529 DOI: 10.1080/09553002.2024.2306328] [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: 05/05/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To provide a synthesis of the published evidence pertaining to the intergenerational health effects of parental preconceptional exposure to ionizing radiation in humans. METHODS The study populations are the descendants of those who were exposed to ionizing radiation prior to conception. A Boolean search identified publications for review in accordance with Office of Health Assessment and Translation guidelines. Initially, a risk of bias assessment was conducted for each published study and relevant data extracted. Information was organized into adverse health outcome groups and exposure situations. To make an assessment from the body of evidence within each group, an initial confidence rating was assigned, before factors including inconsistencies between studies, magnitude of effect, dose response and confounders were considered. From this, 'an effect', 'no effect' or whether the evidence remained 'inadequate' to determine either effect or no effect, was ascertained. This assessment was based primarily upon the author's conclusions within that evidence-base and, by binomial probability testing of the direction of effect reported. RESULTS 2441 publications were identified for review which after screening was reduced to 127. For the majority of the adverse health groups, we find there to be inadequate evidence from which to determine whether the health effect was, or was not, associated with parental preconceptional radiation exposure. This was largely due to heterogeneity between individual study's findings and conclusions within each group and, the limited number of studies within each group. We did observe one health grouping (congenital abnormalities) in occupationally exposed populations, where an increase in effect relative to their controls or large magnitude of effects, were reported, although it is noted that the authors of these studies interpreted their findings as most likely not to be associated with parental radiation exposure. CONCLUSIONS We find there to be a lack of evidence to enable the formal assessment of radiation-related adverse effects in offspring of exposed humans. This is not the same as there being no clear evidence that effects may occur but does infer that if adverse health effects do arise in children of exposed parents, then these effects are small and difficult to reproducibly measure. Inconsistencies in designing studies are unavoidable, however we highlight the need for an element of standardization and, more sharing of primary datasets as part of open access initiatives, in order for future reviews to make reasonable conclusions. Overall, there is a need for future work to ensure comparable measures between studies where possible.
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Affiliation(s)
- Jade Stephens
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Alexander J Moorhouse
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- School of Cellular and Molecular Medicine, University of Bristol, University Walk, Bristol, UK
- Department of Life Sciences, University of Bath, Bath, UK
| | - Kai Craenen
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Ewald Schroeder
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Fotios Drenos
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Rhona Anderson
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
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25
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Christensen JJ, Arnesen EK, Rundblad A, Telle-Hansen VH, Narverud I, Blomhoff R, Bogsrud MP, Retterstøl K, Ulven SM, Holven KB. Dietary fat quality, plasma atherogenic lipoproteins, and atherosclerotic cardiovascular disease: An overview of the rationale for dietary recommendations for fat intake. Atherosclerosis 2024; 389:117433. [PMID: 38219649 DOI: 10.1016/j.atherosclerosis.2023.117433] [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: 04/24/2023] [Revised: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
The scientific evidence supporting the current dietary recommendations for fat quality keeps accumulating; however, a paradoxical distrust has taken root among many researchers, clinicians, and in parts of the general public. One explanation for this distrust may relate to an incomplete overview of the totality of the evidence for the link between fat quality as a dietary exposure, and health outcomes such as atherosclerotic cardiovascular disease (ASCVD). Therefore, the main aim of the present narrative review was to provide a comprehensive overview of the rationale for dietary recommendations for fat intake, limiting our discussion to ASCVD as outcome. Herein, we provide a core framework - a causal model - that can help us understand the evidence that has accumulated to date, and that can help us understand new evidence that may become available in the future. The causal model for fat quality and ASCVD is comprised of three key research questions (RQs), each of which determine which scientific methods are most appropriate to use, and thereby which lines of evidence that should feed into the causal model. First, we discuss the link between low-density lipoprotein (LDL) particles and ASCVD (RQ1); we draw especially on evidence from genetic studies, randomized controlled trials (RCTs), epidemiology, and mechanistic studies. Second, we explain the link between dietary fat quality and LDL particles (RQ2); we draw especially on metabolic ward studies, controlled trials (randomized and non-randomized), and mechanistic studies. Third, we explain the link between dietary fat quality, LDL particles, and ASCVD (RQ3); we draw especially on RCTs in animals and humans, epidemiology, population-based changes, and experiments of nature. Additionally, the distrust over dietary recommendations for fat quality may partly relate to an unclear understanding of the scientific method, especially as applied in nutrition research, including the process of developing dietary guidelines. We therefore also aimed to clarify this process. We discuss how we assess causality in nutrition research, and how we progress from scientific evidence to providing dietary recommendations.
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Affiliation(s)
- Jacob J Christensen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Amanda Rundblad
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Ingunn Narverud
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Martin P Bogsrud
- Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Stine M Ulven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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Sprague NL, Uong SP, Zonnevylle H, Chatterjee T, Hernández D, Rundle AG, Ekenga CC. The CHANGE (Climate Health ANalysis Grading Evaluation) tool for weight of evidence reviews on climate change and health research. Environ Health 2024; 23:7. [PMID: 38243236 PMCID: PMC10797793 DOI: 10.1186/s12940-023-01040-4] [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: 08/03/2023] [Accepted: 12/12/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Climate change has been identified as one of the biggest threats to human health. Despite this claim, there are no standardized tools that assess the rigor of published literature for use in weight of evidence (WOE) reviews. Standardized assessment tools are essential for creating clear and comparable WOE reviews. As such, we developed a standardized tool for evaluating the quality of climate change and health studies focused on evaluating studies that quantify exposure-response relationships and studies that implement and/or evaluate adaptation interventions. METHODS The authors explored systematic-review methodology to enhance transparency and increase efficiency in summarizing and synthesizing findings from studies on climate change and health research. The authors adapted and extended existing WOE methods to develop the CHANGE (Climate Health ANalysis Grading Evaluation) tool. The resulting assessment tool has been refined through application and subsequent team input. RESULTS The CHANGE tool is a two-step standardized tool for systematic review of climate change and health studies of exposure-response relationships and adaptation intervention studies. Step one of the CHANGE tool aims to classify studies included in weight-of-evidence reviews and step two assesses the quality and presence of bias in the climate change and health studies. CONCLUSION The application of the CHANGE tool in WOE reviews of climate change and health will lead to increased comparability, objectivity, and transparency within this research area.
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Affiliation(s)
- Nadav L Sprague
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Stephen P Uong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Hannah Zonnevylle
- Soil and Crop Sciences, School of Integrative Plant Science, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Trinish Chatterjee
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA
| | - Diana Hernández
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Christine C Ekenga
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Li L, Guo Y, Ma S, Wen H, Li Y, Qiao J. Association between exposure to per- and perfluoroalkyl substances (PFAS) and reproductive hormones in human: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 241:117553. [PMID: 37931739 DOI: 10.1016/j.envres.2023.117553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) is persistent endocrine disrupting chemicals. Previous evidence suggests that exposure to PFAS is associated with reproductive hormone levels, but the results of relevant studies are inconsistent. The objective of our study is to determine the association between exposure to PFAS and reproductive hormone levels in gender-specific general population. METHOD Based on scientific search strategies, we systematically searched PubMed, Web of Science, Embase, Medline, and Scopus to obtain the eligible studies published before January 21, 2023. The quality of the included articles was assessed using the Office of Health Assessment and Translation (OHAT) Risk of Bias tool. We combined the β coefficient and 95% confidence intervals (CI) using Stata.17 with random-effect model or fixed-effect model. We also performed subgroup analysis, sensitivity analysis, and Begger's and Egger's tests. RESULTS Eleven studies involving 7714 participants were included. Meta-analysis showed that PFHxS exposure was positively associated with estradiol (E2) levels in female [β = 0.030, 95% CI: (0.013, 0.046), P = 0.000]. A negative association was found between PFOA [β = -0.012, 95% CI: (-0.023, -0.002), P = 0.017] and PFOS [β = -0.011; 95% CI: (-0.021, -0.000), P = 0.042] exposure with male testosterone (TT) levels. In the subgroup analysis, there were stronger associations in children than in adults. And the high heterogeneity was mainly due to the cross-sectional studies. Publication bias was not found in most of the analyses. CONCLUSION Our study showed that PFAS exposure was significantly associated with reproductive hormone levels. Further related studies are needed to identify the association and potential mechanism in the future.
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Affiliation(s)
- Ling Li
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yingkun Guo
- School of Nursing, Weifang Medical University, Weifang, 261053, China
| | - Shuai Ma
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Hui Wen
- School of Nursing, Weifang Medical University, Weifang, 261053, China
| | - Yupei Li
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Jianhong Qiao
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China; The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China.
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Röösli M, Dongus S, Jalilian H, Eyers J, Esu E, Oringanje CM, Meremikwu M, Bosch-Capblanch X. The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A systematic review and meta-analysis on human observational studies. ENVIRONMENT INTERNATIONAL 2024; 183:108338. [PMID: 38104437 DOI: 10.1016/j.envint.2023.108338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/01/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Applications emitting radiofrequency electromagnetic fields (RF-EMF; 100 kHz to 300 GHz) are widely used for communication (e.g. mobile phones), in medicine (diathermy) and in industry (RF heaters). OBJECTIVES The objective is to systematically review the effects of longer-term or repeated local and whole human body radiofrequency electromagnetic field (RF-EMF) exposure on the occurrence of symptoms. Primary hypotheses were tinnitus, migraine and headaches in relation to RF-EMF exposure of the brain, sleep disturbances and composite symptom scores in relation to whole-body RF-EMF exposure. METHODS Eligibility criteria: We included case-control and prospective cohort studies in the general population or workers estimating local or whole-body RF-EMF exposure for at least one week. INFORMATION SOURCES We conducted a systematic literature search in various databases including Web of Science and Medline. Risk of bias: We used the Risk of Bias (RoB) tool developed by OHAT adapted to the topic of this review. SYNTHESIS OF RESULTS We synthesized studies using random effects meta-analysis. RESULTS Included studies: We included 13 papers from eight distinct cohort and one case-control studies with a total of 486,558 participants conducted exclusively in Europe. Tinnitus is addressed in three papers, migraine in one, headaches in six, sleep disturbances in five, and composite symptom scores in five papers. Only one study addressed occupational exposure. SYNTHESIS OF RESULTS For all five priority hypotheses, available research suggests that RF-EMF exposure below guideline values does not cause symptoms, but the evidence is very uncertain. The very low certainty evidence is due the low number of studies, possible risk of bias in some studies, inconsistencies, indirectness, and imprecision. In terms of non-priority hypotheses numerous exposure-outcome combinations were addressed in the 13 eligible papers without indication for an association related to a specific symptom or exposure source. DISCUSSION Limitations of evidence: This review topic includes various challenges related to confounding control and exposure assessment. Many of these aspects are inherently present and not easy to be solved in future research. Since near-field exposure from wireless communication devices is related to lifestyle, a particular challenge is to differentiate between potential biophysical effects and other potential effects from extensive use of wireless communication devices that may compete with healthy behaviour such as sleeping or physical activity. Future research needs novel and innovative methods to differentiate between these two hypothetical mechanisms. INTERPRETATION This is currently the best available evidence to underpin safety of RF-EMF. There is no indication that RF-EMF below guideline values causes symptoms. However, inherent limitations of the research results in substantial uncertainty. OTHER Funding: This review was partially funded by the WHO radioprotection programme. REGISTRATION The protocol for this review has been registered in Prospero (reg no CRD42021239432) and published in Environment International (Röösli et al., 2021).
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Affiliation(s)
- Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Stefan Dongus
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Hamed Jalilian
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - John Eyers
- International Initiative for Impact Evaluation, 3ie, c/o LIDC, 20 Bloomsbury Square, London WC1A 2NS, UK
| | - Ekpereonne Esu
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Chioma Moses Oringanje
- Department of Biology, College of Art & Sciences, Xavier University, Cincinnati, OH, USA
| | - Martin Meremikwu
- Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
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Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X, Jensen N, Terrell R, Hemmerich A, Krewski D. Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol 2024; 54:2-34. [PMID: 38318766 DOI: 10.1080/10408444.2023.2295338] [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: 03/09/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns have been raised about several other potential health risks of fluoride. OBJECTIVE To conduct a robust synthesis of evidence regarding human health risks due to exposure to fluoride in drinking water, and to develop a point of departure (POD) for setting a health-based value (HBV) for fluoride in drinking water. METHODS A systematic review of evidence published since recent reviews of human, animal, and in vitro data was carried out. Bradford Hill considerations were used to weigh the evidence for causality. Several key studies were considered for deriving PODs. RESULTS The current review identified 89 human studies, 199 animal studies, and 10 major in vitro reviews. The weight of evidence on 39 health endpoints was presented. In addition to dental fluorosis, evidence was considered strong for reduction in IQ scores in children, moderate for thyroid dysfunction, weak for kidney dysfunction, and limited for sex hormone disruptions. CONCLUSION The current review identified moderate dental fluorosis and reduction in IQ scores in children as the most relevant endpoints for establishing an HBV for fluoride in drinking water. PODs were derived for these two endpoints, although there is still some uncertainty in the causal weight of evidence for causality for reducing IQ scores in children and considerable uncertainty in the derivation of its POD. Given our evaluation of the overall weight of evidence, moderate dental fluorosis is suggested as the key endpoint until more evidence is accumulated on possible reduction of IQ scores effects. A POD of 1.56 mg fluoride/L for moderate dental fluorosis may be preferred as a starting point for setting an HBV for fluoride in drinking water to protect against moderate and severe dental fluorosis. Although outside the scope of the current review, precautionary concerns for potential neurodevelopmental cognitive effects may warrant special consideration in the derivation of the HBV for fluoride in drinking water.
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Affiliation(s)
- Mohamed Kadry Taher
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Jennifer Go
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Shintaro Hagiwara
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Siva Ramoju
- Risk Sciences International, Ottawa, ON, Canada
| | - Xuefeng Hu
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Natalie Jensen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Rowan Terrell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Alex Hemmerich
- Risk Sciences International, Ottawa, ON, Canada
- Faculty of Education, Queen's University, Kingston, ON, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
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Li J, Zheng X, Liu X, Zhang L, Zhang S, Li Y, Zhang W, Li Q, Zhao Y, Chen X, Wang X, Huang H, Fan Z. Effect and mechanism of microplastics exposure against microalgae: Photosynthesis and oxidative stress. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167017. [PMID: 37717764 DOI: 10.1016/j.scitotenv.2023.167017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/04/2023] [Accepted: 09/10/2023] [Indexed: 09/19/2023]
Abstract
The occurrence of microplastics (MPs) within aquatic ecosystems attracts a major environmental concern. It was demonstrated MPs could cause various ecotoxicological effects on microalgae. However, existing data on the effects of MPs on microalgae showed great variability among studies. Here, we performed a meta-analysis of the latest studies on the effects of MPs on photosynthesis and oxidative stress in microalgae. A total of 835 biological endpoints were investigated from 55 studies extracted, and 37 % of them were significantly affected by MPs. In this study, the impact of MPs against microalgae was concentration-dependent and size-dependent, and microalgae were more susceptible to MPs stress in freshwater than marine. Additionally, we summarized the biological functions of microalgae that are primarily affected by MPs. Under MPs exposure, the content of chlorophyll a (Chl-a) was reduced and electron transfer in the photosynthetic system was hindered, causing electron accumulation and oxidative stress damage, which may also affect biological processes such as energy production, carbon fixation, lipid metabolism, and nucleic acid metabolism. Finally, our findings provide important insights into the effects of MPs stress on photosynthesis and oxidative stress in microalga and enhance the current understanding of the potential risk of MPs pollution on aquatic organisms.
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Affiliation(s)
- Jue Li
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China
| | - Xiaowei Zheng
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China.
| | - Xianglin Liu
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China
| | - Liangliang Zhang
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China
| | - Shun Zhang
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China.
| | - Yanyao Li
- Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Graaf Karel de Goedelaan 5, 8500 Kortrijk, Belgium
| | - Weizhen Zhang
- School of Ecological Environment, Chengdu University of Technology, Chengdu, 610059, China.
| | - Qihui Li
- School of Ecological Environment, Chengdu University of Technology, Chengdu, 610059, China.
| | - Yuqiang Zhao
- Jinan Environmental Research Academy, Jinan 250102, China
| | - Xunfeng Chen
- School of Agriculture and Biology, Shanghai Jiao Tong University, 200240 Shanghai, China
| | - Xiangrong Wang
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China.
| | - Honghui Huang
- Guangdong Provincial Key Laboratory of Fishery Ecology and Environment, Guangzhou 510300, China.
| | - Zhengqiu Fan
- Department of Environmental Science & Engineering, Fudan University, 200438 Shanghai, China.
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Sosso FAE, Matos E, Papadopoulos D. Social disparities in sleep health of African populations: A systematic review and meta-analysis of observational studies. Sleep Health 2023; 9:828-845. [PMID: 37880077 DOI: 10.1016/j.sleh.2023.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To document the relationship between socioeconomic status (SES) and sleep health in African populations. METHODS Observational cross-sectional or cohort studies examining the association between SES indicators and sleep outcomes in participants from African countries were included. The search was performed in the MEDLINE, Embase, and Web of Science Core Collection electronic databases in June 2021. Selection, confounding, attrition/exclusion, detection, and selective reporting bias were assessed using the OHAT Risk of Bias Tool. Random effects meta-analysis was used for summarizing the effect estimates. RESULTS Forty-three reports were selected, having sampled 153,372 Africans from 26 countries. Education was the most frequent SES indicator and composite measures of sleep quality or disturbances was the most common sleep outcome. Low educational attainment was significantly associated with lower odds of short sleep (odds ratio [OR]=0.65, 95% confidence intervals [0.50, 0.84], p = .001) and higher odds of insomnia (OR=1.53, [1.18, 1.99], p = .001) or poor sleep quality (OR=1.60, [1.17, 2.18], p = .003). Low levels of income/assets were related to higher odds of insomnia (OR=1.38, [1.02, 1.86], p = .04) and low occupational/employment status was linked to lower odds of short sleep duration (OR=0.49, [0.30, 0.79], p = .004). CONCLUSIONS Socioeconomic disadvantage was a significant predictor of insomnia and poor sleep quality, while it was associated with longer sleep duration. Significant heterogeneity in terms of exposure and outcomes, scarcity of longitudinal designs, lack of objective outcome measurement, and low representation of rural samples and participants from low-income countries limit the quality of evidence.
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Affiliation(s)
| | - Elsa Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Luben TJ, Wilkie AA, Krajewski AK, Njie F, Park K, Zelasky S, Rappazzo KM. Short-term exposure to air pollution and infant mortality: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 898:165522. [PMID: 37459995 PMCID: PMC11094744 DOI: 10.1016/j.scitotenv.2023.165522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND AND AIM Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term air pollution exposure and infant mortality. METHODS Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria. We extracted data from included studies and applied a systematic rubric for evaluating study quality across domains including participant selection, outcome, exposure, confounding, analysis, selective reporting, sensitivity, and overall quality. We performed meta-analyses, using both fixed and random-effect methods, and estimated pooled odds ratios (ORs) and 95 % confidence intervals (95%CI) for pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), coarse particulate matter (PM10), fine particulate matter (PM2.5), ozone (O3), carbon monoxide (CO)) and infant mortality, neonatal mortality, or postneonatal mortality. RESULTS Our search returned 549 studies. We excluded 490 studies in the abstract screening phase and an additional 37 studies in the full text screening phase, leaving 22 studies for inclusion. Among these 22 studies, 14 included effect estimates for PM10, 13 for O3, 11 for both NO2 and CO, 8 for SO2, and 3 for PM2.5. We did not calculate a pooled OR for PM2.5 due to the limited number of studies available and demonstrated heterogeneity in the effect estimates. The pooled ORs (95%CI) with the greatest magnitudes were for a 10-ppb increase in SO2 or NO2 concentration in the days before death (1.07 [95%CI: 1.02, 1.12], 1.04 [95%CI: 1.01, 1.08], respectively). The pooled OR for PM10 was 1.02 (95%CI: 1.00, 1.03), and the pooled ORs for CO and O3 were 1.01 (95%CI: 1.00, 1.02) and 0.99 (95%CI: 0.97, 1.01). CONCLUSIONS Increased exposure to SO2, NO2, PM10, or CO is associated with infant mortality across studies.
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Affiliation(s)
- Thomas J Luben
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, RTP, NC, USA.
| | - Adrien A Wilkie
- Oak Ridge Institute for Science and Education (ORISE) at the U.S. Environmental Protection Agency, RTP, NC, USA
| | - Alison K Krajewski
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, RTP, NC, USA
| | - Fanny Njie
- Oak Ridge Associated Universities (ORAU) at the U.S. Environmental Protection Agency, RTP, NC, USA
| | - Kevin Park
- Oak Ridge Associated Universities (ORAU) at the U.S. Environmental Protection Agency, RTP, NC, USA
| | - Sarah Zelasky
- Oak Ridge Associated Universities (ORAU) at the U.S. Environmental Protection Agency, RTP, NC, USA
| | - Kristen M Rappazzo
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, RTP, NC, USA
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Boogaard H, Atkinson RW, Brook JR, Chang HH, Hoek G, Hoffmann B, Sagiv SK, Samoli E, Smargiassi A, Szpiro AA, Vienneau D, Weuve J, Lurmann FW, Forastiere F. Evidence Synthesis of Observational Studies in Environmental Health: Lessons Learned from a Systematic Review on Traffic-Related Air Pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:115002. [PMID: 37991444 PMCID: PMC10664749 DOI: 10.1289/ehp11532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/12/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND There is a long tradition in environmental health of using frameworks for evidence synthesis, such as those of the U.S. Environmental Protection Agency for its Integrated Science Assessments and the International Agency for Research on Cancer Monographs. The framework, Grading of Recommendations Assessment, Development, and Evaluation (GRADE), was developed for evidence synthesis in clinical medicine. The U.S. Office of Health Assessment and Translation (OHAT) elaborated an approach for evidence synthesis in environmental health building on GRADE. METHODS We applied a modified OHAT approach and a broader "narrative" assessment to assess the level of confidence in a large systematic review on traffic-related air pollution and health outcomes. DISCUSSION We discuss several challenges with the OHAT approach and its implementation and suggest improvements for synthesizing evidence from observational studies in environmental health. We consider the determination of confidence using a formal rating scheme of up- and downgrading of certain factors, the treatment of every factor as equally important, and the lower initial confidence rating of observational studies to be fundamental issues in the OHAT approach. We argue that some observational studies can offer high-confidence evidence in environmental health. We note that heterogeneity in magnitude of effect estimates should generally not weaken the confidence in the evidence, and consistency of associations across study designs, populations, and exposure assessment methods may strengthen confidence in the evidence. We mention that publication bias should be explored beyond statistical methods and is likely limited when large and collaborative studies comprise most of the evidence and when accrued over several decades. We propose to identify possible key biases, their most likely direction, and their potential impacts on the results. We think that the OHAT approach and other GRADE-type frameworks require substantial modification to align better with features of environmental health questions and the studies that address them. We emphasize that a broader, "narrative" evidence assessment based on the systematic review may complement a formal GRADE-type evaluation. https://doi.org/10.1289/EHP11532.
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Affiliation(s)
| | - Richard W. Atkinson
- Population Health Research Institute, St. George’s University of London, London, United Kingdom
| | - Jeffrey R. Brook
- Occupational and Environmental Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Sharon K. Sagiv
- Center for Environmental Research and Children’s Health, Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Francesco Forastiere
- Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
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Taylor KW, Howdeshell KL, Bommarito PA, Sibrizzi CA, Blain RB, Magnuson K, Lemeris C, Tracy W, Baird DD, Jackson CL, Gaston SA, Rider CV, Walker VR, Rooney AA. Systematic evidence mapping informs a class-based approach to assessing personal care products and pubertal timing. ENVIRONMENT INTERNATIONAL 2023; 181:108307. [PMID: 37948866 DOI: 10.1016/j.envint.2023.108307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Personal care products (PCPs) contain many different compounds and are a source of exposure to endocrine disrupting chemicals (EDCs), including phthalates and phenols. Early-life exposure to EDCs commonly found in PCPs has been linked to earlier onset of puberty. OBJECTIVE To characterize the human and animal evidence on the association between puberty-related outcomes and exposure to PCPs and their chemical constituents and, if there is sufficient evidence, identify groups of chemicals and outcomes to support a systematic review for a class-based hazard or risk assessment. METHODS We followed the OHAT systematic review framework to characterize the human and animal evidence on the association between puberty-related health outcomes and exposure to PCPs and their chemical constituents. RESULTS Ninety-eight human and 299 animal studies that evaluated a total of 96 different chemicals were identified and mapped by key concepts including chemical class, data stream, and puberty-related health outcome. Among these studies, phthalates and phenols were the most well-studied chemical classes. Most of the phthalate and phenol studies examined secondary sex characteristics and changes in estradiol and testosterone levels. Studies evaluating PCP use and other chemical classes (e.g., parabens) had less data. CONCLUSIONS This systematic evidence map identified and mapped the published research evaluating the association between exposure to PCPs and their chemical constituents and puberty-related health outcomes. The resulting interactive visualization allows researchers to make evidence-based decisions on the available research by enabling them to search, sort, and filter the literature base of puberty-related studies by key concepts. This map can be used by researchers and regulators to prioritize and target future research and funding to reduce uncertainties and address data gaps. It also provides information to inform a class-based hazard or risk assessment on the association between phthalate and phenol exposures and puberty-related health outcomes.
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Affiliation(s)
- Kyla W Taylor
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
| | - Kembra L Howdeshell
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Paige A Bommarito
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | | | | | | | | | - Donna D Baird
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Chandra L Jackson
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA; National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Symielle A Gaston
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Cynthia V Rider
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Vickie R Walker
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Andrew A Rooney
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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Xu K, Li Z, Qiao J, Wang S, Xie P, Zong Z, Hu C. Persistent organic pollutants exposure and risk of autism spectrum disorders: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122439. [PMID: 37619697 DOI: 10.1016/j.envpol.2023.122439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Accumulating number of epidemiological studies has recently proposed that improvement in the risk of autism spectrum disorders (ASD) is associated with persistent organic pollutants (POPs) exposure. However, evidence from current researches is limited and inconsistent. Thus, we conducted a systematic review and meta-analysis to investigate the potential associations comprehensively. We systematically and extensively searched two electronic databases (PubMed and EMBASE) from inception to July 3, 2022 and an updated search was performed before submission. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were derived from stratified random-effects meta-analyses by type of exposure and outcome. We also tested the potential heterogeneity across studies, conducted sensitivity analysis and evaluated publication bias. A total of 20 studies were finally included in our study. Meta-analytical effect estimates indicated a positive association between prenatal exposure to PCB-138, PCB-153 and PCB-170 and an increased risk of ASD, with OR of 1.89 (95% CI = 1.21-2.95, I2 = 0%), 1.61 (95% CI = 1.05-2.47, I2 = 0%) and 1.46 (95% CI = 1.03-2.06, I2 = 0%) respectively. In contrast, PFDA was found inversely associated with the risk of ASD (OR = 0.70, 95% CI = 0.52-0.94, I2 = 0%). The level of evidence supporting a link between ASD risk and exposure to PCB-138, PCB-153, PCB-170, and PFDA was respectively categorized as low, low, moderate, and low. In summary, this systematic review and meta-analysis suggest that exposure to PCB-138, PCB-153, and PCB-170 correlates with a heightened risk of ASD, with evidence levels rated as "low", "low", and "moderate", respectively. In contrast, PFDA exposure appears to be inversely associated with ASD risk, with a "low" level of supporting evidence. However, due to the limited number of studies available for each exposure and outcome pairing, these results should be interpreted with caution. Sufficiently powered studies are needed to validate our findings.
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Affiliation(s)
- Kexin Xu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhuoyan Li
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jianchao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Senzheng Wang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Pinpeng Xie
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhiqiang Zong
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Chengyang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Hamed MA, Akhigbe TM, Adeogun AE, Adesoye OB, Akhigbe RE. Impact of organophosphate pesticides exposure on human semen parameters and testosterone: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1227836. [PMID: 37964951 PMCID: PMC10641273 DOI: 10.3389/fendo.2023.1227836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background Organophosphate (OP) pesticides have been associated with a decline in semen quality, although there are still considerable arguments about the magnitude of the association. Objective This study provides a systematic review and meta-analysis of the impacts of OP pesticides on semen quality and male reproductive hormones. Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols. Strategic search was conducted using combined text words as search terms. The eligibility criteria were developed based on Population, Exposure, Comparator, Outcome, and Study designs (PECOS) framework. Relevant data were extracted, risk of bias was evaluated by The Office of Health Assessment and Translation (OHAT) tool, and certainty of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group guidelines. Quantitative meta-analysis was performed by using Review Manager. Results A total of 766 male subjects (349 exposed to OP pesticides and 417 unexposed controls) were included in the meta-analysis. There was no significant difference in the ejaculate volume, seminal fluid volume, sperm multiple anomaly index, sperm, and leukocytes levels of the OP-exposed subjects compared to the control. In addition, OP pesticides exposure did not significantly affect serum concentrations of FSH, LH, and testosterone in subjects who were exposed to OP pesticides compared to their unexposed counterparts. However, we found a significant reduction in the sperm count, sperm concentration, progressive sperm motility, total sperm motility, and normal sperm morphology of OP pesticides-exposed subjects compared to the unexposed subjects. However, after subtype and sensitivity analyses, exposure to OP pesticides did not reduce sperm count. Also, after sensitivity analysis, OP pesticides exposure did not alter progressive sperm motility. Conclusion This study demonstrates that OP pesticides exposure reduced sperm count, concentration, total and progressive motility, and normal sperm morphology, possibly via a testosterone-independent mechanism.
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Affiliation(s)
- Moses A. Hamed
- Department of Medical Laboratory Science, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
- The Brainwill Laboratory, Osogbo, Osun State, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
| | - Tunmise M. Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Agronomy, Osun State Univeristy, Osogbo, Nigeria
| | - Adetomiwa E. Adeogun
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Oluwatosin B. Adesoye
- SickleLive Foundationo, Osogb, Nigeria
- SickleLive Foundation Research Laboratory, Osogbo, Nigeria
- State Specialist Hospital, Osogbo, Osun State, Nigeria
| | - Roland E. Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
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Serafín-Fabian JI, Elena Moreno-Godínez M, Flores-Alfaro E, Parra-Rojas I, Rojas-García AE, Campos-Viguri GE, Cahua-Pablo JÁ, Ramírez-Vargas MA. β-glucuronidase as a biomarker for assessing the exposure to anticholinergic pesticides: A meta-analysis. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 103:104279. [PMID: 37741477 DOI: 10.1016/j.etap.2023.104279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/21/2023] [Accepted: 09/19/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION The human exposure to anticholinergic pesticides has been associated with the development of various diseases. Therefore, several biomarkers have been proposed for biomonitoring human exposure to anticholinergic pesticides. OBJECTIVE This work evaluated the effect of human exposure to anticholinergic pesticides on β-glucuronidase (GUSB) levels. METHODS A systematic review was performed using PubMed, Web of Science, Scopus, and EBSCO databases up to December 2021. The statistical analysis employed standardized mean differences and meta-regression. And the trial sequential analysis was performed. RESULTS Nine studies were included. A monotonic relationship was observed between poisoning severity and GUSB. Furthermore, BuChE levels were correlated with GUSB levels. CONCLUSIONS The results indicated that GUSB levels could be used as a possible diagnosis biomarker in poisoning related to anticholinergic pesticide exposure. However, the use of GUSB to assess the chronic exposure to anticholinergic pesticides could be only performed in recent exposure (≈ 7 days after last exposure).
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Affiliation(s)
- Jesús Isimar Serafín-Fabian
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Epidemiología Clínica y Molecular, Universidad Autónoma De Guerrero, Guerrero, Mexico
| | - Ma Elena Moreno-Godínez
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Toxicología y Salud Ambiental, Universidad Autónoma De Guerrero, Guerrero, Mexico
| | - Eugenia Flores-Alfaro
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Epidemiología Clínica y Molecular, Universidad Autónoma De Guerrero, Guerrero, Mexico
| | - Isela Parra-Rojas
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Investigación en Obesidad y Diabetes, Universidad Autónoma De Guerrero, Guerrero, Mexico
| | - Aurora Elizabeth Rojas-García
- Secretaría de Investigación y Posgrado, Laboratorio de Contaminación y Toxicología Ambiental, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | | | - José Ángel Cahua-Pablo
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Epidemiología Clínica y Molecular, Universidad Autónoma De Guerrero, Guerrero, Mexico
| | - Marco Antonio Ramírez-Vargas
- Facultad de Ciencias Químico-Biológicas, Laboratorio de Toxicología y Salud Ambiental, Universidad Autónoma De Guerrero, Guerrero, Mexico.
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Singh A, Lawler CP, Walker VR, Pelch KE, Garton AE, Rooney AA, Haugen AC. Becoming aWARE: The Development of a Web-Based Tool for Autism Research and the Environment. J Xenobiot 2023; 13:492-499. [PMID: 37754843 PMCID: PMC10532575 DOI: 10.3390/jox13030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
A sharp rise in autism spectrum disorder (ASD) prevalence estimates, beginning in the 1990s, suggested factors additional to genetics were at play. This stimulated increased research investment in nongenetic factors, including the study of environmental chemical exposures, diet, nutrition, lifestyle, social factors, and maternal medical conditions. Consequently, both peer- and non-peer-reviewed bodies of evidence investigating environmental contributors to ASD etiology have grown significantly. The heterogeneity in the design and conduct of this research results in an inconclusive and unwieldy 'virtual stack' of publications. We propose to develop a Web-based tool for Autism Research and the Environment (aWARE) to comprehensively aggregate and assess these highly variable and often conflicting data. The interactive aWARE tool will use an approach for the development of systematic evidence maps (SEMs) to identify and display all available relevant published evidence, enabling users to explore multiple research questions within the scope of the SEM. Throughout tool development, listening sessions and workshops will be used to seek perspectives from the broader autism community. New evidence will be indexed in the tool annually, which will serve as a living resource to investigate the association between environmental factors and ASD.
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Affiliation(s)
- Anisha Singh
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
| | - Cindy P. Lawler
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
| | - Vickie R. Walker
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
| | | | - Amanda E. Garton
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
| | - Andrew A. Rooney
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
| | - Astrid C. Haugen
- National Institute of Environmental Health Sciences, Durham, NC 27709, USA; (A.S.); (C.P.L.); (V.R.W.); (A.E.G.); (A.A.R.)
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Juberg DR, Fox DA, Forcelli PA, Kacew S, Lipscomb JC, Saghir SA, Sherwin CM, Koenig CM, Hays SM, Kirman CR. A perspective on In vitro developmental neurotoxicity test assay results: An expert panel review. Regul Toxicol Pharmacol 2023; 143:105444. [PMID: 37442267 DOI: 10.1016/j.yrtph.2023.105444] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/21/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
For decades, there has been increasing concern about the potential developmental neurotoxicity (DNT) associated with chemicals. Regulatory agencies have historically utilized standardized in vivo testing to evaluate DNT. Owing to considerations including higher-throughput screening for DNT, reduction in animal use, and potential cost efficiencies, the development of alternative new approach methods (NAMs) occurred; specifically, the advent of the DNT in vitro test battery (DNT IVB). SciPinion convened an expert panel to address specific questions related to the interpretation of in vitro DNT test data. The consensus of the expert panel was that the DNT IVB might be used during initial screening, but it is not presently a complete or surrogate approach to determine whether a chemical is a DNT in humans. By itself, the DNT IVB does not have the ability to capture nuances and complexity of the developing nervous system and associated outcomes including behavioral ontogeny, motor activity, sensory function, and learning/memory. Presently, such developmental landmarks cannot be adequately assessed in the DNT IVB or by other NAMs. The expert panel (all who serve as co-authors of this review) recommended that additional data generation and validation is required before the DNT IVB can be considered for application within global regulatory frameworks for decision-making.
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Affiliation(s)
- D R Juberg
- Juberg Toxicology Consulting LLC, Indianapolis, IN, USA
| | - D A Fox
- DAFoxTox Consulting, Austin, TX, USA
| | | | - S Kacew
- University of Ottawa, Ottawa, CA, USA
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Howdeshell KL, Beverly BEJ, Blain RB, Goldstone AE, Hartman PA, Lemeris CR, Newbold RR, Rooney AA, Bucher JR. Evaluating endocrine disrupting chemicals: A perspective on the novel assessments in CLARITY-BPA. Birth Defects Res 2023; 115:1345-1397. [PMID: 37646438 DOI: 10.1002/bdr2.2238] [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: 05/12/2023] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The Consortium Linking Academic and Regulatory Insights on Bisphenol A Toxicity (CLARITY-BPA) was a collaborative research effort to better link academic research with governmental guideline studies. This review explores the secondary goal of CLARITY-BPA: to identify endpoints or technologies from CLARITY-BPA and prior/concurrent literature from these laboratories that may enhance the capacity of rodent toxicity studies to detect endocrine disrupting chemicals (EDCs). METHODS A systematic literature search was conducted with search terms for BPA and the CLARITY-BPA participants. Relevant studies employed a laboratory rodent model and reported results on 1 of the 10 organs/organ systems evaluated in CLARITY-BPA (brain and behavior, cardiac, immune, mammary gland, ovary, penile function, prostate gland and urethra, testis and epididymis, thyroid hormone and metabolism, and uterus). Study design and findings were summarized, and a risk-of-bias assessment was conducted. RESULTS Several endpoints and methods were identified as potentially helpful to detect effects of EDCs. For example, molecular and quantitative morphological approaches were sensitive in detecting alterations in early postnatal development of the brain, ovary, and mammary glands. Hormone challenge studies mimicking human aging reported increased susceptibility of the prostate to disease following developmental BPA exposure. Statistical analyses for nonmonotonic dose responses, and computational approaches assessing multiple treatment-related outcomes concurrently in linked hormone-sensitive organ systems, reported effects at low BPA doses. CONCLUSIONS This review provided an opportunity to evaluate the unique insights provided by nontraditional assessments in CLARITY-BPA to identify technologies and endpoints to enhance detection of EDCs in future studies.
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Affiliation(s)
- Kembra L Howdeshell
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA
| | - Brandiese E J Beverly
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA
| | | | | | | | | | - Retha R Newbold
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA
- NIEHS, retired, Research Triangle Park, North Carolina, United States
| | - Andrew A Rooney
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA
| | - John R Bucher
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, USA
- NIEHS, retired, Research Triangle Park, North Carolina, United States
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Hu CY, Qiao JC, Gui SY, Xu KX, Dzhambov AM, Zhang XJ. Perfluoroalkyl and polyfluoroalkyl substances and hypertensive disorders of pregnancy: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2023; 231:116064. [PMID: 37178750 DOI: 10.1016/j.envres.2023.116064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
Hypertensive disorders of pregnancy (HDP), including gestational hypertension (GH) and preeclampsia (PE), cause significant morbidity and mortality among pregnant women. Several environmental toxins, particularly those that affect the normal function of the placenta and the endothelium, are emerging as potential risk factors for HDP. Among them, per- and polyfluoroalkyl substances (PFAS), widely used in a variety of commercial products, have been related to a variety of adverse health effects including HDP. This study was conducted by searching three databases for observational studies reporting associations between PFAS and HDP, all of which were published before December 2022. We used random-effects meta-analysis to calculate pooled risk estimates, and assessing each combination of exposure and outcome for quality and level of evidence. In total, 15 studies were included in the systematic review and meta-analysis. The results from meta-analyses showed that risk of PE was increased with exposure to PFOA (perfluorooctanoic acid) (RR = 1.39, 95% CI = 1.05, 1.85; N = 6 studies; exposure = 1 ln-unit increment; low certainty), PFOS (perfluorooctane sulfonate) (RR = 1.51, 95% CI = 1.23, 1.86; N = 6 studies; exposure = 1 ln-unit increment; moderate certainty), and PFHxS (perfluorohexane sulfonate) (RR = 1.39, 95% CI = 1.10, 1.76; N = 6 studies; exposure = 1 ln-unit increment; low certainty). PFOS was also associated with an increased risk of HDP (RR = 1.39, 95% CI = 1.10, 1.76; exposure = 1 ln-unit increment; low certainty). Exposure to legacy PFAS (PFOA, PFOS, PFHxS) is associated with an increased risk of PE, and PFOS is further associated with HDP. In view of the limitations of meta-analysis and quality of evidence, these findings should be interpreted with caution. Further research is required that assesses exposure to multiple PFAS in diverse and well-powered cohorts.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Ke-Xin Xu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria, 15A Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria; Research group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Xiao F, An Z, Lv J, Sun X, Sun H, Liu Y, Liu X, Guo H. Association between per- and polyfluoroalkyl substances and risk of hypertension: a systematic review and meta-analysis. Front Public Health 2023; 11:1173101. [PMID: 37655293 PMCID: PMC10466234 DOI: 10.3389/fpubh.2023.1173101] [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: 02/24/2023] [Accepted: 06/27/2023] [Indexed: 09/02/2023] Open
Abstract
Background Existing evidence indicates that exposure to per- and polyfluoroalkyl substances (PFASs) may increase the risk of hypertension, but the findings are inconsistent. Therefore, we aimed to explore the relationship between PFASs and hypertension through this systematic review and meta-analysis. Methods We searched PubMed, Embase, and the Web of Science databases for articles published in English that examined the relationship between PFASs and hypertension before 13 August 2022. The random effects model was used to aggregate the evaluation using Stata 15.0 for Windows. We also conducted subgroup analyses by region and hypertension definition. In addition, a sensitivity analysis was carried out to determine the robustness of the findings. Results The meta-analysis comprised 15 studies in total with 69,949 individuals. The risk of hypertension was substantially and positively correlated with exposure to perfluorooctane sulfonate (PFOS) (OR = 1.31, 95% CI: 1.14, 1.51), perfluorooctanoic acid (PFOA) (OR = 1.16, 95% CI: 1.07, 1.26), and perfluorohexane sulfonate (PFHxS) (OR = 1.04, 95% CI: 1.00, 1.09). However, perfluorononanoic acid (PFNA) exposure and hypertension were not significantly associated (OR = 1.08, 95% CI: 0.99, 1.17). Conclusion We evaluated the link between PFASs exposure and hypertension and discovered that higher levels of PFOS, PFOA, and PFHxS were correlated with an increased risk of hypertension. However, further high-quality population-based and pathophysiological investigations are required to shed light on the possible mechanism and demonstrate causation because of the considerable variability. Systematic review registration https://www.crd.york.ac.uk/prospero/ PROSPERO, registration number: CRD 42022358142.
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Affiliation(s)
- Fang Xiao
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Ziwen An
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Junli Lv
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Xiaoyi Sun
- Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Heming Sun
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Yi Liu
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Xuehui Liu
- Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Huicai Guo
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
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Michel S, Atmakuri A, von Ehrenstein OS. Prenatal exposure to ambient air pollutants and congenital heart defects: An umbrella review. ENVIRONMENT INTERNATIONAL 2023; 178:108076. [PMID: 37454629 DOI: 10.1016/j.envint.2023.108076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Prenatal exposure to ambient air pollutants has been linked to congenital heart defects (CHD), but findings of existing systematic reviews have been mixed. OBJECTIVE To assess the epidemiological evidence on associations between prenatal exposure to ambient air pollutants and CHD subtypes, based on a systematic overview of reviews ("umbrella review"). METHODS We conducted a systematic search for reviews assessing associations between prenatal exposure to criteria air pollutants and CHD. The risk of bias was evaluated using the Risk of Bias in Systematic Reviews (ROBIS) tool. The certainty of the systematic review findings was graded using the Navigation Guide methodology. RESULTS We identified eleven systematic reviews, including eight with meta-analyses, assessing in total 35 primary studies of prenatal exposure to criteria air pollutants and various CHD subtypes. The certainty of the findings of four meta-analyses indicating an increased risk for coarctation of the aorta associated with nitrogen dioxide exposure was rated as moderate. The certainty of findings indicating positive, inverse, or null associations for other pollutant-subtype combinations was rated as very low to low, based on low precision and high statistical heterogeneity of summary odds ratios (SOR), substantial inconsistencies between review findings, and methodological limitations of the systematic reviews. DISCUSSION The inconsistent findings and high statistical heterogeneity of many SOR of the included systematic reviews may partly be traced to differences in methodological approaches, and the risk of bias across included reviews (e.g., inclusion criteria, systematic search strategies, synthesis methods) and primary studies (e.g., exposure assessment, diagnostic criteria). Adherence to appropriate systematic review guidelines for environmental health research, as well as rigorous evaluation of risk of bias in primary studies, are essential for future risk assessments and policy-making. Still, our findings suggest that prenatal exposure to ambient air pollutants may increase risks for at least some CHD subtypes.
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Affiliation(s)
- Sophie Michel
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
| | - Aishwarya Atmakuri
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, California, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA; Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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Lai KY, Webster C, Gallacher JE, Sarkar C. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review. J Urban Health 2023; 100:745-787. [PMID: 37580546 PMCID: PMC10447831 DOI: 10.1007/s11524-023-00764-5] [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] [Accepted: 06/28/2023] [Indexed: 08/16/2023]
Abstract
With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as "probably high" risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as "probably high" risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Ej Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
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Thompson R, Lawrance EL, Roberts LF, Grailey K, Ashrafian H, Maheswaran H, Toledano MB, Darzi A. Ambient temperature and mental health: a systematic review and meta-analysis. Lancet Planet Health 2023; 7:e580-e589. [PMID: 37437999 DOI: 10.1016/s2542-5196(23)00104-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Increasing evidence indicates that ambient outdoor temperature could affect mental health, which is especially concerning in the context of climate change. We aimed to comprehensively analyse the current evidence regarding the associations between ambient temperature and mental health outcomes. METHODS We did a systematic review and meta-analysis of the evidence regarding associations between ambient outdoor temperature and changes in mental health outcomes. We searched WebOfScience, Embase, PsychINFO, and PubMed for articles published from database origin up to April 7, 2022. Eligible articles were epidemiological, observational studies in humans of all ages, which evaluated real-world responses to ambient outdoor temperature, and had mental health as a documented outcome; studies of manipulated or controlled temperature or those with only physical health outcomes were excluded. All eligible studies were synthesised qualitatively. If three or more studies reported the same or equivalent effect statistics and if they had equivalent exposure, outcome, and metrics, the studies were pooled in a random-effects meta-analysis. The risk of bias for individual studies was assessed using the Newcastle-Ottawa Scale. The quality of evidence across studies was assessed using the Office of Health Assessment and Translation (OHAT) approach. FINDINGS 114 studies were included in the systematic review, of which 19 were suitable for meta-analysis. Three meta-analyses were conducted for suicide outcomes: a 1°C increase in mean monthly temperature was associated with an increase in incidence of 1·5% (95% CI 0·8-2·2, p<0·001; n=1 563 109, seven effects pooled from three studies); a 1°C increase in mean daily temperature was associated with an increase in incidence of 1·7% (0·3-3·0, p=0·014; n=113 523, five effects pooled from five studies); and a 1°C increase in mean monthly temperature was associated with a risk ratio of 1·01 (95% CI 1·00-1·01, p<0·001; n=111 794, six effects pooled from three studies). Three meta-analyses were conducted for hospital attendance or admission for mental illness: heatwaves versus non-heatwave periods were associated with an increase in incidence of 9·7% (95% CI 7·6-11·9, p<0·001; n=362 086, three studies); the risk ratio at the 99th percentile of daily mean temperature compared with the 50th percentile was 1·02 (95% CI 1·01-1·03, p=0·006; n=532 296, three studies); and no significant association was found between a 10°C increase in daily mean temperature and hospital attendance. In a qualitative narrative synthesis, we found that ambient outdoor temperature (including absolute temperatures, temperature variability, and heatwaves) was positively associated with attempted and completed suicides (86 studies), hospital attendance or admission for mental illness (43 studies), and worse outcomes for community mental health and wellbeing (19 studies), but much of the evidence was of low certainty with high heterogeneity. INTERPRETATION Increased temperature and temperature variability could be associated with increased cases of suicide and suicidal behaviour, hospital attendance or admission for mental illness, and poor community health and wellbeing. Climate change is likely to increase temperature anomalies, variability, and heatwaves as well as average temperatures; as such, health system leaders and policy makers must be adequately prepared and should develop adaptation strategies. More high-quality, standardised research is required to improve our understanding of these effects. FUNDING None.
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Affiliation(s)
| | - Emma L Lawrance
- Institute of Global Health Innovation, Imperial College London, London, UK; Mental Health Innovations, London, UK.
| | - Lily F Roberts
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Kate Grailey
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Mireille B Toledano
- School of Public Health, Imperial College London, London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, London, UK
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, UK
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Vliet SM, Markey KJ, Lynn SG, Adetona A, Fallacara D, Ceger P, Choksi N, Karmaus AL, Watson A, Ewans A, Daniel AB, Hamm J, Vitense K, Wolf KA, Thomas A, LaLone CA. Weight of evidence for cross-species conservation of androgen receptor-based biological activity. Toxicol Sci 2023; 193:131-145. [PMID: 37071731 PMCID: PMC10796108 DOI: 10.1093/toxsci/kfad038] [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] [Indexed: 04/20/2023] Open
Abstract
The U.S. Environmental Protection Agency's Endocrine Disruptor Screening Program (EDSP) is tasked with assessing chemicals for their potential to perturb endocrine pathways, including those controlled by androgen receptor (AR). To address challenges associated with traditional testing strategies, EDSP is considering in vitro high-throughput screening assays to screen and prioritize chemicals more efficiently. The ability of these assays to accurately reflect chemical interactions in nonmammalian species remains uncertain. Therefore, a goal of the EDSP is to evaluate how broadly results can be extrapolated across taxa. To assess the cross-species conservation of AR-modulated pathways, computational analyses and systematic literature review approaches were used to conduct a comprehensive analysis of existing in silico, in vitro, and in vivo data. First, molecular target conservation was assessed across 585 diverse species based on the structural similarity of ARs. These results indicate that ARs are conserved across vertebrates and are predicted to share similarly susceptibility to chemicals that interact with the human AR. Systematic analysis of over 5000 published manuscripts was used to compile in vitro and in vivo cross-species toxicity data. Assessment of in vitro data indicates conservation of responses occurs across vertebrate ARs, with potential differences in sensitivity. Similarly, in vivo data indicate strong conservation of the AR signaling pathways across vertebrate species, although sensitivity may vary. Overall, this study demonstrates a framework for utilizing bioinformatics and existing data to build weight of evidence for cross-species extrapolation and provides a technical basis for extrapolating hAR-based data to prioritize hazard in nonmammalian vertebrate species.
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Affiliation(s)
- Sara M.F. Vliet
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Computational Toxicology and Exposure, Scientific Computing and Data Curation Division, Duluth, MN, USA
| | - Kristan J. Markey
- U.S. Environmental Protection Agency, Office of Pesticide Programs, Endocrine Disrupter Screening Program, Washington, DC, USA
| | - Scott G. Lynn
- U.S. Environmental Protection Agency, Office of Pesticide Programs, Endocrine Disrupter Screening Program, Washington, DC, USA
| | | | | | | | | | | | | | | | | | | | - Kelsey Vitense
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Computational Toxicology and Exposure, Scientific Computing and Data Curation Division, Duluth, MN, USA
| | | | - Amy Thomas
- Battelle Memorial Institute, Columbus, OH, USA
| | - Carlie A. LaLone
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Computational Toxicology and Exposure, Great Lakes Toxicology and Ecology Division, Duluth, MN, USA
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Zhu X, Liu B, Guo C, Li Z, Cheng M, Zhu X, Wei Y. Short and long-term association of exposure to ambient black carbon with all-cause and cause-specific mortality: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 324:121086. [PMID: 36649881 DOI: 10.1016/j.envpol.2023.121086] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
Black carbon (BC) is a product of incomplete or inefficient combustion and may be associated with a variety of adverse effects on human health. The objective of this study was to analyze the association between various mortalities and long-/short-term exposure to BC as an independent pollutant. In this systematic review, we searched 4 databases for original research in English up to 6th October 2022, that investigated population-wide mortality due to BC exposure. We pooled mortality estimates and expressed them as relative risk (RR) per 10 μg/m3 increase in BC. We used a random-effect model to derive the pooled RRs. Of the 3186 studies identified, 29 articles met the eligibility criteria, including 18 long-term exposure studies and 11 short-term exposure studies. In the major meta-analysis and sensitivity analysis, positive associations were found between BC and total mortality and cause-specific disease mortalities. Among them, the short-term effects of BC on total mortality, cardiovascular disease mortality, respiratory disease mortality, and the long-term effects of BC on total mortality, ischemic heart disease mortality, respiratory disease mortality and lung cancer mortality were found to be statistically significant. The heterogeneity of the meta-analysis results was much lower for short-term studies than for long-term. Few studies were at a high risk of bias in any domain. The certainty of the evidence for most of the exposure-outcome pairs was moderate. Our study showed a significantly positive association between short-/long-term BC exposure and various mortalities. We speculate that BC has a higher adverse health effect on the respiratory system than on the cardiovascular system. This is different from the effect of PM2.5. Therefore, more studies are needed to consider BC as a separate pollutant, and not just as a component of PM2.5.
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Affiliation(s)
- Xiaojing Zhu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Bingqian Liu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Chen Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Zhigang Li
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Miaomiao Cheng
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Xiaoyan Zhu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China; Center for Global Health, School of Public Health, Nanjing Medical University, China.
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Liu J, Chen Y, Liu D, Ye F, Sun Q, Huang Q, Dong J, Pei T, He Y, Zhang Q. Prenatal exposure to particulate matter and term low birth weight: systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:63335-63346. [PMID: 37059952 PMCID: PMC10172254 DOI: 10.1007/s11356-023-26831-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023]
Abstract
To evaluate the relationships between maternal particulate matter exposure and offspring birth weight. Studies were categorized into three subgroups: term low birth weight (TLBW) among full-term births and all births (regardless of gestational age) and low birth weight (LBW) among all births, based on the search results of MEDLINE and the Web of Science from the inception of the database to April 2022. Subgroup analyses were conducted based on the economic status, region, exposure assessment, risk of bias, and adjustment. Sixty-one studies involving 34,506,975 singleton live births in 15 countries were analyzed. Overall, the risk of bias for most studies (75%) was low. In 39 of 47 term birth studies, the pooled odds ratio of TLBW among term births for per interquartile range (IQR) increases throughout the entire pregnancy was 1.02 (1.01 to 1.03) for PM2.5 and 1.03 (1.01 to 1.05) for PM10 after adjustment for covariates. No significant relevance was detected across each trimester period for PM2.5. A stronger effect was observed during the second trimester (1.03, 1.01 to 1.06) for PM10. There was no increased risk of TLBW in all births associated with IQR increases in PM2.5 and PM10. LBW was associated with PM2.5 exposure in 4 of 7 studies, but statistical heterogeneity was considerable. In the TLBW subgroup analysis, the effects of PM2.5 and PM10 were both greater in studies conducted in advanced countries, studies with low bias, and studies that adjusted for maternal age, infant sex, and parity. Stronger effects were present for PM2.5 exposure collected from monitoring stations and PM10 exposure interpolated from the inverse distance weighting model. TLBW may be associated with prenatal exposure to particulate matter, but no critical windows were identified. Stronger associations were observed in advanced countries. Future original study designs need to consider the impact of different exposure assessment modalities and all possible confounding factors.
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Affiliation(s)
- Jing Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuanmei Chen
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Die Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Fang Ye
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qi Sun
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qiang Huang
- State Key Laboratory of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jing Dong
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Tao Pei
- State Key Laboratory of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
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Alves LB, Moura AC, Amorim Dos Santos J, Borges GA, Guerra ENS. Pharmacological PI3K inhibition in head and neck squamous cell carcinoma: A systematic review. Toxicol In Vitro 2023; 88:105558. [PMID: 36681288 DOI: 10.1016/j.tiv.2023.105558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/12/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND This systematic review aimed to investigate the in vitro and in vivo effects of phosphatidylinositol-3-kinase (PI3K) inhibitors on head and neck squamous cell carcinoma (HNSCC). Considering the role of PI3K and its downstream effectors in cell proliferation, invasion, and survival, it is reasonable to expect that treatment with PI3K inhibitors could control HNSCC onset and progression. Thus, the research question for our review was whether pharmacological inhibition of PI3K affects HNSCC progression. METHODS In vitro and in vivo studies were selected from six databases. We collected data regarding cell viability, apoptosis, and the regulation of protein expression levels from in vitro studies. For the in vivo studies, we analyzed the reduction in tumor size or gene and protein expression. RESULTS The included studies showed reduced cell proliferation and apoptosis after treatment with PI3K inhibitors. PI3K inhibitors in combination with other drugs had an enhanced anticancer effects compared to those of single-drug treatments. CONCLUSIONS The results support the potential of PI3K inhibitors as candidates for clinical trials in HNSCC.
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Affiliation(s)
- L B Alves
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasília, Brazil
| | - A C Moura
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasília, Brazil
| | - J Amorim Dos Santos
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasília, Brazil
| | - G A Borges
- Department of Oral Medicine and Periodontics, Faculty of Dentistry, University of Michigan, Ann Arbor, United States
| | - E N S Guerra
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasília, Brazil.
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50
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Thompson R, Smith RB, Karim YB, Shen C, Drummond K, Teng C, Toledano MB. Air pollution and human cognition: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:160234. [PMID: 36427724 DOI: 10.1016/j.scitotenv.2022.160234] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity. METHODS The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses. RESULTS Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM2.5 and general cognition in adults 40+, and PM2.5, NOx, and PM10 and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 μg/m3 increase in NO2 was associated with reduced performance on general cognitive batteries (β = -0.02, p < 0.05) as was a 1 μg/m3 increase in PM2.5 exposure (β = -0.02, p < 0.05). A 1μgm3 increase in PM2.5 was significantly associated with lower verbal fluency by -0.05 words (p = 0.01) and a decrease in executive function task performance of -0.02 points (p < 0.001). DISCUSSION Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particularly with older teenagers and young adults (14-40 years), using multi-exposure modelling, incorporating mechanistic investigation, and in South America, Africa, South Asia and Australasia.
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Affiliation(s)
- Rhiannon Thompson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Rachel B Smith
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK
| | - Yasmin Bou Karim
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chen Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Kayleigh Drummond
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chloe Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Environmental Exposures and Health, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, UK.
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