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Sarzo B, Ballester F, Soler-Blasco R, Sunyer J, Lopez-Espinosa MJ, Ibarluzea J, Lozano M, Julvez J, Iriarte G, Subiza-Perez M, González-Safont L, Fernández-Somoano A, Vallejo-Ortega J, Guxens M, López-González UA, Riaño-Galán I, Riutort-Mayol G, Murcia M, Llop S. The impact of prenatal mercury on neurobehavioral functioning longitudinally assessed from a young age to pre-adolescence in a Spanish birth cohort. ENVIRONMENTAL RESEARCH 2024; 252:118954. [PMID: 38631469 DOI: 10.1016/j.envres.2024.118954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
The objective is to investigate the relation between cord blood mercury concentrations and child neurobehavioural functioning assessed longitudinally during childhood until pre-adolescence. METHODS The study involves mothers and their offspring engaged in the Spanish INMA birth cohort (n = 1147). Total mercury (THg) was determined in cord blood. Behavioural problems were assessed several times during childhood using the ADHD-DSM-IV at age 4, SDQ at ages 7 and 11, CPRS-R:S and the CBCL at ages 7, 9 and 11. Covariates were obtained through questionnaires during the whole period. Multivariate generalised negative binomial (MGNB) models or mixed-effects MGNB (for those tests with information at one or more time points, respectively) were used to investigate the relation between cord blood THg and the children's punctuations. Models were adjusted for prenatal fish intake. Effect modification by sex, prenatal and postnatal fish intake, prenatal fruit and vegetable intake, and maternal polychlorinated biphenyl concentrations (PCBs) was assessed by interaction terms. RESULTS The geometric mean ± standard deviation of cord blood THg was 8.22 ± 2.19 μg/L. Despite adjusting for fish consumption, our results did not show any statistically significant relationship between prenatal Hg and the children's performance on behavioural tests conducted between the ages of 4 and 11. Upon assessing the impact of various factors, we observed no statistically significant interaction. CONCLUSION Despite elevated prenatal THg exposure, no association was found with children's behavioural functioning assessed from early childhood to pre-adolescence. The nutrients in fish could offset the potential neurotoxic impact of Hg. Further birth cohort studies with longitudinal data are warranted.
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Affiliation(s)
- Blanca Sarzo
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain
| | - Ferran Ballester
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain
| | - Raquel Soler-Blasco
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain.
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Maria-Jose Lopez-Espinosa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain
| | - Jesus Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, San Sebastian, Spain; BioGipuzkoa Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Manuel Lozano
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine Department, University of Valencia, Valencia, Spain
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Clinical and Epidemiological Neuroscience (Neuroèpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Gorka Iriarte
- Public Health Laboratory of Euskadi (Headquarters of Araba) (LSPPV), Basque Country, Spain
| | - Mikel Subiza-Perez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, San Sebastian, Spain; BioGipuzkoa Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, BD9 6RJ, Bradford, United Kingdom
| | - Llúcia González-Safont
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
| | - Jorge Vallejo-Ortega
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | | | - Isolina Riaño-Galán
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain; Servicio de Pediatría. Endocrinología pediátrica. HUCA. Oviedo. Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Gabriel Riutort-Mayol
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Department of Computer Science, Aalto University, Finland
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Program and Policy Evaluation Service, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-University of Valencia, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Rosa MJ, Foppa Pedretti N, Goldson B, Mathews N, Merced-Nieves F, Xhani N, Bosquet Enlow M, Gershon R, Ho E, Huddleston K, Wright RO, Wright RJ, Colicino E. Integrating Data Across Multiple Sites in the Northeastern United States to Examine Associations Between a Prenatal Metal Mixture and Child Cognition. Am J Epidemiol 2024; 193:606-616. [PMID: 37981721 DOI: 10.1093/aje/kwad233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
We applied a novel hierarchical Bayesian weighted quantile sum (HBWQS) regression to combine data across 3 study sites to examine associations between prenatal exposure to metals and cognitive functioning in childhood. Data from 326 mother-child dyads enrolled in an ongoing cohort study, the Programming of Intergenerational Stress Mechanisms (PRISM) Study, based in New York, New York (recruitment in 2013-2020) and Boston, Massachusetts (recruitment 2011-2013), and the First Thousand Days of Life (FTDL) cohort study (recruitment 2012-2019), based in northern Virginia, were used. Arsenic, cadmium, manganese, lead, and antimony were measured in urine collected during pregnancy. Cognitive functioning was assessed in children aged 3-11 years using the National Institutes of Health Toolbox Cognition Battery. The HBWQS regression showed a negative association between the urinary metal mixture and the Cognition Early Childhood Composite Score in the PRISM New York City (β = -3.67, 95% credible interval (CrI): -7.61, -0.01) and FTDL (β = -3.76, 95% CrI: -7.66, -0.24) samples, with a similar trend in the PRISM Boston sample (β = -3.24, 95% CrI: -6.77, 0.144). We did not detect these associations in traditionally pooled models. HBWQS regression allowed us to account for site heterogeneity and detect associations between prenatal metal-mixture exposure and cognitive outcomes in childhood. Given the ubiquity of metals exposure, interventions aimed at reducing prenatal exposure may improve cognitive outcomes in children. This article is part of a Special Collection on Environmental Epidemiology.
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Grandjean P, Meddis A, Nielsen F, Beck IH, Bilenberg N, Goodman CV, Hu H, Till C, Budtz-Jørgensen E. Dose dependence of prenatal fluoride exposure associations with cognitive performance at school age in three prospective studies. Eur J Public Health 2024; 34:143-149. [PMID: 37798092 PMCID: PMC10843960 DOI: 10.1093/eurpub/ckad170] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Fluoride may be a developmental neurotoxicant at elevated exposures. We merged new data from a prospective Odense Child Cohort (OCC) with results from two previous birth cohort studies from Mexico and Canada to characterize the dose-effect relationship in greater detail. METHODS The OCC contributed 837 mother-child pairs to the total of >1500. We measured creatinine-adjusted urine-fluoride concentrations in maternal urine samples obtained during late pregnancy. Child IQ was determined at age 7 years using an abbreviated version of the Wechsler Intelligence Scales for Children. Findings from the three cohorts were used to calculate the joint benchmark concentration (BMC) and the lower confidence limit (BMCL) after adjustment for covariables. RESULTS In the OCC, urine-fluoride concentrations varied between 0.08 and 3.04 mg/l (median 0.52 mg/l) but were not significantly associated with full-scale IQ at age 7 years (β = 0.08; 95% confidence interval -1.14 to 1.30 for a doubling in exposure). No difference was apparent between boys and girls. In the OCC, the BMC was 0.92 mg/l, with a BMCL of 0.30 mg/l. The joint analysis of all three cohorts showed a statistically significant association between urine-fluoride and IQ, with a BMC of 0.45 mg/l (BMCL, 0.28 mg/l), slightly higher than the BMC previously reported for the two North American cohorts alone. CONCLUSIONS As the BMCL reflects an approximate threshold for developmental neurotoxicity, the results suggest that pregnant women and children may need protection against fluoride toxicity.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Iben H Beck
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Psychiatry, Odense University Hospital, Odense, Denmark
| | - Carly V Goodman
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | - Howard Hu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christine Till
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
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Lane JM, Liu SH, Pantic I, Martinez-Medina S, Téllez-Rojo MM, Amarasiriwardena C, Wright RO. Sex-specific association between prenatal manganese exposure and working memory in school-aged children in Mexico city: An exploratory multi-media approach. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 333:121965. [PMID: 37286025 PMCID: PMC10527609 DOI: 10.1016/j.envpol.2023.121965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/11/2023] [Accepted: 06/04/2023] [Indexed: 06/09/2023]
Abstract
It remains unclear whether manganese (Mn) exposure affects working memory (WM) in a sexually dimorphic manner. Further, no gold standard media exists to measure Mn, suggesting a combined blood and urinary Mn index may better capture the totality of exposure. We investigated the modification effect of child sex on the influence of prenatal Mn exposure on WM in school-age children, exploring two methodological frameworks to integrate exposure estimates across multiple exposure biomarkers. Leveraging the PROGRESS birth cohort in Mexico City, children (N = 559) ages 6-8 completed the between errors and strategy measures of the CANTAB Spatial Working Memory (SWM) task. Mn levels were assayed in blood and urine of mothers during the 2nd and 3rd trimesters and in umbilical cord blood from mothers and children at delivery. Weighted quantile sum regression estimated the association of a multi-media biomarker (MMB) mixture with SWM. We applied a confirmatory factor analysis to similarly quantify a latent blood Mn burden index. We then used an adjusted linear regression to estimate the Mn burden index with SWM measures. Interaction terms were used to estimate the modification effect by child sex for all models. Results showed that the between-errors-specific MMB mixture (i.e., this model demonstrates the impact of the MMB mixture on the between-error scores.) was associated (β = 6.50, 95% CI: 0.91, 12.08) with fewer between errors for boys and more between errors for girls. The strategy-specific MMB mixture (i.e., this model demonstrates the impact of the MMB mixture on the strategy scores) was associated (β = -1.36, 95% CI: 2.55, - 0.18) with less efficient strategy performance for boys and more efficient strategy performance for girls. A higher Mn burden index was associated (β = 0.86, 95% CI: 0.00, 1.72) with more between errors in the overall sample. The vulnerability to prenatal Mn biomarkers on SWM differs in the directionality by child sex. An MMB mixture and composite index of body burden are stronger predictors than a single biomarker for Mn exposure on WM performance.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Sandra Martinez-Medina
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Politis MD, Yao M, Gennings C, Tamayo-Ortiz M, Valvi D, Kim-Schulze S, Qi J, Amarasiriwardena C, Pantic I, Tolentino MC, Estrada-Gutierrez G, Greenberg JH, Téllez-Rojo MM, Wright RO, Sanders AP, Rosa MJ. Prenatal Metal Exposures and Associations with Kidney Injury Biomarkers in Children. TOXICS 2022; 10:692. [PMID: 36422900 PMCID: PMC9699100 DOI: 10.3390/toxics10110692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
Prenatal exposure to arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) may be nephrotoxic, yet limited studies have examined subclinical kidney injury biomarkers in children. We assessed whether metal exposure in the second trimester (2T), a crucial time of kidney development, is associated with altered urine kidney injury and function biomarkers in preadolescent children. Analyses included 494 children participating in a birth cohort study in Mexico City. Concentrations of As, Cd, and Pb were measured from pregnant women in 2T blood and urine, and Hg in urine only. Kidney biomarkers were measured from children in urine at age 8-12 years. We assessed the associations between individual metals and (1) kidney biomarkers using linear regression and (2) a multi-protein kidney mixture using weighted quantile sum (WQS) regression. Associations of separate urine and blood metal mixtures with individual kidney biomarkers were assessed via WQS. Within the multi-protein mixture, the association with increased urinary As was predominated by urine alpha-1-microglobulin (A1M), interferon gamma-induced protein 10 (IP10), and fatty acid binding protein 1; the association with increased urinary Cd was predominated by A1M, clusterin, and albumin. The urine metal mixture was associated with increased albumin (0.23 ng/mL; 95% confidence interval (CI): 0.10, 0.37), IP10 (0.15 ng/mL; 95% CI: 0.02, 0.28), and cystatin C (0.17 ng/mL; 95% CI: 0.04, 0.31); these associations were mainly driven by urinary As and Cd. We observed null associations between prenatal blood or urine metal mixtures and estimated glomerular filtration rate. Higher prenatal urinary metals, individually and as a mixture were associated with altered kidney injury biomarkers in children. Further research and longer participant follow-up are required to ascertain the risk of kidney disease later in life.
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Affiliation(s)
- Maria D. Politis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Meizhen Yao
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City 06600, Mexico
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Seunghee Kim-Schulze
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Oncological Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jingjing Qi
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ivan Pantic
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City 06600, Mexico
| | - Mari Cruz Tolentino
- Department of Nutrition, National Institute of Perinatology, Mexico City 06600, Mexico
| | | | - Jason H. Greenberg
- Department of Pediatrics, Section of Nephrology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Martha M. Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Alison P. Sanders
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Grandjean P, Hu H, Till C, Green R, Bashash M, Flora D, Tellez-Rojo MM, Song PX, Lanphear B, Budtz-Jørgensen E. A Benchmark Dose Analysis for Maternal Pregnancy Urine-Fluoride and IQ in Children. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:439-449. [PMID: 34101876 PMCID: PMC9831700 DOI: 10.1111/risa.13767] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/30/2021] [Accepted: 05/22/2021] [Indexed: 05/11/2023]
Abstract
As a guide to establishing a safe exposure level for fluoride exposure in pregnancy, we applied benchmark dose modeling to data from two prospective birth cohort studies. We included mother-child pairs from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort in Mexico and the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort in Canada. Maternal urinary fluoride concentrations (U-F, in mg/L, creatinine-adjusted) were measured in urine samples obtained during pregnancy. Children were assessed for intelligence quotient (IQ) at age 4 (n = 211) and between six and 12 years (n = 287) in the ELEMENT cohort, and three to four years (n = 407) in the MIREC cohort. We calculated covariate-adjusted regression coefficients and their standard errors to assess the association of maternal U-F concentrations with children's IQ measures. Assuming a benchmark response of 1 IQ point, we derived benchmark concentrations (BMCs) and benchmark concentration levels (BMCLs). No deviation from linearity was detected in the dose-response relationships, but boys showed lower BMC values than girls. Using a linear slope for the joint cohort data, the BMC for maternal U-F associated with a 1-point decrease in IQ scores was 0.31 mg/L (BMCL, 0.19 mg/L) for the youngest boys and girls in the two cohorts, and 0.33 mg/L (BMCL, 0.20 mg/L) for the MIREC cohort and the older ELEMENT children. Thus, the joint data show a BMCL in terms of the adjusted U-F concentrations in the pregnant women of approximately 0.2 mg/L. These results can be used to guide decisions on preventing excess fluoride exposure in pregnant women.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- Address correspondence to Philippe Grandjean, Environmental Medicine, University of Southern Denmark, J.B. Winslows vej 17A, 5000 Odense C, Denmark; tel: +45 6550 3769; fax: +45 6591 1458;
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Rivka Green
- Faculty of Health, York University, Ontario, Canada
| | - Morteza Bashash
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - David Flora
- Faculty of Health, York University, Ontario, Canada
| | - Martha Maria Tellez-Rojo
- Centro de Investigacion en Salud Poblacional, Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico
| | - Peter X.K. Song
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
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Nephrotoxic Metal Mixtures and Preadolescent Kidney Function. CHILDREN-BASEL 2021; 8:children8080673. [PMID: 34438564 PMCID: PMC8391795 DOI: 10.3390/children8080673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/16/2022]
Abstract
Exposure to metals including lead (Pb), cadmium (Cd), and arsenic (As), may impair kidney function as individual toxicants or in mixtures. However, no single medium is ideal to study multiple metals simultaneously. We hypothesized that multi-media biomarkers (MMBs), integrated indices combining information across biomarkers, are informative of adverse kidney function. Levels of Pb, Cd, and As were quantified in blood and urine in 4–6-year-old Mexican children (n = 300) in the PROGRESS longitudinal cohort study. We estimated the mixture effects of these metals, using weighted quantile sum regression (WQS) applied to urine biomarkers (Umix), blood biomarkers (Bmix), and MMBs, on the cystatin C-based estimated glomerular filtration rate (eGFR) and serum cystatin C assessed at 8–10 years of age, adjusted for covariates. Quartile increases in Umix and the MMB mixture were associated with 2.5% (95%CI: 0.1, 5.0) and 3.0% (95%CI: 0.2, 5.7) increased eGFR and −2.6% (95% CI: −5.1%, −0.1%) and −3.3% (95% CI: −6.5%, −0.1%) decreased cystatin C, respectively. Weights indicate that the strongest contributors to the associations with eGFR and serum cystatin C were Cd and Pb, respectively. MMBs detected mixture effects distinct from associations with individual metals or media-type, highlighting the benefits of incorporating information from multiple exposure media in mixtures analyses.
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Chen Y, Qu J, Sun S, Shi Q, Feng H, Zhang Y, Cao S. Health risk assessment of total exposure from cadmium in South China. CHEMOSPHERE 2021; 269:128673. [PMID: 33268088 DOI: 10.1016/j.chemosphere.2020.128673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 06/12/2023]
Abstract
Heavy metal pollution and hazards are a global major concern. Heavy metals can be directly or indirectly harmful to humans through ingestion, inhalation, and deraml. According to the literature survey, cadmium (Cd) total exposure assessment and health risk assessment were performed in a population group from South China. Results showed that the Cd contents in PM2.5 and vegetables exceeded national standard limits. The same sources of Cd pollution contributed to different media; the main sources were artificial industrial activities such as electroplating, mining and smelting. The average daily dose of Cd via ingestion exceeded the provisional tolerable monthly intake proposed by the Joint Expert Committee on Food Additives (JECFA). Multimedia exposure via all three pathways followed the order 0-5-year-old children (3.26 × 10-3 mg kg-1·d-1)>6-17-year-old children (1.46 × 10-3 mg kg-1·d-1)>adults (1.18 × 10-3 mg kg-1·d-1). The exposure from point source pollution was quite different from the results for nonpoint sources. Ingestion was the exposure pathway that contributes the largest proportion of multipathway and multimedia total exposure, accounting for over 99% of the total exposure in different populations. Staple foods, vegetables and meat were the three main exposure media for ingestion. The hazard quotients of multipathway and multimedia exposure to Cd in different populations were 5.57, 2.87 and 2.26, respectively, all at unacceptable risk levels. This study highlights the importance of multipathway and multimedia in the health risk assessment of heavy metal exposure in South China, and provides risk management measures to reduce noncarcinogenic health risks.
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Affiliation(s)
- Yuefang Chen
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China; Key Laboratory of Industrial Pollutant Resource Treatment, Beijing, 100083, China.
| | - Jinyan Qu
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China
| | - Shanwei Sun
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China
| | - Qingyun Shi
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China
| | - Huimin Feng
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China
| | - Yuqi Zhang
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science & Technology Beijing, Beijing, 100083, China; Key Laboratory of Industrial Pollutant Resource Treatment, Beijing, 100083, China
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9
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Levin-Schwartz Y, Claus Henn B, Gennings C, Coull BA, Placidi D, Horton MK, Smith DR, Lucchini RG, Wright RO. Integrated measures of lead and manganese exposure improve estimation of their joint effects on cognition in Italian school-age children. ENVIRONMENT INTERNATIONAL 2021; 146:106312. [PMID: 33395951 PMCID: PMC7785864 DOI: 10.1016/j.envint.2020.106312] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 05/22/2023]
Abstract
Every day humans are exposed to mixtures of chemicals, such as lead (Pb) and manganese (Mn). An underappreciated aspect of studying the health effects of mixtures is the role that the exposure biomarker media (blood, hair, etc.) may play in estimating the effects of the mixture. Different biomarker media represent different aspects of each chemical's toxicokinetics, thus no single medium can fully capture the toxicokinetic profile for all the chemicals in a mixture. A potential solution to this problem is to combine exposure data across different media to derive integrated estimates of each chemical's internal concentration. This concept, formalized as a multi-media biomarker (MMB) has proven effective for estimating the health impacts of Pb exposure, but may also be useful to estimate mixture effects, such as the joint effects of metals like Pb and Mn, while factoring in how the association changes based upon the biomarker media. Levels of Pb and Mn were quantified in five media: blood, hair, nails, urine, and saliva in the Public Health Impact of Metals Exposure (PHIME) project, a study of Italian adolescents aged 10-14 years. MMBs were derived for both metals using weighted quantile sum (WQS) regression across the five media. Age-adjusted Wechsler Intelligence Scale for Children (WISC) IQ scores, measured at the same time as the exposure measures, were the primary outcome and models were adjusted for sex and socioeconomic status. The levels Pb and Mn were relatively low, with median blood Pb of 1.27 (IQR: 0.84) μg/dL and median blood Mn of 1.09 (IQR: 0.45) μg/dL. Quartile increases in a Pb-Mn combination predicted decreased Full Scale IQ of 1.9 points (95% CI: 0.3, 3.5) when Pb and Mn exposure levels were estimated using MMBs, while individual regressions for each metal were not associated with Full Scale IQ. Additionally, a quartile increase in the WQS index of Pb and Mn, measured using MMBs, were associated with reductions in Verbal IQ by 2.8 points (1.0, 4.5). Weights that determine the contributions of the metals to the joint effect highlighted that the contribution of the Pb-Mn was 72-28% for Full Scale IQ and 42-58% for Verbal IQ. We found that the joint effects of Pb and Mn are strongly affected by the medium used to measure exposure and that the joint effects of the Pb and Mn MMBs on cognition were the stronger than any individual biomarker. Thus, increase power and accuracy for measuring mixture effects compared to individual biomarkers. As the number of chemicals in mixtures increases, appropriate biomarker selection will become increasingly important and MMBs are a natural way to reduce bias in such analyses.
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Affiliation(s)
- Yuri Levin-Schwartz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA.
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Donatella Placidi
- Occupational and Environmental Health, University of Brescia, Brescia, Italy
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Donald R Smith
- Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA; Occupational and Environmental Health, University of Brescia, Brescia, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
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Grandjean P, Hu H, Till C, Green R, Bashash M, Flora D, Tellez-Rojo MM, Song P, Lanphear B, Budtz-Jørgensen E. A Benchmark Dose Analysis for Maternal Pregnancy Urine-Fluoride and IQ in Children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.10.31.20221374. [PMID: 33173917 PMCID: PMC7654913 DOI: 10.1101/2020.10.31.20221374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
As a safe exposure level for fluoride in pregnancy has not been established, we used data from two prospective studies for benchmark dose modeling. We included mother-child pairs from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort in Mexico and the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort in Canada. Children were assessed for IQ at age 4 (n=211) and between 6 and 12 years (n=287) in the ELEMENT cohort and between ages 3 and 4 years (n=512) in the MIREC cohort. We calculated covariate-adjusted regression coefficients and their standard errors to explore the concentration-effect function for maternal urinary fluoride with children's IQ, including possible sex-dependence. Assuming a benchmark response of 1 IQ point, we derived benchmark concentrations (BMCs) of maternal urinary fluoride and benchmark concentration levels (BMCLs). No deviation from linearity was detected from the results of the two studies. Using a linear slope, the BMC for maternal urinary fluoride associated with a 1-point decrease in IQ scores of preschool-aged boys and girls was 0.29 mg/L (BMCL, 0.18 mg/L). The BMC was 0.30 mg/L (BMCL, 0.19 mg/L) when pooling the IQ scores from the older ELEMENT children and the MIREC cohort. Boys showed slightly lower BMC values compared with girls. Relying on two prospective studies, maternal urine-fluoride exposure at levels commonly occurring in the general population, the joint data showed BMCL results about 0.2 mg/L. These results can be used to guide decisions on preventing excess fluoride exposure in vulnerable populations.
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Affiliation(s)
- Philippe Grandjean
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA 02115, USA
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Rivka Green
- Faculty of Health, York University, Ontario, Canada
| | - Morteza Bashash
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - David Flora
- Faculty of Health, York University, Ontario, Canada
| | - Martha Maria Tellez-Rojo
- Centro de Investigacion en Salud Poblacional, Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico
| | - Peter Song
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
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11
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Levin-Schwartz Y, Gennings C, Claus Henn B, Coull BA, Placidi D, Lucchini R, Smith DR, Wright RO. Multi-media biomarkers: Integrating information to improve lead exposure assessment. ENVIRONMENTAL RESEARCH 2020; 183:109148. [PMID: 32004829 PMCID: PMC7167344 DOI: 10.1016/j.envres.2020.109148] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 05/03/2023]
Abstract
Exposure assessment traditionally relies on biomarkers that measure chemical concentrations in individual biological media (i.e., blood, urine, etc.). However, chemicals distribute unevenly among different biological media; thus, each medium provides incomplete information about body burden. We propose that machine learning and statistical approaches can create integrated exposure estimates from multiple biomarker matrices that better represent the overall body burden, which we term multi-media biomarkers (MMBs). We measured lead (Pb) in blood, urine, hair and nails from 251 Italian adolescents aged 11-14 years from the Public Health Impact of Metals Exposure (PHIME) cohort. We derived aggregated MMBs from the four biomarkers and then tested their association with Wechsler Intelligence Scale for Children (WISC) IQ scores. We used three approaches to derive the Pb MMB: one supervised learning technique, weighted quantile sum regression (WQS), and two unsupervised learning techniques, independent component analysis (ICA) and non-negative matrix factorization (NMF). Overall, the Pb MMB derived using WQS was most consistently associated with IQ scores and was the only method to be statistically significant for Verbal IQ, Performance IQ and Total IQ. A one standard deviation increase in the WQS MMB was associated with lower Verbal IQ (β [95% CI] = -2.2 points [-3.7, -0.6]), Performance IQ (-1.9 points [-3.5, -0.4]) and Total IQ (-2.1 points [-3.8, -0.5]). Blood Pb was negatively associated with only Verbal IQ, with a one standard deviation increase in blood Pb being associated with a -1.7 point (95% CI: [-3.3, -0.1]) decrease in Verbal IQ. Increases of one standard deviation in the ICA MMB were associated with lower Verbal IQ (-1.7 points [-3.3, -0.1]) and lower Total IQ (-1.7 points [-3.3, -0.1]). Similarly, an increase of one standard deviation in the NMF MMB was associated with lower Verbal IQ (-1.8 points [-3.4, -0.2]) and lower Total IQ (-1.8 points [-3.4, -0.2]). Weights highlighting the contributions of each medium to the MMB revealed that blood Pb was the largest contributor to most MMBs, although the weights varied from more than 80% for the ICA and NMF MMBs to between 30% and 54% for the WQS-derived MMBs. Our results suggest that MMBs better reflect the total body burden of a chemical that may be acting on target organs than individual biomarkers. Estimating MMBs improved our ability to estimate the full impact of Pb on IQ. Compared with individual Pb biomarkers, including blood, a Pb MMB derived using WQS was more strongly associated with IQ scores. MMBs may increase statistical power when the choice of exposure medium is unclear or when the sample size is small. Future work will need to validate these methods in other cohorts and for other chemicals.
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Affiliation(s)
- Yuri Levin-Schwartz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA.
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Roberto Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA; Department of Occupational Health, University of Brescia, Italy
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
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12
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Grandjean P, Abdennebi-Najar L, Barouki R, Cranor CF, Etzel RA, Gee D, Heindel JJ, Hougaard KS, Hunt P, Nawrot TS, Prins GS, Ritz B, Soffritti M, Sunyer J, Weihe P. Timescales of developmental toxicity impacting on research and needs for intervention. Basic Clin Pharmacol Toxicol 2019; 125 Suppl 3:70-80. [PMID: 30387920 PMCID: PMC6497561 DOI: 10.1111/bcpt.13162] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/29/2018] [Indexed: 12/28/2022]
Abstract
Much progress has happened in understanding developmental vulnerability to preventable environmental hazards. Along with the improved insight, the perspective has widened, and developmental toxicity now involves latent effects that can result in delayed adverse effects in adults or at old age and additional effects that can be transgenerationally transferred to future generations. Although epidemiology and toxicology to an increasing degree are exploring the adverse effects from developmental exposures in human beings, the improved documentation has resulted in little progress in protection, and few environmental chemicals are currently regulated to protect against developmental toxicity, whether it be neurotoxicity, endocrine disruption or other adverse outcome. The desire to obtain a high degree of certainty and verification of the evidence used for decision-making must be weighed against the costs and necessary duration of research, as well as the long-term costs to human health because of delayed protection of vulnerable early-life stages of human development and, possibly, future generations. Although two-generation toxicology tests may be useful for initial test purposes, other rapidly emerging tools need to be seriously considered from computational chemistry and metabolomics to CLARITY-BPA-type designs, big data and population record linkage approaches that will allow efficient generation of new insight; epigenetic mechanisms may necessitate a set of additional regulatory tests to reveal such effects. As reflected by the Prenatal Programming and Toxicity (PPTOX) VI conference, the current scientific understanding and the timescales involved require an intensified approach to protect against preventable adverse health effects that can harm the next generation and generations to come. While further research is needed, the main emphasis should be on research translation and timely public health intervention to avoid serious, irreversible and perhaps transgenerational harm.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Robert Barouki
- INSERM UMR-S 1124, Université Paris Descartes, Paris, France
| | - Carl F Cranor
- Department of Philosophy, University of California, Riverside, California
| | - Ruth A Etzel
- Milken Institute, School of Public Health, The George Washington University, Washington, District of Columbia
| | - David Gee
- Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Jerrold J Heindel
- Program in Endocrine Disruption Strategies, Commonweal, Bolinas, California
| | - Karin S Hougaard
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Patricia Hunt
- School of Molecular Biosciences and Center for Reproductive Biology, Washington State University, Pullman, Washington
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Department of Public Health, Leuven University, Leuven, Belgium
| | - Gail S Prins
- Chicago Center for Health and Environment (CACHET), University of Illinois at Chicago, Chicago, Illinois
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Morando Soffritti
- Ramazzini Institute, Bologna, Italy
- European Foundation for Cancer Research, Environmental and Occupational Diseases "Ruberti Schileo", Treviso, Italy
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Catalonia, Spain
| | - Pal Weihe
- Department of Public Health and Occupational Medicine, Tórshavn, Faroe Islands
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13
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Gallego-Viñas G, Ballester F, Llop S. Chronic mercury exposure and blood pressure in children and adolescents: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2238-2252. [PMID: 30519915 DOI: 10.1007/s11356-018-3796-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/19/2018] [Indexed: 06/09/2023]
Abstract
The aim of this paper is to systematically review the scientific literature on the possible relation of chronic mercury exposure and blood pressure among children and adolescents. We searched for observational studies in 6 electronic databases and grey literature for English, French or Spanish language studies published up to 30th November 2017. We performed a quality assessment of primary studies. We identified 8 articles involving 5 cohorts, 1 cross-sectional study and 1 case-control study. The participants had mean ages of between 3 and 17 years. Mercury was analysed in different matrices and periods of exposure. Four articles evaluated prenatal exposure, 2 evaluated both prenatal and postnatal exposures and 2 postnatal exposure. Blood pressure was measured according to different protocols. The association between mercury and blood pressure was adjusted by different covariates in each study. Four articles found a positive significant association between chronic mercury exposure and blood pressure in children or adolescents. Among these 4 articles, three of them evaluated prenatal exposure. There are still few studies assessing chronic mercury exposure and blood pressure in children and adolescents with inconsistency in results. Designs are very heterogeneous, which hampers their comparability. Evidence of this association is scarce and further research is needed.
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Affiliation(s)
- Gema Gallego-Viñas
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
| | - Ferran Ballester
- FISABIO-UJI-Universitat de València Joint Research Unit in Epidemiology and Environmental Health, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Nursing Department, University of Valencia, Valencia, Spain
| | - Sabrina Llop
- FISABIO-UJI-Universitat de València Joint Research Unit in Epidemiology and Environmental Health, Valencia, Spain.
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Avda. Catalunya 21, 46020, Valencia, Spain.
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14
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Calder RSD, Bromage S, Sunderland EM. Risk tradeoffs associated with traditional food advisories for Labrador Inuit. ENVIRONMENTAL RESEARCH 2019; 168:496-506. [PMID: 30477821 PMCID: PMC6317887 DOI: 10.1016/j.envres.2018.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 08/04/2018] [Accepted: 09/05/2018] [Indexed: 05/23/2023]
Abstract
The traditional Inuit diet includes wild birds, fish and marine mammals, which can contain high concentrations of the neurotoxicant methylmercury (MeHg). Hydroelectric development may increase MeHg concentrations in traditional foods. Consumption advisories are often used to mitigate such risks and can result in reduced intake of traditional foods. Data from a dietary survey, MeHg exposure assessment and risk analysis for individuals in three Inuit communities in Labrador, Canada (n = 1145) in 2014 indicate reducing traditional food intake is likely to exacerbate deficiencies in n-3 polyunsaturated fatty acids and vitamins B12 and B2. Traditional foods accounted for < 5% of per-capita calories but up to 70% of nutrients consumed. Although consumption advisories could lower neurodevelopmental risks associated with an increase in MeHg exposure (90th-percentile ∆IQ = - 0.12 vs. - 0.34), they may lead to greater risks of cardiovascular mortality (90th-percentile increase: + 58% to + 116% vs. + 25%) and cancer mortality (90th-percentile increase + 2% to + 4% vs. no increase). Conversely, greater consumption of locally caught salmon mostly unaffected by hydroelectric flooding would lower all these risks (90th-percentile ∆IQ = + 0.4; cardiovascular risk: - 45%; cancer risk: - 1.4%). We thus conclude that continued consumption of traditional foods is essential for Inuit health in these communities.
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Affiliation(s)
- Ryan S D Calder
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA 02138, USA.
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Elsie M Sunderland
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA 02138, USA
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15
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Budtz-Jørgensen E, Grandjean P. Application of benchmark analysis for mixed contaminant exposures: Mutual adjustment of perfluoroalkylate substances associated with immunotoxicity. PLoS One 2018; 13:e0205388. [PMID: 30339706 PMCID: PMC6195268 DOI: 10.1371/journal.pone.0205388] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 09/25/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Developmental exposure to perfluorinated alkylate substances (PFASs) is associated with deficient IgG antibody responses to childhood vaccines. As this immunotoxicity outcome may represent a critical effect, calculation of benchmark dose (BMD) results would be useful for defining protective limits of exposure. However, exposures to the major PFASs that are associated with this adverse effect are interrelated, and mutually adjusted BMD results would be desirable. METHODS We carried out BMD calculations on prospective data from two prospective birth cohort studies from the Faroe Islands with a total of 1,146 children. Exposure data included serum concentrations of five major PFASs at birth and at age 5 years and, as outcome parameters, the serum concentrations of specific IgG antibodies against tetanus and diphtheria at ages 5 and 7. We calculated the BMDs and their lower confidence bounds (BMDLs) and included mutual adjustment for five major PFASs. BMD and BMDL were expressed in terms of the serum concentration of the PFASs. RESULTS The BMDLs for the immunotoxicants were of similar magnitude before and after adjustment. As compared to linear dose-response models, the PFASs showed lower results for a piecewise linear model, which also provided a slightly better fit. Weaker associations with the antibody outcomes were observed after adjustments due to the correlation between the PFASs. However, while the adjustments resulted in elevated BMD results and p values, the BMDL values were not materially changed. CONCLUSIONS Adjustment for co-exposure to a related immunotoxicant increased both the BMD values and their standard errors, though affected the BMDL values only to a negligible extent. Thus, when correlated toxicants appear to affect the same outcome and none of them is known a priori to be solely responsible, all exposures may be considered responsible in BMD calculations. Our BMDL results, both before and after adjustment are generally below current exposure levels and therefore suggest that all five perfluorinated substances should attract regulatory attention, at least until additional evidence shows otherwise.
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Affiliation(s)
- Esben Budtz-Jørgensen
- Department of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School Public Health, Boston, Massachusetts, United States of America
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16
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Reproductive Function in a Population of Young Faroese Men with Elevated Exposure to Polychlorinated Biphenyls (PCBs) and Perfluorinated Alkylate Substances (PFAS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091880. [PMID: 30200252 PMCID: PMC6165232 DOI: 10.3390/ijerph15091880] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 01/12/2023]
Abstract
Semen quality may be adversely affected by exposure to environmental chemicals such as polychlorinated biphenyls (PCBs) and perfluorinated alkylate substances (PFASs) that are persistent and may act as endocrine disrupting compounds. The aim of this study was to explore whether PCBs or PFASs exposure were associated with abnormalities in semen quality or reproductive hormones in Faroese men. This population based cross-sectional study includes 263 Faroese men (24⁻26 years) who delivered a semen sample for assessment of sperm concentration, total sperm count, semen volume, morphology and motility. A blood sample was drawn and analyzed for reproductive hormones, PCBs and PFASs. Exposure to ∑PCBs and perfluorooctane sulfonate (PFOS) was positively associated with sex hormone-binding globulin (SHBG) and luteinizing hormone (LH). In addition, total testosterone (T) was positively associated with ∑PCB. Both PCBs and PFOS appear to lead to increased SHBG, perhaps mediated via the liver. The higher total T associated with PCB may represent a compensatory adaption to elevated SHBG levels to maintain an unchanged free testosterone concentration. The positive association to LH for both PCBs and PFOS may indicate a direct adverse effect on the testosterone producing Leydig cells.
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17
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Grandjean P, Heilmann C, Weihe P, Nielsen F, Mogensen UB, Timmermann A, Budtz-Jørgensen E. Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years. J Immunotoxicol 2018; 14:188-195. [PMID: 28805477 DOI: 10.1080/1547691x.2017.1360968] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Perfluorinated alkylate substances (PFASs) are highly persistent and may cause immunotoxic effects. PFAS-associated attenuated antibody responses to childhood vaccines may be affected by PFAS exposures during infancy, where breastfeeding adds to PFAS exposures. Of 490 members of a Faroese birth cohort, 275 and 349 participated in clinical examinations and provided blood samples at ages 18 months and 5 years. PFAS concentrations were measured at birth and at the clinical examinations. Using information on duration of breastfeeding, serum-PFAS concentration profiles during infancy were estimated. As outcomes, serum concentrations of antibodies against tetanus and diphtheria vaccines were determined at age 5. Data from a previous cohort born eight years earlier were available for pooled analyses. Pre-natal exposure showed inverse associations with the antibody concentrations five years later, with decreases by up to about 20% for each two-fold higher exposure, while associations for serum concentrations at ages 18 months and 5 years were weaker. Modeling of serum-PFAS concentration showed levels for age 18 months that were similar to those measured. Concentrations estimated for ages 3 and 6 months showed the strongest inverse associations with antibody concentrations at age 5 years, particularly for tetanus. Joint analyses showed statistically significant decreases in tetanus antibody concentrations by 19-29% at age 5 for each doubling of the PFAS exposure in early infancy. These findings support the notion that the developing adaptive immune system is particularly vulnerable to immunotoxicity during infancy. This vulnerability appears to be the greatest during the first 6 months after birth, where PFAS exposures are affected by breast-feeding.
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Affiliation(s)
- Philippe Grandjean
- a Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,b Department of Environmental Medicine , University of Southern Denmark , Odense , Denmark
| | - Carsten Heilmann
- c Pediatric Clinic , Rigshospitalet - National University Hospital , Copenhagen , Denmark
| | - Pal Weihe
- d Department of Occupational Medicine and Public Health , Faroese Hospital System , Torshavn , Faroe Islands
| | - Flemming Nielsen
- b Department of Environmental Medicine , University of Southern Denmark , Odense , Denmark
| | - Ulla B Mogensen
- e Department of Biostatistics , University of Copenhagen , Copenhagen , Denmark
| | - Amalie Timmermann
- b Department of Environmental Medicine , University of Southern Denmark , Odense , Denmark
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18
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Ballester F, Iñiguez C, Murcia M, Guxens M, Basterretxea M, Rebagliato M, Vioque J, Lertxundi A, Fernandez-Somoano A, Tardon A, Sunyer J, Llop S. Prenatal exposure to mercury and longitudinally assessed fetal growth: Relation and effect modifiers. ENVIRONMENTAL RESEARCH 2018; 160:97-106. [PMID: 28968527 DOI: 10.1016/j.envres.2017.09.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/06/2017] [Accepted: 09/16/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prenatal mercury exposure has been related to reductions in anthropometry at birth. Levels of mercury have been reported as being relatively elevated in the Spanish population. OBJECTIVE To investigate the relation between prenatal exposure to mercury and fetal growth. METHODS Study subjects were pregnant women and their newborns (n:1867) participating in a population-based birth cohort study set up in four Spanish regions from the INMA Project. Biparietal diameter (BPD), femur length (FL), abdominal circumference (AC), and estimated fetal weight (EFW) were measured by ultrasounds at 12, 20, and 34 weeks of gestation. Size at and growth between these points were assessed by standard deviation (SD) scores adjusted for constitutional characteristics. Total mercury (T-Hg) was determined in cord blood. Associations were investigated by linear regression models, adjusted by sociodemographic, environmental, nutritional - including four seafood groups - and lifestyle-related variables in each sub-cohort. Final estimates were obtained using meta-analysis. Effect modification by sex, seafood intake and polychlorinated biphenyl (PCB) congener 153 concentration was assessed. RESULTS Geometric mean of cord blood T-Hg was 8.2μg/L. All the estimates of the association between prenatal Hg and growth from 0 to 12 weeks showed reductions in SD-scores, which were only statistically significant for BPD. A doubling of cord blood T-Hg was associated with a 0.58% reduction in size of BPD at week 12 (95% confidence interval -CI-: - 1.10, - 0.07). Size at week 34 showed estimates suggestive of a small reduction in EFW, i.e., a doubling of T-Hg levels was associated with a reduction of 0.38% (95% CI: - 0.91, 0.15). An interaction between PCB153 and T-Hg was found, with statistically significant negative associations of T-Hg with AC and EFW in late pregnancy among participants with PCB153 below the median. CONCLUSIONS Exposure to mercury during pregnancy was associated with early reductions in BPD. Moreover, an antagonism with PCB 153 was observed with noteworthy reductions late in pregnancy in AC and EFW in the group with lower PCB153.
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Affiliation(s)
- Ferran Ballester
- Nursing School, Universitat de València, Valencia, Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
| | - Carmen Iñiguez
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Mikel Basterretxea
- Public Health Division of Gipuzkoa, San Sebastián, Spain; Health Research Institute (BIODONOSTIA), San Sebastián, Spain
| | - Marisa Rebagliato
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Medicine Department, Universitat Jaume I, Castelló de la Plana, Spain
| | - Jesús Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universidad del País Vasco, Spain
| | - Ana Fernandez-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; IUOPA, Departamento de Medicina, Universidad de Oviedo, Spain
| | - Adonina Tardon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Sabrina Llop
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
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Basu N, Eng JWL, Perkins M, Santa-Rios A, Martincevic G, Carlson K, Neitzel RL. Development and application of a novel method to characterize methylmercury exposure in newborns using dried blood spots. ENVIRONMENTAL RESEARCH 2017; 159:276-282. [PMID: 28825981 PMCID: PMC6309537 DOI: 10.1016/j.envres.2017.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 05/13/2023]
Abstract
BACKGROUND Methylmercury (MeHg) is a pollutant of global concern. While there is a need to gauge early-life exposures, there remain outstanding ethical, financial, and practical challenges with using the preferred biomarker, whole blood, notably in pregnant women, infants, toddlers, and children. Dried bloodspots (DBS) may help overcome some of these challenges. Notably DBS are collected from newborns in many jurisdictions offering an institutionalized platform to efficiently characterize exposures. OBJECTIVE To develop, validate, and apply a new method to measure MeHg levels in DBS with a specific aim to use this method to increase understanding of newborn exposures. METHODS Method development and validation was pursued by consulting U.S. EPA Method 1630 and other resources. The method was applied to measure MeHg levels in DBS from newborns (n = 675) from the Michigan BioTrust for Health program. RESULTS The assay's detection limit (0.3μg/L), accuracy (96-115% of expected), precision, linearity, and range met performance criteria guidelines. In the newborn DBS samples, the mean (SD) and geometric mean values of MeHg were 1.46 (0.90) and 1.25μg/L respectively, and ranged from 0.09 to 9.97μg/L. The values we report here are similar to cord blood mercury values reported elsewhere. CONCLUSIONS This is the first characterization of MeHg exposure in newborns, and thus fills an important data gap as prior studies have focused on pregnant women, cord blood, or toddlers. This method helps overcome technical challenges associated with other proposed approaches, and moving ahead there is great promise for applying this DBS-based method for population-level surveillance, particularly in resource-limited settings and for children's health.
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Affiliation(s)
- Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Jenny W L Eng
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Marie Perkins
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Andrea Santa-Rios
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Gordana Martincevic
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Krystin Carlson
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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20
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Grandjean P, Heilmann C, Weihe P, Nielsen F, Mogensen UB, Budtz-Jørgensen E. Serum Vaccine Antibody Concentrations in Adolescents Exposed to Perfluorinated Compounds. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:077018. [PMID: 28749778 PMCID: PMC5744724 DOI: 10.1289/ehp275] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/06/2016] [Accepted: 07/12/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND Postnatal exposure to perfluorinated alkylate substances (PFASs) is associated with lower serum concentrations of specific antibodies against certain childhood vaccines at 7 y. OBJECTIVES We prospectively followed a Faroese birth cohort to determine these associations at 13 y. METHODS In 516 subjects (79% of eligible cohort members) who were 13 years old, serum concentrations of PFASs and of antibodies against diphtheria and tetanus were measured and were compared with data from the previous examination at 7 y. Multiple regression analyses and structural equation models were applied to determine the association between postnatal PFAS exposures and antibody concentrations. RESULTS Serum concentrations of PFASs and antibodies generally declined from 7 y to 13 y. However, 68 subjects had visited the emergency room and had likely received a vaccination booster, and a total of 202 children showed higher vaccine antibody concentrations at 13 y than at 7 y. Therefore, separate analyses were conducted after exclusion of these two subgroups. Diphtheria antibody concentrations decreased at elevated PFAS concentrations at 13 y and 7 y; the associations were statistically significant for perfluorodecanoate (PFDA) at 7 y and for perfluorooctanoate (PFOA) at 13 y, both suggesting a decrease by ∼25% for each doubling of exposure. Structural equation models showed that a doubling in PFAS exposure at 7 y was associated with losses in diphtheria antibody concentrations at 13 y of 10–30% for the five PFASs. Few associations were observed for anti-tetanus concentrations. CONCLUSIONS These results are in accord with previous findings of PFAS immunotoxicity at current exposure levels. https://doi.org/10.1289/EHP275.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Carsten Heilmann
- Paediatric Clinic, Rigshospitalet – National University Hospital, Copenhagen, Denmark
| | - Pal Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Tórshavn, Faroe Islands, Denmark
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Ulla B Mogensen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
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21
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Grandjean P. Paracelsus Revisited: The Dose Concept in a Complex World. Basic Clin Pharmacol Toxicol 2016; 119:126-32. [PMID: 27214290 PMCID: PMC4942381 DOI: 10.1111/bcpt.12622] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/09/2016] [Indexed: 11/28/2022]
Abstract
At the time that Paracelsus coined his famous dictum, 'What is there that is not poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not a poison', embryonic toxicology was a fairly focused discipline that mainly dealt with occupational poisonings and side effects of pharmaceuticals, such as mercury. While Paracelsus paved the way for the modern threshold concept and the no-adverse effect level, modern-day toxicology is now tussling with highly complex issues, such as developmental exposures, genetic predisposition and other sources of hypersusceptibility, multiple causes of underestimated toxicity, and the continuous presence of uncertainty, even in regard to otherwise well-studied mercury compounds. Further, the wealth of industrial chemicals now challenges the 'untested-chemical assumption', that the lack of documentation means that toxic potentials can be ignored. Unfortunately, in its ambition to provide solid evidence, toxicology has been pushed into almost endless replications, as evidenced by the thousands of toxicology publications every year that focus on toxic metals, including mercury, while less well-known hazards are ignored. From a public health viewpoint, toxicology needs to provide better guidance on decision-making under ever-present uncertainty. In this role, we need to learn from the stalwart Paracelsus the insistence on relying on facts rather than authority alone to protect against chemical hazards.
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Affiliation(s)
- Philippe Grandjean
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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22
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Kioumourtzoglou MA, Roberts AL, Nielsen F, Tworoger SS, Grandjean P, Weisskopf MG. Within-person reproducibility of red blood cell mercury over a 10- to 15-year period among women in the Nurses' Health Study II. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:219-23. [PMID: 25492240 PMCID: PMC4465060 DOI: 10.1038/jes.2014.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 05/25/2023]
Abstract
Most epidemiologic studies of methylmercury (MeHg) health effects rely on a single measurement of a MeHg biomarker to assess long-term exposures. Long-term reproducibility data are, therefore, needed to assess the reliability of a single measure to reflect long-term exposures. In this study, we assessed within-person reproducibility of red blood cell (RBC) mercury (Hg), a marker of methyl-mercury, over 10-15 years in a sample of 57 women. Fifty-seven women from the Nurses' Health Study II provided two blood samples 10-15-years apart (median: 12 years), which were analyzed for mercury levels in the red blood cells (B-Hg*). To characterize within-person reproducibility, we estimated correlation and intraclass correlation coefficients (r and ICC) across the two samples. Further, we compared different prediction models, including variables on fish and seafood consumption, for B-Hg* at the first sample, using leave-one-out cross-validation to assess predictive ability. Overall, we observed strong correlations over 10-15 years (r=0.69), as well as a high ICC (0.67; 95% CI: 0.49, 0.79). Fish and seafood consumption reported concurrently with the first B-Hg* sample accounted for 26.8% of the variability in that B-Hg*, giving a correlation of r=0.52. Despite decreasing B-Hg* levels over time, we observed strong correlations and high ICC estimates across B-Hg* measured 10-15 years apart, suggesting good relative within-person stability over time. Our results indicate that a single measurement of B-Hg* likely is adequate to represent long-term exposures.
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Affiliation(s)
| | - Andrea L Roberts
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Philippe Grandjean
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
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23
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Sunderland EM, Driscoll CT, Hammitt JK, Grandjean P, Evans JS, Blum JD, Chen CY, Evers DC, Jaffe DA, Mason RP, Goho S, Jacobs W. Benefits of Regulating Hazardous Air Pollutants from Coal and Oil-Fired Utilities in the United States. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:2117-20. [PMID: 26848613 DOI: 10.1021/acs.est.6b00239] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Elsie M Sunderland
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University , Cambridge, Massachusetts 02138, United States
- Harvard T.H. Chan School of Public Health, Harvard University , Cambridge, Massachusetts 02138, United States
| | - Charles T Driscoll
- Department of Civil and Environmental Engineering, Syracuse University , Syracuse, New York 13244, United States
| | - James K Hammitt
- Harvard T.H. Chan School of Public Health, Harvard University , Cambridge, Massachusetts 02138, United States
| | - Philippe Grandjean
- Harvard T.H. Chan School of Public Health, Harvard University , Cambridge, Massachusetts 02138, United States
| | - John S Evans
- Harvard T.H. Chan School of Public Health, Harvard University , Cambridge, Massachusetts 02138, United States
| | - Joel D Blum
- Department of Earth and Environmental Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Celia Y Chen
- Department of Biological Sciences, Dartmouth College , Hanover, New Hampshire 03755, United States
| | - David C Evers
- Biodiversity Research Institute , Portland, Maine 04103, United States
| | - Daniel A Jaffe
- Science and Technology Program, University of Washington-Bothell , Bothell, Washington 98011, United States
| | - Robert P Mason
- Department of Marine Sciences, University of Connecticut , Groton, Connecticut 06340, United States
| | - Shaun Goho
- Emmett Environmental Law & Policy Clinic, Harvard Law School, Harvard University , Cambridge, Massachusetts 02138, United States
| | - Wendy Jacobs
- Emmett Environmental Law & Policy Clinic, Harvard Law School, Harvard University , Cambridge, Massachusetts 02138, United States
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Grandjean P. Toxicology research for precautionary decision-making and the role of Human & Experimental Toxicology. Hum Exp Toxicol 2015; 34:1231-7. [PMID: 26614810 DOI: 10.1177/0960327115601762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A key aim of toxicology is the prevention of adverse effects due to toxic hazards. Therefore, the dissemination of toxicology research findings must confront two important challenges: one being the lack of information on the vast majority of potentially toxic industrial chemicals and the other being the strict criteria for scientific proof usually required for decision-making in regard to prevention. The present study ascertains the coverage of environmental chemicals in four volumes of Human & Experimental Toxicology and the presentation and interpretation of research findings in published articles. Links in SciFinder showed that the 530 articles published in four selected volumes between 1984 and 2014 primarily dealt with metals (126 links) and other toxicants that have received substantial attention in the past. Thirteen compounds identified by US authorities in 2006 as high-priority substances, for which toxicology documentation is badly needed, were not covered in the journal issues at all. When reviewing published articles, reliance on p values was standard, and non-significant findings were often called 'negative.' This tradition may contribute to the perceived need to extend existing research on toxic hazards that have already been well characterized. Several sources of bias towards the null hypothesis can affect toxicology research, but are generally not considered, thus adding to the current inclination to avoid false positive findings. In this regard, toxicology is particularly prone to bias because of the known paucity of false positives and, in particular, the existence of a vast number of toxic hazards which by default are considered innocuous due to lack of documentation. The Precautionary Principle could inspire decision-making on the basis of incomplete documentation and should stimulate a change in toxicology traditions and in toxicology research publication.
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Affiliation(s)
- P Grandjean
- Department of Public Health, University of Southern Denmark, Odense C, Denmark Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
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25
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Debes F, Weihe P, Grandjean P. Cognitive deficits at age 22 years associated with prenatal exposure to methylmercury. Cortex 2015; 74:358-69. [PMID: 26109549 DOI: 10.1016/j.cortex.2015.05.017] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 05/03/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
Prenatal exposure to mercury has been associated with adverse effects on child neurodevelopment. The present study aims to determine the extent to which methylmercury-associated cognitive deficits persist into adult age. In a Faroese birth cohort originally formed in 1986-1987 (N = 1,022), prenatal methylmercury exposure was assessed in terms of the mercury concentration in cord blood and maternal hair. Clinical examinations of 847 cohort members at age 22 years were carried out in 2008-2009 using a panel of neuropsychological tests that reflected major functional domains. Subjects with neurological and psychiatric diagnoses were excluded from the data analysis, thus leaving 814 subjects. Multiple regression analysis included covariates previously identified for adjustment. Deficits in Boston Naming Test (BNT) and other tests of verbal performance were significantly associated with the cord-blood mercury concentration. Deficits were also present in all other tests applied, although most were not statistically significant. Structural equation models were developed to ascertain the possible differences in vulnerability of specific functional domains and the overall association with general intelligence. In models for individual domains, all of them showed negative associations, with crystallized intelligence being highly significant. A hierarchical model for general intelligence based on all domains again showed a highly significant negative association with the exposure, with an approximate deficit that corresponds to about 2.2 IQ points at a 10-fold increased prenatal methylmercury exposure. Thus, although the cognitive deficits observed were smaller than at examinations at younger ages, maternal diets with contaminated seafood were associated with adverse effects in this birth cohort at age 22 years. The deficits affected major domains of brain functions as well as general intelligence. Thus, prenatal exposure to this marine contaminant appears to cause permanent adverse effects on cognition.
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Affiliation(s)
- Frodi Debes
- Faroese Hospital System, Torshavn, Faroe Islands
| | - Pal Weihe
- Faroese Hospital System, Torshavn, Faroe Islands
| | - Philippe Grandjean
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA; Institute of Public Health, University of Southern Denmark, Odense, Denmark.
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26
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Grandjean P, Herz KT. Trace elements as paradigms of developmental neurotoxicants: Lead, methylmercury and arsenic. J Trace Elem Med Biol 2015; 31:130-4. [PMID: 25175507 PMCID: PMC4321972 DOI: 10.1016/j.jtemb.2014.07.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 11/26/2022]
Abstract
Trace elements have contributed unique insights into developmental neurotoxicity and serve as paradigms for such adverse effects. Many trace elements are retained in the body for long periods and can be easily measured to assess exposure by inexpensive analytical methods that became available several decades ago so that past and cumulated exposures could be easily characterized through analysis of biological samples, e.g. blood and urine. The first compelling evidence resulted from unfortunate poisoning events that allowed scrutiny of long-term outcomes of acute exposures that occurred during early development. Pursuant to this documentation, prospective studies of children's cohorts that applied sensitive neurobehavioral methods supported the notion that the brain is uniquely vulnerable to toxic damage during early development. Lead, methylmercury, and arsenic thereby serve as paradigm neurotoxicants that provide a reference for other substances that may have similar adverse effects. Less evidence is available on manganese, fluoride, and cadmium, but experience from the former trace elements suggest that, with time, adverse effects are likely to be documented at exposures previously thought to be low and safe.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, 5000 Odense, Denmark; Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
| | - Katherine T Herz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA
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27
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Affiliation(s)
- David C Bellinger
- Boston Children's Hospital, Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts
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28
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Fonseca MDF, De Souza Hacon S, Grandjean P, Choi AL, Bastos WR. Iron status as a covariate in methylmercury-associated neurotoxicity risk. CHEMOSPHERE 2014; 100:89-96. [PMID: 24411835 DOI: 10.1016/j.chemosphere.2013.12.053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 06/03/2023]
Abstract
Intrauterine methylmercury exposure and prenatal iron deficiency negatively affect offspring's brain development. Since fish is a major source of both methylmercury and iron, occurrence of negative confounding may affect the interpretation of studies concerning cognition. We assessed relationships between methylmercury exposure and iron-status in childbearing females from a population naturally exposed to methylmercury through fish intake (Amazon). We concluded a census (refuse <20%) collecting samples from 274 healthy females (12-49 years) for hair-mercury determination and assessed iron-status through red cell tests and determination of serum ferritin and iron. Reactive C protein and thyroid hormones was used for excluding inflammation and severe thyroid dysfunctions that could affect results. We assessed the association between iron-status and hair-mercury by bivariate correlation analysis and also by different multivariate models: linear regression (to check trends); hierarchical agglomerative clustering method (groups of variables correlated with each other); and factor analysis (to examine redundancy or duplication from a set of correlated variables). Hair-mercury correlated weakly with mean corpuscular volume (r=.141; P=.020) and corpuscular hemoglobin (r=.132; .029), but not with the best biomarker of iron-status, ferritin (r=.037; P=.545). In the linear regression analysis, methylmercury exposure showed weak association with age-adjusted ferritin; age had a significant coefficient (Beta=.015; 95% CI: .003-.027; P=.016) but ferritin did not (Beta=.034; 95% CI: -.147 to .216; P=.711). In the hierarchical agglomerative clustering method, hair-mercury and iron-status showed the smallest similarities. Regarding factor analysis, iron-status and hair-mercury loaded different uncorrelated components. We concluded that iron-status and methylmercury exposure probably occur in an independent way.
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Affiliation(s)
- Márlon de Freitas Fonseca
- Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Av. Rui Barbosa 716, Flamengo, Rio de Janeiro, RJ 22250-020, Brazil; Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center Room 3-110 East, Boston, MA 02215, USA.
| | - Sandra De Souza Hacon
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
| | - Philippe Grandjean
- Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center Room 3-110 East, Boston, MA 02215, USA; Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 17A/2, DK-5000 Odense C, Denmark.
| | - Anna Lai Choi
- Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center Room 3-110 East, Boston, MA 02215, USA
| | - Wanderley Rodrigues Bastos
- Laboratório de Biogeoquímica Ambiental Wolfgang Christian Pfeiffer, Universidade Federal de Rondônia, Rodovia BR 364 Km 9,5 Sentido Acre, Zona Rural, Porto Velho, RO 76801-974, Brazil.
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Abstract
Neurodevelopmental disabilities, including autism, attention-deficit hyperactivity disorder, dyslexia, and other cognitive impairments, affect millions of children worldwide, and some diagnoses seem to be increasing in frequency. Industrial chemicals that injure the developing brain are among the known causes for this rise in prevalence. In 2006, we did a systematic review and identified five industrial chemicals as developmental neurotoxicants: lead, methylmercury, polychlorinated biphenyls, arsenic, and toluene. Since 2006, epidemiological studies have documented six additional developmental neurotoxicants-manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene, and the polybrominated diphenyl ethers. We postulate that even more neurotoxicants remain undiscovered. To control the pandemic of developmental neurotoxicity, we propose a global prevention strategy. Untested chemicals should not be presumed to be safe to brain development, and chemicals in existing use and all new chemicals must therefore be tested for developmental neurotoxicity. To coordinate these efforts and to accelerate translation of science into prevention, we propose the urgent formation of a new international clearinghouse.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark; Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
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30
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Guo BQ, Cai SZ, Guo JL, Xu J, Wu W, Li H, Zhou X, Kim DS, Yan CH, Lü HD. Levels of prenatal mercury exposure and their relationships to neonatal anthropometry in Wujiang City, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2013; 182:184-189. [PMID: 23920315 DOI: 10.1016/j.envpol.2013.07.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 06/02/2023]
Abstract
We determined the levels of prenatal Hg exposure in Wujiang City, located in the southeast of Taihu Lake in China's Jiangsu Province, and analyze the relationship between prenatal exposure to Hg and neonatal anthropometry, including birth weight, body length, and head circumference. From June 2009 to July 2010, a total of 213 mother-infant pairs were enrolled. The geometric means of Hg levels in maternal hair, fetal hair, placentas, and cord blood were 496.76 μg/kg, 233.94 μg/kg, 3.58 μg/kg, and 1.54 μg/L, respectively. The Hg levels detected in our study were significantly lower than those reported by previous studies. In addition, no significant correlations were found between Hg levels in maternal hair, fetal hair, placenta, or cord blood and neonatal anthropometrics. Together, our findings may be important for understanding the effects of prenatal exposure to Hg on newborns' development and have implications concerning the recommended dose for Hg.
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Affiliation(s)
- Bao-Qiang Guo
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China
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Marques RC, Bernardi JVE, Dórea JG, Leão RS, Malm O. Mercury transfer during pregnancy and breastfeeding: hair mercury concentrations as biomarker. Biol Trace Elem Res 2013; 154:326-32. [PMID: 23836367 DOI: 10.1007/s12011-013-9743-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 06/23/2013] [Indexed: 01/09/2023]
Abstract
UNLABELLED Hair mercury (HHg) concentration is a biomarker of exposure that is widely used to assess environmental contamination by fish methylmercury and neurodevelopment in children. In the Rio Madeira basin (Brazilian Amazon), total HHg concentrations in 649 mother-infant pairs were measured at birth (prenatal exposure) and after 6 months of exclusive breastfeeding; these mother-infant pairs were from high fish-eating communities (urban, n = 232; rural, n = 35; and Riverine, n = 262) and low fish-eating tin-miner settlers (n = 120). Differences in kinetics were seen between Hg exposure from fish consumption and environmental exposure to a tin-ore mining environment. Overall maternal HHg concentrations (at childbirth and after 6 months of lactation) were higher than those of infant HHg. However, the relative change in HHg after 6 months of lactation showed that mothers decreased HHg while infants increased HHg. The relative change showed a consistently higher increase for girls than boys with a statistical significance only in high fish-eating mothers. The correlation coefficients between maternal and newborn hair were high and statistically significant for mothers living in urban (r = 0.66, p < 0.001), rural (r = 0.89, p < 0.001), and Riverine (r = 0.89, p < 0.001) communities not for tin miner settlers (r = 0.07, p = 0.427). After 6 months of exclusive breastfeeding, correlation coefficients showed high correlation coefficients and statistical significance for all groups (urban, r = 0.73, p < 0.001; rural, r = 0.88, p < 0.001; Riverine, r = 0.91, p < 0.001) except for Tin miners (r = -0.07, p = 0.428). A linear model analysis was used to assess the longitudinal associations of maternal total HHg and total HHg at birth (0 days) and 6 months of age in exclusively breastfed infants. Regression analysis significantly predicted HHg in newborn from maternal HHg for high fish-eating maternal-infant pairs. CONCLUSION The concentration of mercury accumulated in newborn tissues (in utero and during breastfeeding) relevant to both, maternal sources and infant exposure, can be reliably assessed from maternal hair.
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Affiliation(s)
- Rejane C Marques
- Universidade Federal do Rio de Janeiro, Campus Macaé, Rio de Janeiro, RJ, Brazil.
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Scientific Opinion on the risk for public health related to the presence of mercury and methylmercury in food. EFSA J 2012. [DOI: 10.2903/j.efsa.2012.2985] [Citation(s) in RCA: 276] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Hinners T, Tsuchiya A, Stern AH, Burbacher TM, Faustman EM, Mariën K. Chronologically matched toenail-Hg to hair-Hg ratio: temporal analysis within the Japanese community (U.S.). Environ Health 2012; 11:81. [PMID: 23113987 PMCID: PMC3511224 DOI: 10.1186/1476-069x-11-81] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/07/2012] [Indexed: 05/02/2023]
Abstract
BACKGROUND Toenail-Hg levels are being used as a marker of methylmercury (MeHg) exposure in efforts to associate exposure with effects such as cardiovascular disease. There is a need to correlate this marker with more established biomarkers that presently underlie existing dose-response relationships in order to compare these relationships across studies. METHODS As part of the Arsenic Mercury Intake Biometric Study, toenail clippings were collected at three time points over a period of one year amongst females from within the population of Japanese living near Puget Sound in Washington State (US). Variability in temporal intra-individual toenail-Hg levels was examined and chronologically matched hair and toenail samples were compared to more accurately define the toxicokinetic variability of Hg levels observed between the two compartments. RESULTS Mean toenail-Hg values (n=43) for the 1st, 2nd and 3rd visits were 0.60, 0.60 and 0.56 ng/mg. Correlations were as follows: r=0.92 between 1st and 2nd clinic visits, r=0.75 between 1st and 3rd visits and r=0.87 between 2nd and 3rd visits. With few exceptions, toenail-Hg values from any visit were within 50-150% of the individual's mean toenail-Hg level. Nearly all participants had less than a two-fold change in toenail-Hg levels across the study period. A regression model of the relationship between toenail-Hg and hair-Hg (n = 41) levels representing the same time period of exposure, gave a slope (Hg ng/mg) of 2.79 for hair relative to toenail (r=0.954). CONCLUSIONS A chronologically matched hair-Hg to toenail-Hg ratio has been identified within a population that consumes fish regularly and in quantity. Intra-individual variation in toenail-Hg levels was less than two-fold and may represent dietary-based fluctuations in body burden for individuals consuming various fish species with different contaminant levels. The chronologically matched ratio will be useful for relating MeHg exposure and dose-response derived from toenail-Hg measurements to those derived from hair-Hg measurements in other studies, and may be useful in future investigations as an indicator of stable MeHg body burden within a population.
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Affiliation(s)
- Thomas Hinners
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Las Vegas, NV, USA
| | - Ami Tsuchiya
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
| | - Alan H Stern
- Department of Environmental Protection, Trenton, NJ, USA
| | - Thomas M Burbacher
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
| | - Elaine M Faustman
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
- Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
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Grandjean P, Weihe P, Nielsen F, Heinzow B, Debes F, Budtz-Jørgensen E. Neurobehavioral deficits at age 7 years associated with prenatal exposure to toxicants from maternal seafood diet. Neurotoxicol Teratol 2012; 34:466-72. [PMID: 22705177 PMCID: PMC3407364 DOI: 10.1016/j.ntt.2012.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 06/01/2012] [Accepted: 06/01/2012] [Indexed: 10/28/2022]
Abstract
To determine the possible neurotoxic impact of prenatal exposure to polychlorinated biphenyls (PCBs), we analyzed banked cord blood from a Faroese birth cohort for PCBs. The subjects were born in 1986-1987, and 917 cohort members had completed a series of neuropsychological tests at age 7 years. Major PCB congeners (118, 138, 153, and 180), the calculated total PCB concentration, and the PCB exposure estimated in a structural equation model showed weak associations with test deficits, with statistically significant negative associations only with the Boston Naming test. Likewise, neither hexachlorobenzene nor p,p'-dichlorodiphenyldichloroethylene showed clear links to neurobehavioral deficits. Thus, these associations were much weaker than those associated with the cord-blood mercury concentration, and adjustment for mercury substantially attenuated the regression coefficients for PCB exposure. When the outcomes were joined into motor and verbally mediated functions in a structural equation model, the PCB effects remained weak and virtually disappeared after adjustment for methylmercury exposure, while mercury remained statistically significant. Thus, in the presence of elevated methylmercury exposure, PCB neurotoxicity may be difficult to detect, and PCB exposure does not explain the methylmercury neurotoxicity previously reported in this cohort.
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Affiliation(s)
- Philippe Grandjean
- Institute of Public Health, University of Southern Denmark, Odense, Denmark.
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Karagas MR, Choi AL, Oken E, Horvat M, Schoeny R, Kamai E, Cowell W, Grandjean P, Korrick S. Evidence on the human health effects of low-level methylmercury exposure. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:799-806. [PMID: 22275730 PMCID: PMC3385440 DOI: 10.1289/ehp.1104494] [Citation(s) in RCA: 448] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 01/24/2012] [Indexed: 05/17/2023]
Abstract
BACKGROUND Methylmercury (MeHg) is a known neuro-toxicant. Emerging evidence indicates it may have adverse effects on the neuro-logic and other body systems at common low levels of exposure. Impacts of MeHg exposure could vary by individual susceptibility or be confounded by beneficial nutrients in fish containing MeHg. Despite its global relevance, synthesis of the available literature on low-level MeHg exposure has been limited. OBJECTIVES We undertook a synthesis of the current knowledge on the human health effects of low-level MeHg exposure to provide a basis for future research efforts, risk assessment, and exposure remediation policies worldwide. DATA SOURCES AND EXTRACTION We reviewed the published literature for original human epidemiologic research articles that reported a direct biomarker of mercury exposure. To focus on high-quality studies and those specifically on low mercury exposure, we excluded case series, as well as studies of populations with unusually high fish consumption (e.g., the Seychelles), marine mammal consumption (e.g., the Faroe Islands, circumpolar, and other indigenous populations), or consumption of highly contaminated fish (e.g., gold-mining regions in the Amazon). DATA SYNTHESIS Recent evidence raises the possibility of effects of low-level MeHg exposure on fetal growth among susceptible subgroups and on infant growth in the first 2 years of life. Low-level effects of MeHg on neuro-logic outcomes may differ by age, sex, and timing of exposure. No clear pattern has been observed for cardio-vascular disease (CVD) risk across populations or for specific CVD end points. For the few studies evaluating immunologic effects associated with MeHg, results have been inconsistent. CONCLUSIONS Studies targeted at identifying potential mechanisms of low-level MeHg effects and characterizing individual susceptibility, sexual dimorphism, and non-linearity in dose response would help guide future prevention, policy, and regulatory efforts surrounding MeHg exposure.
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Affiliation(s)
- Margaret R Karagas
- Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
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Mahaffey KR, Sunderland EM, Chan HM, Choi AL, Grandjean P, Mariën K, Oken E, Sakamoto M, Schoeny R, Weihe P, Yan CH, Yasutake A. Balancing the benefits of n-3 polyunsaturated fatty acids and the risks of methylmercury exposure from fish consumption. Nutr Rev 2011; 69:493-508. [PMID: 21884130 PMCID: PMC3219437 DOI: 10.1111/j.1753-4887.2011.00415.x] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Fish and shellfish are widely available foods that provide important nutrients, particularly n-3 polyunsaturated fatty acids (n-3 PUFAs), to many populations globally. These nutrients, especially docosahexaenoic acid, confer benefits to brain and visual system development in infants and reduce risks of certain forms of heart disease in adults. However, fish and shellfish can also be a major source of methylmercury (MeHg), a known neurotoxicant that is particularly harmful to fetal brain development. This review documents the latest knowledge on the risks and benefits of seafood consumption for perinatal development of infants. It is possible to choose fish species that are both high in n-3 PUFAs and low in MeHg. A framework for providing dietary advice for women of childbearing age on how to maximize the dietary intake of n-3 PUFAs while minimizing MeHg exposures is suggested.
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Affiliation(s)
- Kathryn R Mahaffey
- Department of Occupational and Environmental Health, George Washington University School of Public Health, Washington DC, USA
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Grandjean P, Herz KT. Methylmercury and brain development: imprecision and underestimation of developmental neurotoxicity in humans. ACTA ACUST UNITED AC 2011; 78:107-18. [PMID: 21259267 DOI: 10.1002/msj.20228] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Methylmercury is now recognized as an important developmental neurotoxicant, though this insight developed slowly over many decades. Developmental neurotoxicity was first reported in a Swedish case report in 1952, and from a serious outbreak in Minamata, Japan, a few years later. Whereas the infant suffered congenital poisoning, the mother was barely harmed, thus reflecting a unique vulnerability of the developing nervous system. Nonetheless, exposure limits for this environmental chemical were based solely on adult toxicity until 50 years after the first report on developmental neurotoxicity. Even current evidence is affected by uncertainty, most importantly by imprecision of the exposure assessment in epidemiological studies. Detailed calculations suggest that the relative imprecision may be as much as 50%, or greater, thereby substantially biasing the results toward the null. In addition, as methylmercury exposure usually originates from fish and seafood that also contains essential nutrients, so-called negative confounding may occur. Thus, the beneficial effects of the nutrients may appear to dampen the toxicity, unless proper adjustment is included in the analysis to reveal the true extent of adverse effects. These problems delayed the recognition of low-level methylmercury neurotoxicity. However, such problems are not unique, and many other industrial compounds are thought to cause developmental neurotoxicity, mostly with less epidemiological support than methylmercury. The experience obtained with methylmercury should therefore be taken into account when evaluating the evidence for other substances suspected of being neurotoxic.
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