Diet as a Source of Exposure to Environmental Contaminants for Pregnant Women and Children from Six European Countries

Investigating the role of food pollutants in autism spectrum disorder: a comprehensive analysis of heavy metals, pesticides, and mycotoxins

Food pollutants, including heavy metals, pesticides, and mycotoxins, have been proposed as potential risk factors for autism spectrum disorder (ASD) during pregnancy and early childhood. This paper examines the impact of food pollutants on ASD risk. A systematic search through PubMed, Google Scholar, and Sciverse yielded studies from 1990 to present. Research indicates elevated levels of heavy metals in children with ASD, linking pesticides and toxins to brain development disruptions. Mycotoxins, specifically, show a correlation with ASD and can contaminate food, posing a threat to neurodevelopment. Strategies like choosing organic foods and reducing exposure to toxins may benefit individuals with ASD and those vulnerable to the disorder. Further research is essential to comprehend the food pollutant-ASD relationship and devise effective exposure reduction strategies.

Toxicokinetic of perfluorinated compounds - A study of liver sequestration in Baltic cod (Gadus morhua callarias) and human dietary exposure

This study assessed the concentrations and temporal trends of perfluorinated compounds (PFCs) in the muscle and liver tissues of Baltic cod (Gadus morhua) from 2017 to 2023. The Environmental Quality Standard (EQS) for biota and the Estimated Weekly Intake (EWI) for human consumers were calculated to evaluate potential health risks associated with PFC exposure. Significant variations in PFC concentrations were observed across different compounds and sampling years. Perfluorooctanoic acid (PFOA) had a mean concentration ranging from 0.03 ng g⁻1 wet weight (ww) to 0.17 ng g⁻1 ww (mean: 0.093 ng g⁻1 ww), while perfluorononanoic acid (PFNA) ranged from 0.05 ng g⁻1 ww to 0.97 ng g⁻1 ww (mean: 0.46 ng g⁻1 ww). Perfluorooctane sulfonate (PFOS) demonstrated mean concentrations between 1.98 ng g⁻1 ww and 9.03 ng g⁻1 ww (mean: 4.78 ng g⁻1 ww). PFOSA exhibited the lowest liver sequestration factor, indicating a higher elimination potential. The EQS for biota, expressed in PFOA-equivalents, ranged from 9.36 ng g⁻1 ww to 28.5 ng g⁻1 ww (mean: 18.5 ng g⁻1 ww), showing an overall increasing trend over the study period. The EWI for Baltic cod muscle (ΣPFAS-4) indicated an average exposure of 1.84 ng kg⁻1 body weight (bw) per week for adults, with a maximum of 3.46 ng kg⁻1 bw per week. For cod liver consumers, the maximum exposure reached 6.45 ng kg⁻1 bw per week, exceeding the Tolerable Weekly Intake (TWI) in some cases. The rising PFC concentrations in Baltic cod, especially in liver tissues, pose health risks to consumers. Ongoing monitoring and risk assessments are essential to reduce the impacts of PFC exposure from seafood.

Dietary exposure to metals/metalloids and persistent organic pollutants in Spanish preschool and primary school children

Diet is a primary source of pollutant exposure. Given children's vulnerability to their effects, this study assessed dietary intake of metals/metalloids and different persistent organic pollutants in children in Tarragona (Spain), compared it with the health-based guideline values (HBGV), and identified the main dietary sources. The analysis included 533 preschoolers and 443 primary school children from the EPINED and ECLIPSES studies. Dietary intake of cadmium (Cd), methylmercury (MeHg), lead (Pb), inorganic arsenic (inAs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), dioxin-like polychlorinated biphenyls (DL-PCBs), and non-dioxin-like polychlorinated biphenyls (NDL-PCBs) was estimated using validated food frequency questionnaires and a database from the Catalan Agency for Food Safety. Preschoolers and primary school children exceeded the relevant reference value for InAs and DL-PCBs. Only preschoolers exceeded the limit for MeHg and PCDD/Fs. Cd, Pb, and NDL-PCBs intakes did not exceed the limits in either age group. Salted cereals/potatoes were the main source of InAs; fish for MeHg and DL-PCBs; and milk/yogurt for PCDD/Fs, followed by white fish in preschoolers and fatty fish in primary school children. The findings highlight that dietary exposure to some pollutants poses a significant risk to these children, emphasizing the need for public health policies to reduce pollutants in their diets.

Food biodiversity and gastrointestinal cancer risk in nine European countries: Analysis within a prospective cohort study

BACKGROUND

Food biodiversity in human diets has potential co-benefits for both public health and sustainable food systems. However, current evidence on the potential relationship between food biodiversity and cancer risk, and particularly gastrointestinal cancers typically related to diet, remains limited. This study evaluated how dietary species richness (DSR) was associated with gastrointestinal cancer risk in a pan-European population.

METHODS

Associations between DSR and subsequent gastrointestinal cancer risk were examined among 450,111 adults enrolled in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC, initiated in 1992), free of cancer at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires. DSR of an individual's yearly diet was calculated based on the absolute number of unique biological species in each food and drink item. Associations between DSR and cancer risk were assessed by multivariable Cox proportional hazards regression models.

FINDINGS

During a median follow-up time of 14.1 years (SD=3.9), 10,705 participants were diagnosed with gastrointestinal cancer. Hazard ratios (HRs) and 95 % confidence intervals (CIs) comparing overall gastrointestinal cancer risk in the highest versus lowest quintiles of DSR indicated inverse associations in multivariable-adjusted models [HR (95 % CI): 0.77 (0.69-0.87); P-value < 0·0001] (Table 2). Specifically, inverse associations were observed between DSR and oesophageal squamous cell carcinoma, proximal colon, colorectal, and liver cancer risk (p-trend<0.05 for all cancer types).

INTERPRETATION

Greater food biodiversity in the diet may lower the risk of certain gastrointestinal cancers. Further research is needed to replicate these novel findings and to understand potential mechanisms.

Association between dietary exposure to chemical contaminants and risk of dementia in older persons

BACKGROUND

Diet is a major route of exposure to potentially neurotoxic chemicals, yet the epidemiological association of diet contaminants with dementia is unknown. We studied the link between dietary exposure to multiple chemicals and dementia risk in older persons, considering interaction with dietary fat content, which may modify the bioavailability and toxicity of (lipophilic) chemicals.

METHODS

We included 1,288 non-demented participants from the French Three-City cohort who answered a food frequency questionnaire and 24-hour recall at baseline and were followed for incident dementia. Dietary exposure to 167 contaminants was assessed by combining food intakes with food chemical content from the French second Total Diet Study. We assessed the relation of each individual contaminant with dementia risk using multivariable-adjusted Cox models, exploring effect modification by high-fat diet (>35 % energy from fat). Among high-fat diet consumers, we looked for a signature of contaminants associated with dementia using elastic-net penalization and assess their joint effect.

RESULTS

Participants were 76 years-old on average at baseline and 62 % were women. In total, 314 individuals developed dementia over a median 10 years. No contaminant was associated with dementia in the whole population. However, having a high-fat diet was a strong effect modifier for 85 contaminants (FDR-corrected p < 0.05 for interactions) in single-chemical analyses, so that higher intakes were significantly associated with higher dementia risk among high-fat consumers only (n = 386). Among them, a multi-chemical approach revealed a signature of 9 contaminants related to dementia, including 4 perfluoroalkyl substances, 2 flame retardants hexabromocyclododecane (HBCDD) congeners, 2 mycotoxins, and nitrites. This selection included two top hits from the single-chemical analyses (α-HBCDD and perfluorooctanesulfonic acid [PFOS]), and was mainly provided by delicatessen meat, seafood and bread/crispbread.

CONCLUSION

In this large population-based study, dietary exposure to several chemicals was associated with higher dementia risk among older persons consuming > 35 % energy from fat in diet.

Early-life exposure to per- and polyfluoroalkyl substances: Analysis of levels, health risk and binding abilities to transport proteins

Per- and polyfluoroalkyl substances (PFAS) can pass through the placenta and adversely affect fetal development. However, there is a lack of comparison of legacy and emerging PFAS levels among different biosamples in pregnant women and their offspring. This study, based on the Shanghai Maternal-Child Pairs Cohort, analyzed the concentrations of 16 PFAS in the maternal serum, cord serum, and breast milk samples from 1,076 mother-child pairs. The placental and breastfeeding transfer efficiencies of PFAS were determined in maternal-cord and maternal-milk pairs, respectively. The binding affinities of PFAS to five transporters were simulated using molecular docking. The results suggested that PFAS were frequently detected in different biosamples. The median concentration of perfluorooctane sulfonate (PFOS) was the highest at 8.85 ng/mL, followed by perfluorooctanoic acid (PFOA) at 7.13 ng/mL and 6:2 chlorinated polyfluorinated ether sulfonate at 5.59 ng/mL in maternal serum. The median concentrations of PFOA were highest in cord serum (4.23 ng/mL) and breast milk (1.08 ng/mL). PFAS demonstrated higher placental than breastfeeding transfer efficiencies. The transfer efficiencies and the binding affinities of most PFAS to proteins exhibited alkyl chain length-dependent patterns. Furthermore, we comprehensively assessed the estimated daily intakes (EDIs) of PFAS in breastfeeding infants of different age groups and used the hazard quotient (HQ) to characterize the potential health risk. EDIs decreased with infant age, and PFOS had higher HQs than PFOA. These findings highlight the significance of considering PFAS exposure, transfer mechanism, and health risks resulting from breast milk intake in early life.

Pesticide residues and polyphenols in urine - A combined LC-HRMS screening to reveal intake patterns

Human exposure to pesticides in the general population occurs mainly through food consumption. However, specific dietary habits or food products that contribute to pesticide exposure are often unknown. In this study, we propose a combined screening for polyphenols and pesticide residues by liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS) to assess the diet and the associated pesticide exposure. We measured 587 urine samples from women around the 34th week of pregnancy of a prospective mother-child cohort. A non-targeted screening for flavonoid-like compounds related to fruit and vegetable consumption was performed, prioritizing 164 features and identifying a total of 46 features by spectral library search. Based on a subset of markers, k-means clustering was performed, leading to four clusters with presumably similar dietary habits. The clusters were compared against food questionnaire data collected within the period of sample collection. Suspect screening of more than 500 pesticide residues including metabolites was performed, with a total of 40 residues being reported for 27 different pesticides. The detection of pesticide residues was compared across the different clusters of dietary habits. Indications were found that pyrimethanil metabolites might be associated with the consumption of citrus fruits or derivate products. We demonstrate that the method used has the potential to reveal patterns of pesticide intake from specific food commodities.

Emerging technologies for the removal of pesticides from contaminated soils and their reuse in agriculture

Pesticides are becoming more prevalent in agriculture to protect crops and increase crop yields. However, nearly all pesticides used for this purpose reach non-target crops and remain as residues for extended periods. Contamination of soil by widespread pesticide use, as well as its toxicity to humans and other living organisms, is a global concern. This has prompted us to find solutions and develop alternative remediation technologies for sustainable management. This article reviews recent technological developments for remediating pesticides from contaminated soil, focusing on the following major points: (1) The application of various pesticide types and their properties, the sources of pesticides related to soil pollution, their transport and distribution, their fate, the impact on soil and human health, and the extrinsic and intrinsic factors that affect the remediation process are the main points of focus. (2) Sustainable pesticide degradation mechanisms and various emerging nano- and bioelectrochemical soil remediation technologies. (3) The feasible and long-term sustainable research and development approaches that are required for on-site pesticide removal from soils, as well as prospects for applying them directly in agricultural fields. In this critical analysis, we found that bioremediation technology has the potential for up to 90% pesticide removal from the soil. The complete removal of pesticides through a single biological treatment approach is still a challenging task; however, the combination of electrochemical oxidation and bioelectrochemical system approaches can achieve the complete removal of pesticides from soil. Further research is required to remove pesticides directly from soils in agricultural fields on a large-scale.

Association of diet with per- and polyfluoroalkyl substances in plasma and human milk in the New Hampshire Birth Cohort Study

Per- and polyfluoroalkyl substances (PFAS) are related to various adverse health outcomes, and food is a common source of PFAS exposure. Dietary sources of PFAS have not been adequately explored among U.S. pregnant individuals. We examined associations of dietary factors during pregnancy with PFAS concentrations in maternal plasma and human milk in the New Hampshire Birth Cohort Study. PFAS concentrations, including perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), and perfluorodecanoate (PFDA), were measured in maternal plasma collected at ∼28 gestational weeks and human milk collected at ∼6 postpartum weeks. Sociodemographic, lifestyle and reproductive factors were collected from prenatal questionnaires and diet from food frequency questionnaires at ∼28 gestational weeks. We used adaptive elastic net (AENET) to identify important dietary variables for PFAS concentrations. We used multivariable linear regression to assess associations of dietary variables selected by AENET models with PFAS concentrations. Models were adjusted for sociodemographic, lifestyle, and reproductive factors, as well as gestational week of blood sample collection (plasma PFAS), postpartum week of milk sample collection (milk PFAS), and enrollment year. A higher intake of fish/seafood, eggs, coffee, or white rice during pregnancy was associated with higher plasma or milk PFAS concentrations. For example, every 1 standard deviation (SD) servings/day increase in egg intake during pregnancy was associated with 4.4 % (95 % CI: 0.6, 8.4), 3.3 % (0.1, 6.7), and 10.3 % (5.6, 15.2) higher plasma PFOS, PFOA, and PFDA concentrations respectively. Similarly, every 1 SD servings/day increase in white rice intake during pregnancy was associated with 7.5 % (95 % CI: -0.2, 15.8) and 12.4 % (4.8, 20.5) greater milk PFOS and PFOA concentrations, respectively. Our study suggests that certain dietary factors during pregnancy may contribute to higher PFAS concentrations in maternal plasma and human milk, which could inform interventions to reduce PFAS exposure for both birthing people and offspring.

Associations among neighborhood walkability, metal exposure, and sex steroid hormone levels: Results from Hangzhou Birth Cohort Study Ⅱ

BACKGROUND

Neighborhood walkability may influence maternal-fetal exposure to environmental hazards and maternal-fetal health (e.g., fetal growth restriction, reproductive toxicity). However, few studies have explored the association between neighborhood walkability and hormones in pregnant women.

METHODS

We included 533 pregnant women from the Hangzhou Birth Cohort Study II (HBCS-II) with testosterone (TTE) and estradiol (E2) measured for analysis. Neighborhood walkability was evaluated by calculating a walkability index based on geo-coded addresses. Placental metals were measured using inductively coupled plasma mass spectrometry (ICP-MS). TTE and E2 levels in umbilical cord blood were measured using chemiluminescence microparticle immunoassay (CMIA). Linear regression model was used to estimate the relationship between the walkability index, placental metals, and sex steroid hormones. Effect modification was also assessed to estimate the effect of placental metals on the associations of neighborhood walkability with TTE and E2.

RESULTS

Neighborhood walkability was significantly linked to increased E2 levels (P trend=0.023). Compared with participants at the first quintile (Q1) of walkability index, those at the third quintiles (Q3) had lower chromium (Cr) levels (β = -0.212, 95% CI = -0.421 to -0.003). Arsenic (As), cobalt (Co), manganese (Mn), molybdenum (Mo), nickel (Ni), lead (Pb), antimony (Sb), selenium (Se), tin (Sn), and vanadium (V) were linked to decreased TTE levels, and cadmium (Cd) was linked to increased TTE levels. No metal was significantly associated with E2 levels in trend analysis. In the analysis of effect modification, the associations of neighborhood walkability with TTE and E2 were significantly modified by Mn (P = 0.005) and Cu (P = 0.049) respectively.

CONCLUSION

Neighborhood walkability could be a favorable factor for E2 production during pregnancy, which may be inhibited by maternal exposure to heavy metals.

Systematic evidence mapping of potential correlates of exposure for per- and poly-fluoroalkyl substances (PFAS) based on measured occurrence in biomatrices and surveys of dietary consumption and product use

Per- and poly-fluoroalkyl substances (PFAS) are widely observed in environmental media and often are found in indoor environments as well as personal-care and consumer products. Humans may be exposed through water, food, indoor dust, air, and the use of PFAS-containing products. Information about relationships between PFAS exposure sources and pathways and the amounts found in human biomatrices can inform source-contribution assessments and provide targets for exposure reduction. This work collected and collated evidence for correlates of PFAS human exposure as measured through sampling of biomatrices and surveys of dietary consumption and use of consumer products and articles. A systematic evidence mapping approach was applied to perform a literature search, conduct title-abstract and full-text screening, and to extract primary data into a comprehensive database for 16 PFAS. Parameters of interest included: sampling dates and locations, cohort descriptors, PFAS measured in a human biomatrix, information about food consumption in 11 categories, use of products/articles in 11 categories, and reported correlation values (and their statistical strength). The literature search and screening process yielded 103 studies with information for correlates of PFAS exposures. Detailed data were extracted and compiled on measures of PFAS correlations between biomatrix concentrations and dietary consumption and other product/article use. A majority of studies (61/103; 59%) were published after 2015 with few (8/103; 8%) prior to 2010. Studies were most abundant for dietary correlates (n = 94) with fewer publications reporting correlate assessments for product use (n = 56), while some examined both. PFOA and PFOS were assessed in almost all studies, followed by PFHxS, PFNA, and PFDA which were included in >50% of the studies. No relevant studies included PFNS or PFPeS. Among the 94 studies of dietary correlates, significant correlations were reported in 83% of the studies for one or more PFAS. The significant dietary correlations most commonly were for seafood, meats/eggs, and cereals/grains/pulses. Among the 56 studies of product/article correlates, significant correlations were reported in 70% of the studies. The significant product/article correlations most commonly were for smoking/tobacco, cosmetics/toiletries, non-stick cookware, and carpet/flooring/furniture and housing. Six of 11 product/article categories included five or fewer studies, including food containers and stain- and water-resistant products. Significant dietary and product/article correlations most commonly were positive. Some studies found a mix of positive and negative correlations depending on the PFAS, specific correlate, and specific response level, particularly for fats/oils, dairy consumption, food containers, and cosmetics/toiletries. Most of the significant findings for cereals/grains/pulses were negative correlations. Substantial evidence was found for correlations between dietary intake and biomatrix levels for several PFAS in multiple food groups. Studies examining product/article use relationships were relatively sparse, except for smoking/tobacco, and would benefit from additional research. The resulting database can inform further assessments of dietary and product use exposure relationships and can inform new research to better understand PFAS source-to-exposure relationships. The search strategy should be extended and implemented to support living evidence review in this rapidly advancing area.

Predictors of Serum Per- and Polyfluoroalkyl Substances Concentrations among U.S. Couples Attending a Fertility Clinic

Previous studies have examined the predictors of PFAS concentrations among pregnant women and children. However, no study has explored the predictors of preconception PFAS concentrations among couples in the United States. This study included 572 females and 279 males (249 couples) who attended a U.S. fertility clinic between 2005 and 2019. Questionnaire information on demographics, reproductive history, and lifestyles and serum samples quantified for PFAS concentrations were collected at study enrollment. We examined the PFAS distribution and correlation within couples. We used Ridge regressions to predict the serum concentration of each PFAS in females and males using data of (1) socio-demographic and reproductive history, (2) diet, (3) behavioral factors, and (4) all factors included in (1) to (3) after accounting for temporal exposure trends. We used general linear models for univariate association of each factor with the PFAS concentration. We found moderate to high correlations for PFAS concentrations within couples. Among all examined factors, diet explained more of the variation in PFAS concentrations (1-48%), while behavioral factors explained the least (0-4%). Individuals reporting White race, with a higher body mass index, and nulliparous women had higher PFAS concentrations than others. Fish and shellfish consumption was positively associated with PFAS concentrations among both females and males, while intake of beans (females), peas (male), kale (females), and tortilla (both) was inversely associated with PFAS concentrations. Our findings provide important data for identifying sources of couples' PFAS exposure and informing interventions to reduce PFAS exposure in the preconception period.

Recent Insights and Recommendations for Preventing Excessive Gestational Weight Gain

Recommendations for weight gain during pregnancy are based on pre-pregnancy body mass index (BMI). Pregnancy is a risk factor for excessive weight gain and many endocrine problems, making it difficult to return to pre-pregnancy weight and increasing the risk of postpartum obesity and, consequently, type 2 diabetes and metabolic syndrome. Both excessive gestational weight gain (EGWG) and obesity are associated with an increased risk of gestational hypertension, pre-eclampsia, gestational diabetes, cesarean section, shoulder dystocia, and neonatal macrosomia. In the long term, EGWG is associated with increased morbidity and mortality, particularly from diabetes, cardiovascular disorders, and some cancers. This study aims to present recommendations from various societies regarding weight gain during pregnancy, dietary guidance, and physical activity. In addition, we discuss the pathophysiology of this complication and the differential diagnosis in pregnant women with EGWG. According to our research, inadequate nutrition might contribute more significantly to the development of EGWG than insufficient physical activity levels in pregnant women. Telehealth systems seem to be a promising direction for future EGWG prevention by motivating women to exercise. Although the importance of adequate pre-pregnancy weight and weight gain during pregnancy is well known, an increasing number of women gain excessive weight during pregnancy.

Evaluation of Aflatoxins Occurrence and Exposure in Cereal-Based Baby Foods: An Update Review

PURPOSE OF REVIEW

The first stages of human life, which include the fetal period, infancy, and early childhood, are the most critical for human growth and development. This is the most vulnerable phase to health challenges due to the immature immune system and rapid development. Mycotoxins such as aflatoxins, ochratoxin A, patulin, fumonisins, zearalenone, and deoxynivalenol are secondary metabolites secreted by various fungal species, primarily Aspergillus, Fusarium, Penicillium, and Alternaria. Aflatoxins are one of the major mycotoxins produced in cereals and cereal-based foods by several species of Aspergillus, mainly Aspergillus flavus. In this context, this review provides a brief overview of the occurrence, exposure, legal regulations, and health effects of aflatoxins (B1, B2, G1, G2, and M1) in cereal-based baby foods and breast milk.

RECENT FINDINGS

Human aflatoxin exposure in utero and through breast milk, infant formulas, cereals, and cereal-based foods has been linked to various health consequences, including adverse birth outcomes, impaired growth and development, immune system suppression, and hepatic dysfunction. Recent evidence suggests that especially infants and children are more susceptible to aflatoxins due to their lower body weight, lowered capacity to detoxify harmful substances, more restrictive diet, immature metabolism and elimination, and faster rates of growth and development. It is essential for both food safety and infant and child health that aflatoxins in cereal and cereal-based products are precisely detected, detoxified, and managed.

Long-term exposure from perinatal life to food-grade TiO2 alters intestinal homeostasis and predisposes to food allergy in young mice

BACKGROUND

Food allergy (FA) is an inappropriate immunological response to food proteins resulting from an impaired induction of oral tolerance. Various early environmental factors can affect the establishment of intestinal homeostasis, predisposing to FA in early life. In this context, we aimed to assess the effect of chronic perinatal exposure to food-grade titanium dioxide (fg-TiO2 ), a common food additive.

METHODS

Dams were fed a control versus fg-TiO2 -enriched diet from preconception to weaning, and their progeny received the same diet at weaning. A comprehensive analysis of baseline intestinal and systemic homeostasis was performed in offspring 1 week after weaning by assessing gut barrier maturation and microbiota composition, and local and systemic immune system and metabolome. The effect of fg-TiO2 on the susceptibility of progeny to develop oral tolerance versus FA to cow's milk proteins (CMP) was performed starting at the same baseline time-point, using established models. Sensitization to CMP was investigated by measuring β-lactoglobulin and casein-specific IgG1 and IgE antibodies, and elicitation of the allergic reaction by measuring mouse mast cell protease (mMCP1) in plasma collected after an oral food challenge.

RESULTS

Perinatal exposure to fg-TiO2 at realistic human doses led to an increased propensity to develop FA and an impaired induction of oral tolerance only in young males, which could be related to global baseline alterations in intestinal barrier, gut microbiota composition, local and systemic immunity, and metabolism.

CONCLUSIONS

Long-term perinatal exposure to fg-TiO2 alters intestinal homeostasis establishment and predisposes to food allergy, with a clear gender effect.

Bread Consumption-Induced Heavy Metal Exposures and Health Risk Assessment of Pregnant Women: Turkey

Affordable, nutritious, and easily available bread has a significant place in the nutrition of pregnant women. This study aims to determine bread consumption-induced heavy metal exposure in pregnant women with different sociodemographic characteristics living in Turkey and to evaluate it for non-carcinogenic health risks. Bread consumption data of pregnant women covered a retrospective 24-h period. Heavy metal exposure was calculated according to the deterministic model. Non-carcinogenic health risk assessment was evaluated by target hazard quotient (THQ) and hazard index (HI). Bread consumption-induced Mn, Al, Cu, Ni, Pb, As, Cr, Co, Cd, and Hg exposures of all pregnant women (n = 446) were 44.0, 25.0, 6.62, 0.69, 0.15, 0.06, 0.04, 0.03, 0.03, and < 0.00 µg/kg bw/day, respectively. Bread consumption-induced Mn exposure was higher than the tolerable daily intake level. The HI (1.37 [Formula: see text] 1.71) related to bread consumption is greater than 1 in all pregnant women in different age groups and trimesters and bread consumption may cause some health concerns in terms of non-carcinogenic health risks for pregnant women. The bread consumption can be limited, but bread consumption should not be abandoned.

Prenatal dietary exposure to mixtures of chemicals is associated with allergy or respiratory diseases in children in the ELFE nationwide cohort

INTRODUCTION

Prenatal exposure to environmental chemicals may be associated with allergies later in life. We aimed to examine the association between prenatal dietary exposure to mixtures of chemicals and allergic or respiratory diseases up to age 5.5 y.

METHODS

We included 11,638 mother-child pairs from the French "Étude Longitudinale Française depuis l'Enfance" (ELFE) cohort. Maternal dietary exposure during pregnancy to eight mixtures of chemicals was previously assessed. Allergic and respiratory diseases (eczema, food allergy, wheezing and asthma) were reported by parents between birth and age 5.5 years. Associations were evaluated with adjusted logistic regressions. Results are expressed as odds ratio (OR[95%CI]) for a variation of one SD increase in mixture pattern.

RESULTS

Maternal dietary exposure to a mixture composed mainly of trace elements, furans and polycyclic aromatic hydrocarbons (PAHs) was positively associated with the risk of eczema (1.10 [1.05; 1.15]), this association was consistent across sensitivity analyses. Dietary exposure to one mixture of pesticides was positively associated with the risk of food allergy (1.10 [1.02; 1.18]), whereas the exposure to another mixture of pesticides was positively but slightly related to the risk of wheezing (1.05 [1.01; 1.08]). This last association was not found in all sensitivity analyses. Dietary exposure to a mixture composed by perfluoroalkyl acids, PAHs and trace elements was negatively associated with the risk of asthma (0.89 [0.80; 0.99]), this association was consistent across sensitivity analyses, except the complete-case analysis.

CONCLUSION

Whereas few individual chemicals were related to the risk of allergic and respiratory diseases, some consistent associations were found between prenatal dietary exposure to some mixtures of chemicals and the risk of allergic or respiratory diseases. The positive association between trace elements, furans and PAHs and the risk of eczema, and that between pesticides mixtures and food allergy need to be confirmed in other studies. Conversely, the negative association between perfluoroalkyl acids, PAHs and trace elements and the risk of asthma need to be further explored.

Tracing the Bioaccessibility of Per- and Polyfluoroalkyl Substances in Fish during Cooking Treatment

The effect of cooking on the contents of per- and polyfluoroalkyl substances (PFAS) in foods has been widely studied, but whether cooking-induced structural and chemical modifications in foods affect the oral bioaccessibility of PFAS remains largely unknown. In this study, three kinds of fishes with different fat contents were selected, and the bioaccessibility of PFAS during cooking treatment (steaming and frying) was evaluated using in vitro gastrointestinal simulation with gastric lipase addition. The results showed that related to their molecular structures, the bioaccessibility of an individual PFAS varied greatly, ranging from 26.0 to 108.1%. Cooking can reduce the bioaccessibility of PFAS, and steaming is more effective than oil-frying; one of the possible reasons for this result is that the PFAS is trapped in protein aggregates after heat treatment. Fish lipids and cooking oil ingested with meals exert different effects on the bioaccessibility of PFAS, which may be related to the state of the ingested lipid/oil and the degree of unsaturation of fatty acids. Gastric lipase boosted the release of long-chain PFAS during in vitro digestion, indicating that the degree of lipolysis considerably influences the bioaccessibility of hydrophobic PFAS. Estimated weekly PFAS intakes were recalibrated using bioaccessibility data, enabling more accurate and reliable dietary exposure assessments.

Associations between per- and polyfluoroalkyl substances, liver function, and daily alcohol consumption in a sample of U.S. adults

BACKGROUND AND AIM

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous in the environment and in the serum of the U.S.

POPULATION

We sought to evaluate the association of PFAS independently and jointly with alcohol intake on liver function biomarkers in a sample of the U.S. general population.

METHODS

Using data from the National Health and Nutrition Examination Survey (2003-2016; N = 11,794), we examined the five most historically prevalent PFAS with >75% detection rates. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between PFAS (quartiles and log-transformed continuous, ng/mL) and high levels (>95th percentile) of liver injury biomarkers using logistic regression models adjusted for key confounders. We evaluated interactions between PFAS and alcohol consumption and sex via stratified analyses and conducted sub-analyses adjusting for daily alcohol intake among those with available drinking history (N = 10,316).

RESULT

Serum perfluorooctanoic acid (PFOA) was positively associated with high levels of alanine transferase (ALT) without monotonic trend (ORQ4vsQ1 = 1.45, CI: 0.99-2.12; p-trend = 0.18), and with increased aspartate transaminase when modeled continuously (OR = 1.15, CI: 1.02-1.30; p-trend = 0.03). Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were both inversely associated with alkaline phosphatase while a trend was evident only for PFHxS (p = 0.02). A non-monotonic inverse association was observed with PFOA (p-trend = 0.10). The highest quartile of PFOS was associated with high total bilirubin (TB; ORQ4vsQ1 = 1.57, CI: 1.01-2.43, p-trend = 0.02). No significant associations were found between any PFAS and γ-glutamyl transpeptidase. We found no associations for perfluorodecanoic acid and perfluorononanoic acid. We observed some suggestive interactions with alcohol intake, particularly among heavy drinkers.

CONCLUSION

Consistent with other studies, serum levels of PFOA, PFHxS and PFNA were positively associated with high levels of ALT, and we also observed weak positive associations between some PFAS and TB. Associations observed among heavy drinkers warrant additional evaluation.

Construction, evaluation, and AOP framework-based application of the EpPRS as a genetic surrogate for assessing environmental pollutants

BACKGROUND

Environmental pollutant measurement is essential for accurate health risk assessment. However, the detection of humans' internal exposure to pollutants is cost-intensive and consumes time and energy. Polygenic risk scores (PRSs) have been widely applied in genetic studies of complex trait diseases. It is important to construct a genetically relevant environmental surrogate for pollutant exposure and to explore its utility for disease prediction and risk assessment.

OBJECTIVES

This study enrolled 714 individuals with complete genomic data and exposomic data on 22 plasma-persistent organic pollutants (POPs).

METHODS

We first conducted 22 POP genome-wide association studies (GWAS) and constructed the corresponding environmental pollutant-based PRS (EpPRS) by clumping and P value thresholding (C + T), lassosum, and PRS-CS methods. The best-fit EpPRS was chosen by its regression R2. An adverse outcome pathway (AOP) framework was developed to assess the effects of contaminants on candidate diseases. Furthermore, Mendelian randomization (MR) analysis was performed to explore the causal association between POPs and cancer risk.

RESULTS

The C + T method produced the best-performing EpPRSs for 7 PCBs and 4 PBDEs. EpPRSs replicated the correlations of environmental exposure measurements based on consistent patterns. The diagnostic performance of type 2 diabetes mellitus (T2DM) PRS was improved by the combined model of T2DM-EpPRS of PCB126/BDE153. Finally, the AKT1-mediated AOP framework illustrated that PCB126 and BDE153 may increase the risk of T2DM by decreasing AKT1 phosphorylation through the cGMP-PKG pathway and promoting abnormal glucose homeostasis. MR analysis showed that digestive system tumors, such as colorectal cancer and biliary tract cancer, are more sensitive to POP exposure.

CONCLUSIONS

EpPRSs can serve as a proxy for assessing pollutant internal exposure. The application of the EpPRS to disease risk assessment can reveal the toxic pathway and mode of action linking exposure and disease in detail, providing a basis for the development of environmental pollutant control strategies.

Hair and cord blood element levels and their relationship with air pollution, dietary intake, gestational diabetes mellitus, and infant neurodevelopment

BACKGROUND & AIMS

Exposure to a range of elements, air pollution, and specific dietary components in pregnancy has variously been associated with gestational diabetes mellitus (GDM) risk or infant neurodevelopmental problems. We measured a range of pregnancy exposures in maternal hair and/or infant cord serum and tested their relationship to GDM and infant neurodevelopment.

METHODS

A total of 843 pregnant women (GDM = 224, Non-GDM = 619) were selected from the Complex Lipids in Mothers and Babies cohort study. Forty-eight elements in hair and cord serum were quantified using inductively coupled plasma-mass spectrometry analysis. Binary logistic regression was used to estimate the associations between hair element concentrations and GDM risk, while multiple linear regression was performed to analyze the relationship between hair/cord serum elements and air pollutants, diet exposures, and Bayley Scales of infant neurodevelopment at 12 months of age.

RESULTS

After adjusting for maternal age, BMI, and primiparity, we observed that fourteen elements in maternal hair were associated with a significantly increased risk of GDM, particularly Ta (OR = 9.49, 95% CI: 6.71, 13.42), Re (OR = 5.21, 95% CI: 3.84, 7.07), and Se (OR = 5.37, 95% CI: 3.48, 8.28). In the adjusted linear regression model, three elements (Rb, Er, and Tm) in maternal hair and infant cord serum were negatively associated with Mental Development Index scores. For dietary exposures, elements were positively associated with noodles (Nb), sweetened beverages (Rb), poultry (Cs), oils and condiments (Ca), and other seafood (Gd). In addition, air pollutants PM2.5 (LUR) and PM10 were negatively associated with Ta and Re in maternal hair.

CONCLUSIONS

Our findings highlight the potential influence of maternal element exposure on GDM risk and infant neurodevelopment. We identified links between levels of these elements in both maternal hair and infant cord serum related to air pollutants and dietary factors.

Application of targeted maximum likelihood estimation in public health and epidemiological studies: a systematic review

PURPOSE

The targeted maximum likelihood estimation (TMLE) statistical data analysis framework integrates machine learning, statistical theory, and statistical inference to provide a least biased, efficient, and robust strategy for estimation and inference of a variety of statistical and causal parameters. We describe and evaluate the epidemiological applications that have benefited from recent methodological developments.

METHODS

We conducted a systematic literature review in PubMed for articles that applied any form of TMLE in observational studies. We summarized the epidemiological discipline, geographical location, expertize of the authors, and TMLE methods over time. We used the Roadmap of Targeted Learning and Causal Inference to extract key methodological aspects of the publications. We showcase the contributions to the literature of these TMLE results.

RESULTS

Of the 89 publications included, 33% originated from the University of California at Berkeley, where the framework was first developed by Professor Mark van der Laan. By 2022, 59% of the publications originated from outside the United States and explored up to seven different epidemiological disciplines in 2021-2022. Double-robustness, bias reduction, and model misspecification were the main motivations that drew researchers toward the TMLE framework. Through time, a wide variety of methodological, tutorial, and software-specific articles were cited, owing to the constant growth of methodological developments around TMLE.

CONCLUSIONS

There is a clear dissemination trend of the TMLE framework to various epidemiological disciplines and to increasing numbers of geographical areas. The availability of R packages, publication of tutorial papers, and involvement of methodological experts in applied publications have contributed to an exponential increase in the number of studies that understood the benefits and adoption of TMLE.

Prenatal dietary exposure to chemicals and allergy or respiratory diseases in children in the EDEN mother-child cohort

INTRODUCTION

Maternal exposure to food chemicals may increase the risk of allergy and respiratory disorders in offspring. We aimed to assess the association of prenatal dietary exposure to single chemicals and chemical mixtures with allergy or respiratory events reported before age 8 y in children.

METHODS

We included 1428 mother-child pairs enrolled in the EDEN mother-child cohort. Maternal dietary exposure to 209 chemicals and eight associated mixtures was investigated. Allergic and respiratory diseases (wheezing, asthma, allergic rhinitis, eczema and food allergy) were reported by parents between birth and age 8 y. Associations with the studied outcomes were evaluated with three approaches based on adjusted logistic regression, estimating odds ratios (ORs) and 95 % confidence intervals (CIs). First, food chemicals were considered individually, with correction for multiple testing. Second, chemicals selected by elastic net regression were considered simultaneously in a multiple exposure model. Third, predefined mixtures were introduced in the same adjusted logistic regression. Results are expressed as odds ratio (OR[95 % CI]).

RESULTS

Prenatal single exposure to 74 food chemicals was associated with higher risk of allergic rhinitis. Prenatal single exposure to 11 chemicals was associated with higher risk of wheezing. In the multi-exposure approach, risk of wheezing was associated with the pesticides diazinon and triadimenol, and polycyclic aromatic hydrocarbon 5-methylchrysene. Phytoestrogen resveratrol was negatively associated with lower risk of both wheezing and allergic rhinitis, and mycotoxin monoacetoxyscirpenol was negatively associated with risk of eczema. Finally, a chemical mixture composed mainly of trace elements, furans and polycyclic aromatic hydrocarbons, was associated with higher risk of allergic rhinitis (1.33 [1.02;1.73]).

CONCLUSION

Prenatal dietary exposure to chemicals was associated with risk of allergic rhinitis or wheezing up to age 8 y. A few chemicals were associated with other allergic and respiratory diseases. Larger prospective studies are needed to confirm these findings.

Environmental exposure to per- and perfluoroalkyl substances in early pregnancy and newborn anogenital distance: A prospective cohort study

Per- and polyfluoroalkyl substances (PFAS) are persistent, ubiquitous pollutants, and the current epidemiological evidence regarding the impact of in utero exposure to PFAS on anogenital distance (AGD) is limited and inconclusive. The primary aim of this study was to investigate the potential associations between maternal exposure to PFAS during pregnancy and AGD in newborns. A total of 2273 mother-child pairs were recruited for this study, and both PFAS levels and AGD were measured. Multiple linear regression models were utilized to explore the relationships between individual PFAS and AGD. Additionally, quantile-based g-computation (QGC) was employed to assess the joint effects of mixtures of PFAS on AGD. Our findings showed that maternal exposure to PFOS (β = 0.518, 95% CI: 0.093, 0.942), PFNA (β = 0.487, 95% CI: 0.037, 0.937), PFDA (β = 0.443, 95% CI: 0.048, 0.838), PFUA (β = 0.434, 95% CI: 0.031, 0.838), and PFBS (β = 0.444, 95% CI: 0.124, 0.763) during early pregnancy had a significant positive association with AGD in boys. Similarly, in girls, maternal exposure to PFOS (β = 0.423, 95% CI: 0.006, 0.841), PFNA (β = 0.641, 95% CI: 0.207, 1.074), PFDA (β = 0.670, 95% CI: 0.306, 1.033), PFUA (β = 0.895, 95% CI: 0.509, 1.281), and PFBS (β = 0.474, 95% CI: 0.178, 0.770) had a positive association with AGD, while PFOA (β = -1.254, 95% CI: -1.786, -0.723) had a negative association. QGC models further confirmed that PFAS mixtures were positively associated with AGD. Moreover, PFBS was the primary contributor to the joint effects of PFAS mixtures on AGD. In summary, our study has provided further corroboration for the possibility that PFAS exposure can have an impact on AGD in both boys and girls. The use of AGD as a promising biomarker for endocrine disruption highlights the significance of our findings, which may have valuable clinical implications for reproductive diseases.

Frequency of urinary pesticides in children: a scoping review

Pesticides are any mix of ingredients and substances used to eliminate or control unwanted vegetable or animal species recognized as plagues. Its use has been discussed in research due to the scarcity of strong scientific evidence about its health effects. International literature is still insufficient to establish a global recommendation through public policy. This study aims to explore international evidence of the presence of pesticides in urine samples from children and their effects on health through a scoping review based on the methodology described by Arksey and O'Malley. The number of articles resulting from the keyword combination was 454, and a total of 93 manuscripts were included in the results and 22 were complementary. Keywords included in the search were: urinary, pesticide, children, and childhood. Children are exposed to pesticide residues through a fruit and vegetable intake environment and household insecticide use. Behavioral effects of neural damage, diabetes, obesity, and pulmonary function are health outcomes for children that are commonly studied. Gas and liquid chromatography-tandem mass spectrometry methods are used predominantly for metabolite-pesticide detection in urine samples. Dialkylphosphates (DAP) are common in organophosphate (OP) metabolite studies. First-morning spot samples are recommended to most accurately characterize OP dose in children. International evidence in PubMed supports that organic diets in children are successful interventions that decrease the urinary levels of pesticides. Several urinary pesticide studies were found throughout the world's population. However, there is a knowledge gap that is important to address (public policy), due to farming activities that are predominant in these territories.

Association between gestational levels of toxic metals and essential elements and cerebral palsy in children

Introduction

Cerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children.

Methods

In a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses.

Results

The essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified.

Conclusion

Using mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

Maternal co-exposure to mercury and perfluoroalkyl acid isomers and their associations with child neurodevelopment in a Canadian birth cohort

BACKGROUND

Perfluoroalkyl acids (PFAAs) within the broader class of per- and polyfluoroalkyl substances (PFAS) are present in human serum as isomer mixtures, but epidemiological studies have yet to address isomer-specific associations with child development and behavior.

OBJECTIVES

To examine associations between prenatal exposure to 25 PFAAs, including perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) isomers, and child neurodevelopment among 490 mother-child pairs in a prospective Canadian birth cohort, the Alberta Pregnancy Outcomes and Nutrition (APrON) study. To consider the influence of a classic neurotoxicant, total mercury (THg), based on its likelihood of co-exposure with PFAAs from common dietary sources.

METHODS

Maternal blood samples were collected in the second trimester and child neurodevelopment was assessed at 2 years of age using the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III). Linear or curvilinear multiple regression models were used to examine associations between exposures and neurodevelopment outcomes.

RESULTS

Select PFAAs were associated with lower Cognitive composite scores, including perfluoroheptanoate (PFHpA) (β = -0.88, 95% confidence interval (CI): -1.7, -0.06) and perfluorododecanoate (PFDoA) (β = -2.0, 95% CI: -3.9, -0.01). Non-linear relationships revealed associations of total PFOS (β = -4.4, 95% CI: -8.3, -0.43), and linear-PFOS (β = -4.0, 95% CI: -7.5, -0.57) and 1m-PFOS (β = -1.8, 95% CI: -3.3, -0.24) isomers with lower Language composite scores. Although there was no effect modification, including THg interaction terms in PFAA models revealed negative associations between perfluorononanoate (PFNA) and Motor (β = -3.3, 95% CI: -6.2, -0.33) and Social-Emotional (β = -3.0, 95% CI: -5.6, -0.40) composite scores.

DISCUSSION

These findings reinforce previous reports of adverse effects of maternal PFAA exposure during pregnancy on child neurodevelopment. The unique hazards posed from isomers of PFOS justify isomer-specific analysis in future studies. To control for possible confounding, mercury co-exposure may be considered in studies of PFAAs.

Effects of preterm birth and postnatal exposure to metal mixtures on neurodevelopment in children at 24 months of age

The effects of early-life metal exposure on neurodevelopment in very low birth weight preterm (VLBMP) children (with a birth weight of <1500 g and a gestational age of <37 weeks) have not been clearly established. We aimed to investigate associations of childhood exposure to multiple metals and preterm low birth weight with neurodevelopment among children at 24 months of corrected age. VLBWP children (n = 65) and normal birth weight term (NBWT) children (n = 87) were enrolled from Mackay Memorial Hospital in Taiwan between December 2011 and April 2015. Lead (Pb), cadmium (Cd), arsenic (As), methylmercury (MeHg), and selenium (Se) concentrations in the hair and fingernails were analyzed as biomarkers for metal exposure. The Bayley Scale of Infant and Toddler Development, Third Edition, was used to determine neurodevelopment levels. VLBWP children had significantly lower scores in all development domains compared to NBWT children. We also investigated preliminary exposure levels of VLBWP children to metals as reference values for future epidemiological and clinical survey. Fingernails are a useful biomarker for metal exposure to evaluate the effects on neurological development. A multivariable regression analysis revealed that fingernail Cd concentrations were significantly negatively associated with cognition (β = -0.63, 95% confidence interval (CI): -1.17 to -0.08) and receptive language function (β = -0.43, 95% CI: -0.82 to -0.04) among VLBWP children. VLBWP children with a 10-μg/g increase in the As concentration in their nails had a 8.67-point lower composite score in cognitive ability and a 1.82-point lower score in gross-motor functions. Effects of preterm birth and postnatal exposure to Cd and As were associated with poorer cognitive, receptive language, and gross-motor abilities. VLBWP children are at risk for neurodevelopmental impairments when exposed to metals. Further large-scale studies are needed assess to the risk of neurodevelopmental impairments when vulnerable children are exposed to metal mixtures.

Environmental exposures in early-life and general health in childhood

BACKGROUND

Early-life environmental exposures are suspected to be involved in the development of chronic diseases later in life. Most studies conducted so far considered single or few exposures and single-health parameter. Our study aimed to identify a childhood general health score and assess its association with a wide range of pre- and post-natal environmental exposures.

METHODS

The analysis is based on 870 children (6-12 years) from six European birth cohorts participating in the Human Early-Life Exposome project. A total of 53 prenatal and 105 childhood environmental factors were considered, including lifestyle, social, urban and chemical exposures. We built a general health score by averaging three sub-scores (cardiometabolic, respiratory/allergy and mental) built from 15 health parameters. By construct, a child with a low score has a low general health status. Penalized multivariable regression through Least Absolute Shrinkage and Selection Operator (LASSO) was fitted in order to identify exposures associated with the general health score.

FINDINGS

The results of LASSO show that a lower general health score was associated with maternal passive and active smoking during pregnancy and postnatal exposure to methylparaben, copper, indoor air pollutants, high intake of caffeinated drinks and few contacts with friends and family. Higher child's general health score was associated with prenatal exposure to a bluespace near residency and postnatal exposures to pets, cobalt, high intakes of vegetables and more physical activity. Against our hypotheses, postnatal exposure to organochlorine compounds and perfluorooctanoate were associated with a higher child's general health score.

CONCLUSION

By using a general health score summarizing the child cardiometabolic, respiratory/allergy and mental health, this study reinforced previously suspected environmental factors associated with various child health parameters (e.g. tobacco, air pollutants) and identified new factors (e.g. pets, bluespace) warranting further investigations.

Urinary Glyphosate Concentrations among Pregnant Participants in a Randomized, Crossover Trial of Organic and Conventional Diets

BACKGROUND

Consumption of an organic diet reduces exposure to a range of agricultural pesticides. Only three studies have examined the effect of an organic diet intervention on exposure to the herbicide glyphosate, the most heavily used agricultural chemical in the world. Despite its widespread use, the primary sources of glyphosate exposure in humans are poorly understood.

OBJECTIVE

Our objective was to examine the effect of an organic diet intervention on urinary glyphosate concentrations among pregnant individuals.

METHODS

We conducted a 2-wk randomized crossover trial in which 39 pregnant participants living near (≤ 0.5 km ) and far (> 0.5 km ) from agricultural fields received a 1-wk supply of conventional groceries and 1 wk of organic groceries, randomized to order. We collected daily first morning void urine samples and analyzed composite samples from each week for glyphosate. We examined differences in urinary glyphosate concentrations between the conventional week and the organic week among all participants and stratified by residential proximity to an agricultural field.

RESULTS

Median specific gravity-adjusted glyphosate concentrations were 0.19 μ g / L and 0.16 μ g / L during the conventional and organic weeks, respectively. We observed modest decreases in urinary glyphosate concentrations from the conventional to organic week among far-field participants, but no difference among near-field participants. In secondary analyses excluding participants who did not meet a priori criteria of compliance with the intervention, we observed significant decreases in urinary glyphosate concentrations, particularly among far-field participants (p < 0.01 - 0.02 , depending on exclusion criteria).

DISCUSSION

This trial is the first to examine the effect of an organic diet intervention on glyphosate among people living near and far from agricultural fields. Our results suggest that diet is an important contributor to glyphosate exposure in people living > 0.5 km from agricultural fields; for people living near crops, agriculture may be a dominant exposure source during the pesticide spray season. https://doi.org/10.1289/EHP12155.

Early-life exposure to endocrine-disrupting chemicals and autistic traits in childhood and adolescence: a systematic review of epidemiological studies

Aims

Exposure to endocrine-disrupting chemicals (EDCs) during critical neurodevelopmental windows has been associated with the risk of autistic traits. This systematic review of epidemiological studies examined the association between maternal exposure to EDCs during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.

Methods

We searched PubMed, Web of Science, Scopus, and Google Scholar from inception to November 17, 2022, for studies investigating the association between prenatal exposure to EDCs and outcomes related to ASD. Two independent reviewers screened studies for eligibility, extracted data, and assessed the risk of bias. The review was registered in PROSPERO (CRD42023389386).

Results

We included 27 observational studies assessing prenatal exposure to phthalates (8 studies), polychlorinated biphenyls (8 studies), organophosphate pesticides (8 studies), phenols (7 studies), perfluoroalkyl substances (6 studies), organochlorine pesticides (5 studies), brominated flame retardants (3 studies), dioxins (1 study), and parabens (1 study). The number of examined children ranged from 77 to 1,556, the age at the assessment of autistic traits ranged from 3 to 14 years, and most studies assessed autistic traits using the Social Responsiveness Scale. All but one study was considered to have a low risk of bias. Overall, there was no association between maternal exposure to specific ECDs during pregnancy and the occurrence of autistic traits in offspring.

Conclusions

Findings from the epidemiological studies evaluated here do not support an association between prenatal exposure to ECDs and the likelihood of autistic traits in later in life. These findings should not be interpreted as definitive evidence of the absence of neurodevelopment effects of EDCs affecting ASD risk, given the limitations of current studies such as representative exposure assessment, small sample sizes, inadequacy to assess sexually dimorphic effects, or the effects of EDC mixtures. Future studies should carefully address these limitations.

Periconceptional diet quality and its relation to blood heavy metal concentrations among pregnant women: The Japan environment and Children's study

BACKGROUND

Diets contain toxic chemical contaminants as well as essential nutrients, both of which influence the intrauterine environment for foetal growth. However, whether a high-quality diet that is nutritionally healthy also results in lower exposure to chemical contaminants is unknown.

OBJECTIVE

We examined associations between periconceptional maternal diet quality and circulating concentrations of heavy metals during pregnancy.

DESIGN

Dietary intake over the year prior to the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81,104 pregnant Japanese women who participated in the Japan Environment and Children's Study. Overall diet quality was determined using the Balanced Diet Score (BDS) based on the Japanese Food Guide Spinning Top, the Healthy Eating Index-2015 (HEI-2015), the Dietary Approaches to Stop Hypertension (DASH) score and the Mediterranean diet score (MDS). We measured whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) during the second or third trimester of pregnancy.

RESULTS

After controlling for confounders, all diet quality scores were positively associated with blood Hg concentrations. By contrast, higher BDS, HEI-2015 and DASH scores were associated with lower concentrations of Pb and Cd. Although the MDS was positively associated with concentrations of Pb and Cd, when dairy products were classified as a beneficial (rather than detrimental) food component, these associations were attenuated.

CONCLUSION

A high-quality diet may reduce exposure to Pb and Cd but not Hg. Further studies are required to determine the optimal balance between mercury exposure risk and nutritional benefits of high-quality diets prior to pregnancy.

Maternal Serum, Cord and Human Milk Levels of Per- and Polyfluoroalkyl Substances (PFAS), Association with Predictors and Effect on Newborn Anthropometry

BACKGROUND

The understanding of per- and polyfluoroalkyl substances (PFAS) health effects is rapidly advancing among critical populations. Therefore, the objective of this study was to assess PFAS serum levels among Lebanese pregnant women, cord serum and human milk levels, their determinants, and effects on newborn anthropometry.

METHODS

We measured concentrations of six PFAS (PFHpA, PFOA, PFHxS, PFOS, PFNA and PFDA) using liquid chromatography MS/MS for 419 participants, of which 269 had sociodemographic, anthropometric, environmental and dietary information.

RESULTS

The percentage of detection for PFHpA, PFOA, PFHxS and PFOS was 36.3-37.7%. PFOA and PFOS levels (95th percentile) were higher than HBM-I and HBM-II values. While PFAS were not detected in cord serum, five compounds were detected in human milk. Multivariate regression showed that fish/shellfish consumption, vicinity to illegal incineration and higher educational level were associated with an almost twice higher risk of elevated PFHpA, PFOA, PFHxS and PFOS serum levels. Higher PFAS levels in human milk were observed with higher eggs and dairy products consumption, in addition to tap water (preliminary findings). Higher PFHpA was significantly associated with lower newborn weight-for-length Z-score at birth.

CONCLUSIONS

Findings establish the need for further studies, and urgent action to reduce exposure among subgroups with higher PFAS levels.

Nutrition paves the way to environmental toxicants and influences fetal development during pregnancy

Nutrition plays a major role in the healthy pregnancy and development of the fetus. In addition, nutrition can expose humans to a wide range of potentially hazardous environmental constituents, such as organic pollutants and heavy metals from marine or agricultural food products while processing, producing, and packaging. Humans constantly face these constituents through air, water, soil, food, and domestic products. During pregnancy, the rate of cellular division and differentiation is higher; exposure to any of these environmental toxicants can lead to developmental defects as they cross the placental barrier and, in some cases, can harm the successive generation too, as some contaminants can act on the reproductive cells of the fetus (Diethylstilbestrol). Pregnant women are considered a vulnerable population to food contaminant exposure and require a proper dietary chart and conscious food choices. Food is a source of both essential nutrients and environmental toxicants. Here, we have researched the possible toxicants of the food industry and their influence on the fetus's in-utero development, along with the importance of dietary interventions and the need to balance a healthy diet to overcome the harms. The cumulative exposure to environmental toxicants can influence the mother's prenatal environment and affect the fetus's development.

Determinants of maternal and neonatal PFAS concentrations: a review

Per- and polyfluoroalkyl substances (PFAS) are used for their properties such as stain and water resistance. The substances have been associated with adverse health outcomes in both pregnant mothers and infants, including pre-eclampsia and low birthweight. A growing body of research suggests that PFAS are transferred from mother to fetus through the placenta, leading to in utero exposure. A systematic review was performed using the PubMed database to search for studies evaluating determinants of PFAS concentrations in blood matrices of pregnant mothers and neonates shortly after birth. Studies were included in this review if an observational study design was utilized, exposure to at least one PFAS analyte was measured, PFAS were measured in maternal or neonatal matrices, at least one determinant of PFAS concentrations was assessed, and results such as beta estimates were provided. We identified 35 studies for inclusion in the review and evaluated the PFAS and determinant relationships among the factors collected in these studies. Parity, breastfeeding history, maternal race and country of origin, and household income had the strongest and most consistent evidence to support their roles as determinants of certain PFAS concentrations in pregnant mothers. Reported study findings on smoking status, alcohol consumption, and pre-pregnancy body mass index (BMI) suggest that these factors are not important determinants of PFAS concentrations in pregnant mothers or neonates. Further study into informative factors such as consumer product use, detailed dietary information, and consumed water sources as potential determinants of maternal or neonatal PFAS concentrations is needed. Research on determinants of maternal or neonatal PFAS concentrations is critical to estimate past PFAS exposure, build improved exposure models, and further our understanding on dose-response relationships, which can influence epidemiological studies and risk assessment evaluations. Given the potential for adverse outcomes in pregnant mothers and neonates exposed to PFAS, it is important to identify and understand determinants of maternal and neonatal PFAS concentrations to better implement public health interventions in these populations.

Dietary and maternal sociodemographic determinants of perfluoroalkyl and polyfluoroalkyl substance levels in pregnant women

Diet, including drinking water, and demographic characteristics have been associated with PFAS exposure levels in the general population. But data in pregnant women are scarce. We aimed to examine the PFAS levels in relation to these factors in early pregnancy and included 2545 pregnant women in early pregnancy from the Shanghai Birth Cohort. Ten PFAS were measured using high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) in plasma samples at around 14 weeks of gestation. Geometric mean (GM) ratios were used to estimate the associations between demographic characteristics, food intake and source of drinking water and concentrations of nine PFAS with a detection rate of at least 70%, and the total perfluoroalkyl carboxylic acids (∑PFCA), perfluoroalkyl sulfonic acids (∑PFSA) and all the PFAS concentrations (∑PFAS). Median concentrations of plasma PFAS ranged from 0.03 ng/mL for PFBS to 11.56 ng/mL for PFOA. In the multivariable linear models, maternal age, parity, parental education level, marine fish, freshwater fish, shellfish, shrimps, crabs, animal kidneys, animal liver, eggs, and bone soup in early pregnancy were positively associated with plasma concentrations of certain PFAS. Whereas pre-pregnancy BMI, plant-based foods, and drinking bottled water were negatively associated with some PFAS concentrations. In summary, this study suggested that fish and seafood, animal offal, and high-fat foods (eggs and bone soup) were significant sources of PFAS. PFAS exposure may be reduced by consuming more plant-based foods and potential interventions, such as drinking water treatment.

Exposure to non-persistent pesticides and sexual maturation of Spanish adolescent males

BACKGROUND

Several non-persistent pesticides are endocrine disrupting chemicals and may impact on sexual maturation.

OBJECTIVE

To examine the association between urinary biomarkers of non-persistent pesticides and sexual maturation in adolescent males in the Environment and Childhood (INMA) Project.

METHODS

The metabolites of several pesticides were measured in spot urine samples collected from 201 boys aged 14-17 years, including: 3,5,6-trichloro-2-pyridinol (TCPy), metabolite of chlorpyrifos; 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPy), metabolite of diazinon; malathion diacid (MDA), metabolite of malathion; diethyl thiophosphate (DETP) and diethyl dithiophosphate, non-specific metabolites of organophosphates; 3-phenoxybenzoic acid (3-PBA) and dimethyl cyclopropane carboxylic acid, metabolites of pyrethroids; 1-naphthol (1-NPL), metabolite of carbaryl; and ethylene thiourea (ETU), metabolite of dithiocarbamate fungicides. Sexual maturation was assessed using Tanner stages, self-reported Pubertal Development Scale, and testicular volume (TV). Multivariate logistic regression was employed to examine associations between urinary pesticide metabolites and the odds of being in Tanner stage 5 of genital development (G5) or pubic hair growth (PH5); stage ≥4 of overall pubertal development, gonadarche, and adrenarche; or having mature TV (≥25 mL).

RESULTS

DETP concentrations>75th percentile (P75) were associated with lower odds of being in stage G5 (OR = 0.27; 95% CI = 0.10-0.70), detectable TCPy with lower odds of gonadal stage≥4 (OR = 0.50; 95% CI = 0.26-0.96), and intermediate detectable MDA concentrations (<P75) with lower odds of adrenal stage≥4 (OR = 0.32; 95% CI = 0.11-0.94). Conversely, detectable concentrations of 1-NPL were associated with higher odds of adrenal stage≥4 (OR = 2.61; 95% CI = 1.30-5.24) but lower odds of mature TV (OR = 0.42; 95% CI = 0.19-0.90).

CONCLUSION

Exposure to certain pesticides may be associated with delayed sexual maturity in adolescent males.

Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Childhood Autism-related Outcomes

BACKGROUND

Epidemiologic evidence linking prenatal exposure to per- and polyfluoroalkyl substances (PFAS) with altered neurodevelopment is inconclusive, and few large studies have focused on autism-related outcomes. We investigated whether blood concentrations of PFAS in pregnancy are associated with child autism-related outcomes.

METHODS

We included 10 cohorts from the National Institutes of Health (NIH)-funded Environmental influences on Child Health Outcomes (ECHO) program (n = 1,429). We measured 14 PFAS analytes in maternal blood collected during pregnancy; eight analytes met detection criteria for analysis. We assessed quantitative autism-related traits in children via parent report on the Social Responsiveness Scale (SRS). In multivariable linear models, we examined relationships of each PFAS (natural log-transformed) with SRS scores. We further modeled PFAS as a complex mixture using Bayesian methods and examined modification of these relationships by child sex.

RESULTS

Most PFAS in maternal blood were not associated with child SRS T-scores. Perfluorononanoic acid (PFNA) showed the strongest and most consistent association: each 1-unit increase in ln-transformed PFNA was associated with greater autism-related traits (adjusted β [95% confidence interval (CI)] = 1.5 [-0.1, 3.0]). The summed mixture, which included six PFAS detected in >70% of participants, was not associated with SRS T-scores (adjusted β [95% highest posterior density interval] = 0.7 [-1.4, 3.0]). We did not observe consistent evidence of sex differences.

CONCLUSIONS

Prenatal blood concentrations of PFNA may be associated with modest increases in child autism-related traits. Future work should continue to examine the relationship between exposures to both legacy and emerging PFAS and additional dimensional, quantitative measures of childhood autism-related outcomes.

Co-variate adjusted associations between serum concentrations of selected perfluoroalkyl substances and urinary concentrations of selected arsenic species

Data from National Health and Nutrition Examination Survey for 2011-2012 were used to estimate associations of the serum concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluoroundecanoic acid (PFUnDA), and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (Me-PFOSA) with urinary concentrations of total arsenic (UAS), inorganic arsenic (IAS), arsenobetaine (UAB), and dimethyl arsinic acid (UDMA) among US adults aged >  = 20 years. Concentrations of PFNA were positively associated with all four arsenic variables but statistical significance was observed for IAS only (β = 0.33364, P = 0.04). Concentrations of PFDA were positively associated with UAS (β = 0.20688, P = 0.01), IAS (β = 0.23712, P = 0.02), and UAB (β = 0.26049, P = 0.02). Concentrations of PFUnDA were positively associated with UAS (β = 0.49946, P < 0.01), IAS (β = 0.51782, P < 0.01), UAB (β = 0.62924, P < 0.01), and UDMA (β = 0.26375, P < 0.01). Concentrations of Me-PFOSA with PFAS were inversely associated with every PFAS but statistical significance was observed for UDMA only (β =  - 0.05613, P = 0.03). PFOA, PFHxS, and PFOS were, in general, negatively associated with concentrations of all four arsenic variables but without reaching statistical significance. Positive associations of PFDA, PFNA, and PFUnDA with arsenic necessitate investigation about impact of the co-exposure of these PFAS with arsenic and their impact on health. Fluorinated carbon chain length > 8 as opposed to ≤ 8 may have a role in defining associations of PFAS with arsenic.

Nutritional Modulation of Associations between Prenatal Exposure to Persistent Organic Pollutants and Childhood Obesity: A Prospective Cohort Study

BACKGROUND

Prenatal exposure to persistent organic pollutants (POPs) may contribute to the development of childhood obesity and metabolic disorders. However, little is known about whether the maternal nutritional status during pregnancy can modulate these associations.

OBJECTIVES

The main objective was to characterize the joint associations and interactions between prenatal levels of POPs and nutrients on childhood obesity.

METHODS

We used data from to the Spanish INfancia y Medio Ambiente-Environment and Childhood (INMA) birth cohort, on POPs and nutritional biomarkers measured in maternal blood collected at the first trimester of pregnancy and child anthropometric measurements at 7 years of age. Six organochlorine compounds (OCs) [dichlorodiphenyldichloroethylene, hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH) and polychlorinated biphenyls 138, 153, 180] and four per- and polyfluoroalkyl substances (PFAS) were measured. Nutrients included vitamins (D, B12, and folate), polyunsaturated fatty acids (PUFAs), and dietary carotenoids. Two POPs-nutrients mixtures data sets were established: a) OCs, PFAS, vitamins, and carotenoids (n=660), and b) OCs, PUFAs, and vitamins (n=558). Joint associations of mixtures on obesity were characterized using Bayesian kernel machine regression (BKMR). Relative importance of biomarkers and two-way interactions were identified using gradient boosting machine, hierarchical group lasso regularization, and BKMR. Interactions were further characterized using multivariate regression models in the multiplicative and additive scale.

RESULTS

Forty percent of children had overweight or obesity. We observed a positive overall joint association of both POPs-nutrients mixtures on overweight/obesity risk, with HCB and vitamin B12 the biomarkers contributing the most. Recurrent interactions were found between HCB and vitamin B12 across screening models. Relative risk for a natural log increase of HCB was 1.31 (95% CI: 1.11, 1.54, pInteraction=0.02) in the tertile 2 of vitamin B12 and in the additive scale a relative excess risk due to interaction of 0.11 (95% CI: 0.02, 0.20) was found. Interaction between perfluorooctane sulfonate and β-cryptoxanthin suggested a protective effect of the antioxidant on overweight/obesity risk.

CONCLUSION

These results support that maternal nutritional status may modulate the effect of prenatal exposure to POPs on childhood overweight/obesity. These findings may help to develop a biological hypothesis for future toxicological studies and to better interpret inconsistent findings in epidemiological studies. https://doi.org/10.1289/EHP11258.

Periconceptional maternal diet quality influences blood heavy metal concentrations and their effect on low birth weight: the Japan Environment and Children's Study

BACKGROUND

Both poor maternal nutrition and toxic heavy metal exposure influence foetal growth and development. However, whether consumption of a variety of healthy foods modifies the association between prenatal heavy metal exposure and foetal growth is unknown.

OBJECTIVE

We examined whether long-term maternal diet quality in periconception modifies the associations between maternal circulating concentrations of heavy metals and foetal growth.

DESIGN

Data of 72,317 Japanese women who delivered singleton infants was extracted from the Japan Environment and Children's Study. Maternal diet over a 1-year before the first trimester of pregnancy was assessed using a validated food frequency questionnaire, and overall diet quality was determined using the balanced diet score based on the Japanese Food Guide Spinning Top. Maternal whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) were measured during the second/third trimester of pregnancy. Bayesian inference of multiple linear regression analysis was performed to evaluate the relationships between maternal diet quality and the blood concentrations of heavy metals; Bayesian logistic regression was used to analyse the risk of low birth weight (LBW; <2,500 g).

RESULTS

After controlling for confounders, a high maternal balanced diet score was associated with low concentrations of blood Pb and Cd and high Hg. While all heavy metals assessed were positively associated with LBW risk, a higher maternal balanced diet score was negatively associated with LBW risk. A high-quality maternal diet attenuated the effect of Pb on LBW, an effect that was more marked at high blood Pb concentrations.

CONCLUSION

A high-quality, 'well-balanced' diet prior to conception may reduce exposure to some heavy metals and mitigate the elevated risk of LBW associated with prenatal Pb exposure in Japanese mother-child pairs.

Dietary predictors of prenatal per- and poly-fluoroalkyl substances exposure

BACKGROUND

Per- and poly-fluoroalkyl substances (PFAS) are commonly detected in a variety of foods and food packaging materials. However, few studies have examined diet as a potential source of PFAS exposure during pregnancy. In the present cross-sectional study, we examined prenatal PFAS levels in relation to self-reported consumption of meats, dairy products, and processed foods during pregnancy.

METHODS

Participants were enrolled in the Chemicals in Our Bodies study, a demographically diverse pregnancy cohort in San Francisco, CA (N = 509). Diet was assessed using a self-reported interview questionnaire administered during the second trimester. Participants were asked on average how many times a day, week, or month they ate 11 different foods since becoming pregnant. Responses were categorized as at least once a week or less than once a week and foods were grouped into three categories: processed foods, dairy products, and meats. Twelve PFAS (ng/mL) were measured in second trimester serum samples. We investigated relationships between consumption of individual dairy products, meats, and processed foods and natural log-transformed PFAS using separate linear regression models adjusted for maternal age, education, race/ethnicity, and nativity.

RESULTS

Seven PFAS were detected in ≥65% of participants. Consumption of dairy milk and cheese at least once per week was moderately associated with elevated levels of perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDeA) relative to those who ate dairy products less than once week. The strongest associations observed were with PFDeA for dairy milk (β = 0.2, 95% confidence interval [CI] = 0.02, 0.39) and PFNA for cheese (β = 0.22, 95% CI = 0.02, 0.41). Eating fish, poultry, and red meat at least once per week was associated with higher levels of perfluoroundecanoic acid, PFDeA, PFNA, and perflucorooctane sulfonic acid.

CONCLUSIONS

Results indicate that consumption of animal products may contribute to elevated prenatal PFAS levels.

Childhood exposure to non-persistent pesticides and pubertal development in Spanish girls and boys: Evidence from the INMA (Environment and Childhood) cohort

This study assessed cross-sectional associations between urinary metabolites of non-persistent pesticides and pubertal development in boys and girls from urban and rural areas in Spain and examined effect modification by body mass index (BMI). Four metabolites of insecticides (TCPy, metabolite of chlorpyrifos; IMPy, metabolite of diazinon; DETP, non-specific metabolite of organophosphates; 3-PBA, metabolite of pyrethroids) and the metabolite of ethylene-bis-dithiocarbamate fungicides (ETU) were quantified in urine collected in 2010-2016 from 7 to 11-year-old children (606 girls, 933 boys) participating in the INMA Project. Pubertal development was ascertained by Tanner stages and/or parent-reported Pubertal Development Scale (PDS). Associations between pesticide metabolites and odds of being in stage 2+ for breast development (girls), genital development (boys), pubic hair growth (girls and boys), and/or overall puberty onset, gonadarche, and adrenarche (PDS for girls and boys) were examined by mixed-effect logistic regression. Effect modification by BMI was explored by interaction terms and stratified analysis. In girls, DETP and ETU concentrations>75th percentile (P75) were associated with higher odds of overall puberty development (OR [95%CI] = 1.86 [1.07-3.24] and 1.71 [1.03-2.83], respectively, for > P75 vs. undetected concentrations), while ETU > P75 was also associated with higher odds of breast development (OR [95%CI] = 5.55 [2.83-12.91]), particularly in girls with underweight/normal weight (OR [95%CI] = 10.08 [2.62-38.76]). In boys, detection of TCPy (40%) and 3-PBA (34%) was associated with higher odds of genital development (OR [95%CI] = 1.97 [1.08-3.57] and 2.08 [1.15-3.81], respectively), and the association with 3-PBA was observed in boys with overweight/obesity alone. In addition, ETU > P75 was associated with higher odds of genital development in boys with underweight/normal weight (OR [95%CI] = 2.89 [1.08-7.74]) but higher DETP with lower odds of puberty in boys with overweight/obesity (OR [95%CI] = 0.94 [0.89-0.99] per log-unit increase in concentration). Results suggest an association of childhood exposure to ETU and certain insecticides with earlier puberty in girls and boys that may be modified by child BMI.

Determinants of organophosphorus pesticide urinary metabolite levels in pregnant women from the CHAMACOS cohort

Organophosphosphorus pesticides (OPs) are widely used as insecticides in agriculture. Human exposure to OPs has been linked to adverse effects including poorer child neurodevelopment, reduced birth weight, altered serum hormone levels, and reduced semen quality. We measured six OP dialkyl phosphate (DAP) metabolites [three dimethyl alkylphosphates (DMs) and three diethyl alkylphosphates (DEs)] in urine samples collected two times during pregnancy (~13 and ~26 weeks gestation) from 594 women participating in the CHAMACOS birth cohort study and resided in an agricultural community in the United States (U.S.) between 1999 and 2000. Previous studies have shown these women have higher OP exposures compared with the general U.S. population. We examined bivariate associations between prenatal DAP metabolite levels and exposure determinants such as age, season, years living in the US, housing characteristics, fruit and vegetable consumption, occupation and residential proximity to agricultural fields. Final multivariable models indicated that season of urine collection was significantly associated (p < 0.01) with specific gravity-adjusted DM, DE and total DAP metabolites; samples collected in fall and winter had higher concentrations than those collected in spring-summer. Specific gravity-adjusted levels of DM and total DAP metabolites were significantly higher in women who had resided in the U.S. for 5 years or less (p < 0.05). Levels of DM metabolites also increased with daily fruit and vegetable servings (p < 0.01), and levels of DE metabolites were higher in residences with poorer housekeeping quality (p < 0.01) and in mothers that worked in agriculture (p < 0.05). These findings suggest that there are multiple determinants of OP exposure in pregnant women.

Polychlorinated biphenyls alter hepatic m6A mRNA methylation in a mouse model of environmental liver disease

Exposure to polychlorinated biphenyls (PCBs) has been associated with liver injury in human cohorts and with nonalcoholic steatohepatitis (NASH) in mice fed a high fat diet (HFD). N (6)-methyladenosine (m6A) modification of mRNA regulates transcript fate, but the contribution of m6A modification on the regulation of transcripts in PCB-induced steatosis and fibrosis is unknown. This study tested the hypothesis that PCB and HFD exposure alters the levels of m6A modification in transcripts that play a role in NASH in vivo. Male C57Bl6/J mice were fed a HFD (12 wks) and administered a single oral dose of Aroclor1260, PCB126, or Aroclor1260 + PCB126. Genome-wide identification of m6A peaks was accomplished by m6A mRNA immunoprecipitation sequencing (m6A-RIP) and the mRNA transcriptome identified by RNA-seq. Exposure of HFD-fed mice to Aroclor1260 decreased the number of m6A peaks and m6A-containing genes relative to PCB vehicle control whereas PCB126 or the combination of Aroclor1260 + PCB126 increased m6A modification frequency. ∼41% of genes had one m6A peak and ∼49% had 2-4 m6A peaks. 117 m6A peaks were common in the four experimental groups. The Aroclor1260 + PCB126 exposure group showed the highest number (52) of m6A-peaks. qRT-PCR confirmed enrichment of m6A-containing fragments of the Apob transcript with PCB exposure. A1cf transcript abundance, m6A peak count, and protein abundance was increased with Aroclor1260 + PCB126 co-exposure. Irrespective of the PCB type, all PCB groups exhibited enriched pathways related to lipid/lipoprotein metabolism and inflammation through the m6A modification. Integrated analysis of m6A-RIP-seq and mRNA-seq identified 242 differentially expressed genes (DEGs) with increased or reduced number of m6A peaks. These data show that PCB exposure in HFD-fed mice alters the m6A landscape offering an additional layer of regulation of gene expression affecting a subset of gene responses in NASH.

Prenatal mercury exposure, fish intake and child emotional behavioural regulation in the Norwegian Mother, Father and Child Cohort Study

Objective

While maternal fish consumption in pregnancy has consistently been linked to better cognitive and emotional outcomes in children, fish is also a primary source of exposure to methyl mercury (MeHg), which has been linked to poorer child cognitive outcomes. The aim of this study was to evaluate the associations between MeHg exposure, using calculated MeHg exposure from maternal diet and total mercury (Hg) concentration in maternal blood during pregnancy, and child internalising and externalising behaviours at 3 and 5 years of age.

Design and participants

The study sample comprised 51 238 mother-child pairs in the Norwegian Mother, Father and Child Cohort Study. Data on maternal blood Hg concentration in gestational week 18 were available for a sub-sample of 2936 women. Maternal MeHg exposure from diet was calculated from a validated Food Frequency Questionnaire answered in mid-pregnancy. Mothers reported children's emotional behaviour at age 3 and 5 years by questionnaires including twenty items from the Child Behaviour Checklist. Longitudinal associations were examined using generalised estimating equations, adjusted for potential confounders and stratified by maternal fish intake.

Results

Maternal blood Hg concentration (median=1.02 µg/L, 90th percentile=2.22, range=0-13.8) was not associated with emotional behaviour in children. Increasing dietary MeHg intake (median 0.15 µg/kg body weight/week, 90th percentiles=0.31, range=0-1.86) was significantly associated with lower internalising β=-0.03 (95% CI -0.05 to -0.00) and externalising child behaviours β=-0.04 (95% CI -0.07 to -0.02) in adjusted models. The inverse associations were also apparent when stratifying by low/high maternal fish intake (<400 and ≥400 g/week).

Conclusions

The results indicated that prenatal MeHg exposure, well below the weekly tolerable intake established by European Food Safety Authority (1.3 µg/kg bw), did not adversely affect child emotional regulation. Children of mothers consuming fish regularly were less likely to show signs of emotional behavioural problems.

Phthalate and bisphenol a exposures during pregnancy: Findings from the National Children's Study

Maternal exposure to phthalates and bisphenol A (BPA) during pregnancy can result in many adverse offspring health outcomes. Exposure to phthalates and BPA can vary depending on consumption of certain foods, some of which may vary by race/ethnicity. This study relates urine phthalate and BPA concentrations to sociodemographic and diet data. Concentrations of bisphenol A (BPA) and 11 phthalate metabolites were measured from spot urine at the third trimester visit of a sample of 485 pregnant women from the National Children's Study Vanguard Study Pilot data from seven U.S. cities. At the same time, food frequency questionnaires (FFQ) using the Diet*Calc software were obtained from 313 (65%) participants to assess dietary behavior. Overall, phthalate metabolites were highest among Hispanic women, particularly mBP, miBP, and mECPP, and these disparities were not explained by diet. Participants who did not attend college had higher concentrations of mBP, mBzP, mEP, and miBP, and lower mCOP. These disparities were also not explained by diet. The causes for these disparities should be further studied to reduce potential negative health outcomes associated with phthalate exposure for children of Hispanic or non-college educated women.

Cross-sectional and longitudinal associations between urinary arsenic and lung function among urban Chinese adults

To investigate the associations of arsenic exposure with lung function and ventilatory impairment. The repeated-measures study was developed with 8479 observations from three study periods of the Wuhan-Zhuhai cohort. Urinary arsenic and lung function were measured during each period. Linear mixed models were used to estimate the cross-sectional and longitudinal relationships between urinary arsenic and lung function. Logistic regression models and COX regression models were used to evaluate the cross-sectional and longitudinal associations between urinary arsenic and ventilatory impairment, respectively. In the cross-sectional analysis, each 1-unit increase in log-transformed urinary arsenic was associated with a -22.499 mL (95 % confidence interval (CI): -35.832 to -9.165), -15.081 mL (-25.205 to -4.957), and -0.274 % (-0.541 to -0.007) change in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC, respectively. In the longitudinal analysis, each 1-unit increase in log-transformed urinary arsenic was associated with an annual change rate of -6.240 mL/year (95 % CI: -12.429 to -0.051), -5.855 mL/year (-10.632 to -1.079), and -0.143 %/year (-0.234 to -0.051) in FVC, FEV1, and FEV1/FVC, respectively. Stratified analyses suggested a modification role of gender on the cross-sectional and longitudinal associations between urinary arsenic and FEV1, with the stronger associations were found among males (P for modification 0.0384 and 0.0168). Furtherly, each 1-unit increase in log-transformed urinary arsenic was associated with a 14.8 % (odds ratio 1.148, 95 % CI: 1.043 to 1.263) and 11.7 % (hazard ratio 1.117, 95 % CI: 1.023 to 1.218) increase in the prevalent and incident risk of restrictive ventilatory impairment, respectively. Source analyses suggested that fish intake and fine particulate matter inhalation positively associated with the total arsenic levels. In conclusion, arsenic exposure was associated with lung function decline and the risk of restrictive ventilatory impairment.

Occurrence and health implications of heavy metals in preschool children's clothing manufactured in four Asian regions

Clothing may be a potential contributor to body metal burden in children. However, available information on heavy metals in children's clothing is extremely limited and the associated health risks remain poorly understood. This study investigated the concentrations of Pb, Cd, Co, Zn, Cr, As, Cu and Ni in new preschool children's clothing manufactured in four Asian regions. The children's clothing had higher levels of Ni and Cr but lower levels of Pb and Cd in comparison to the concentrations reported in other textile products. The concentrations of Cd were higher in the black clothing than those in the white and color samples. The non-cotton samples contained higher Co concentrations. The Pb concentrations in the samples manufactured in China were significantly higher than those in the other three regions. We estimated the dermal exposure doses for these metals and calculated the associated risks. The results indicated that the health risks from exposure to these metals in the children's clothing were acceptable. However, more research is required to investigate heavy metals and the associated risks in child clothing due to the increasing complexity of their materials and manufacturing processes.

Determinants of phthalate exposures in pregnant women in New York City

Previous studies have provided data on determinants of phthalates in pregnant women, but results were disparate across regions. We aimed to identify the food groups and demographic factors that predict phthalate exposure in an urban contemporary pregnancy cohort in the US. The study included 450 pregnant women from the New York University Children's Health and Environment Study in New York City. Urinary concentrations of 22 phthalate metabolites, including metabolites of di-2-ethylhexylphthalate (DEHP), were determined at three time points across pregnancy by liquid chromatography coupled with tandem mass spectrometry. The Diet History Questionnaire II was completed by pregnant women at mid-pregnancy to assess dietary information. Linear mixed models were fitted to examine determinants of urinary phthalate metabolite concentrations. Using partial-linear single-index (PLSI) models, we assessed the major contributors, among ten food groups, to phthalate exposure. Metabolites of DEHP and its ortho-phthalate replacement, diisononyl phthalate (DiNP), were found in >90% of the samples. The sum of creatinine-adjusted DiNP metabolite concentrations was higher in older and single women and in samples collected in summer. Hispanic and non-Hispanic Black women had lower urinary concentrations of summed metabolites of di-n-octyl phthalate (DnOP), but higher concentrations of low molecular weight phthalates compared with non-Hispanic White women. Each doubling of grain products consumed was associated with a 20.9% increase in ∑DiNP concentrations (95%CI: 4.5, 39.9). PLSI models revealed that intake of dried beans and peas was the main dietary factor contributing to urinary ∑DEHP, ∑DiNP, and ∑DnOP levels, with contribution proportions of 76.3%, 35.8%, and 27.4%, respectively. Urinary metabolite levels of phthalates in pregnant women in NYC varied by age, marital status, seasonality, race/ethnicity, and diet. These results lend insight into the major determinants of phthalates levels, and may be used to identify exposure sources and guide interventions to reduce exposures in susceptible populations.