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Taibl KR, Liang D, Dunlop AL, Barr DB, Smith MR, Steenland K, Tan Y, Ryan PB, Panuwet P, Everson T, Marsit CJ, Kannan K, Jones DP, Eick SM. Pregnancy-related hemodynamic biomarkers in relation to trimester-specific maternal per - and polyfluoroalkyl substances exposures and adverse birth outcomes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 323:121331. [PMID: 36813097 PMCID: PMC10023492 DOI: 10.1016/j.envpol.2023.121331] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The fate of environmental chemicals in maternal and fetal tissues might be affected by pregnancy-related hemodynamic changes that occur across gestation. Specifically, hemodilution and renal function are hypothesized to confound associations between per- and polyfluoroalkyl substances (PFAS) exposure measures in late pregnancy with gestational length and fetal growth. We sought to analyze two pregnancy-related hemodynamic biomarkers, creatinine and estimated glomerular filtration rate (eGFR), as confounders of the trimester-specific relationships between maternal serum PFAS concentrations and adverse birth outcomes. Participants were enrolled in the Atlanta African American Maternal-Child Cohort between 2014 and 2020. Biospecimens were collected at up to two timepoints, which were categorized into the 1st trimester (N = 278; 11 mean weeks gestation), 2nd trimester (N = 162; 24 mean weeks gestation), and 3rd trimester (N = 110; 29 mean weeks gestation). We quantified six PFAS in serum, creatinine in serum and urine, and eGFR using the Cockroft-Gault equation. Multivariable regression models estimated the associations between single PFAS and their sum with gestational age at delivery (weeks), preterm birth (PTB, <37 gestational weeks), birthweight z-scores, and small for gestational age (SGA). Primary models were adjusted for sociodemographics. We additionally adjusted for serum creatinine, urinary creatinine, or eGFR in the confounding assessments. An interquartile range increase in perfluorooctanoic acid (PFOA) produced a non-significant reduction in birthweight z-score during the 1st and 2nd trimesters (β = -0.01 g [95% CI = -0.14, 0.12] and β = -0.07 g [95% CI = -0.19, 0.06], respectively) whereas the relationship was significant and positive during the 3rd trimester (β = 0.15 g; 95% CI = 0.01, 0.29). Trimester-specific effects were similar for the other PFAS and adverse birth outcomes, which persisted after adjusting for creatinine or eGFR. The relationships between prenatal PFAS exposure and adverse birth outcomes were not strongly confounded by renal function or hemodilution. However, 3rd trimester samples consistently exhibited different effects than those collected during the 1st and 2nd trimesters.
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Affiliation(s)
- Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - M Ryan Smith
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Todd Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Wilson TN, Nambiema A, Porro B, Descatha A, Aublet-Cuvelier A, Evanoff B, Roquelaure Y. Effectiveness of Physical Activity Interventions on Return to Work After a Cancer Diagnosis: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:4-19. [PMID: 35779184 PMCID: PMC10025244 DOI: 10.1007/s10926-022-10052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Purpose The aim of this study was to assess the effectiveness of physical activity (PA) interventions on return to work (RTW) in cancer survivors, compared to usual care, and to determine the dose of PA needed to improve this outcome. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. Six electronic databases including PubMed, Embase, Web of Science, CENTRAL, PsycINFO, and Scopus were searched to identify studies, and completed by a search of grey literature and health organization websites. Two authors performed screening, selection, and data extraction independently. Study and intervention characteristics were extracted and summarized. Pooled risk ratio (RR) was estimated using a weight random-effects model with 95% confidence intervals (CIs). Results A total of 2655 records were identified, of which 8 intervention studies were included. The sample size of the included studies varied between 41 and 240, giving a total of 1087 participants aged between 18 and 75 years. Compared with usual care, PA interventions had a significant positive effect on RTW among cancer survivors with a pooled RR of 1.29 (95% CI 1.17, 1.42). We found that PA interventions (aerobic and resistance exercises) with an exercise dose between 7.6 METs.h/week and 15 METs.h/week, consisting in 50-60 min per session of moderate to vigorous physical exercise, twice a week seems relevant in improving RTW. Conclusions Our results showed, with moderate quality evidence that PA interventions are more effective than usual care in increasing the rate of RTW in cancer survivors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration Number, CRD42020203614.
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Affiliation(s)
- Têtê Norbert Wilson
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France.
| | - Aboubakari Nambiema
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Bertrand Porro
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Agnès Aublet-Cuvelier
- Direction des Etudes et de Recherches, INRS (Institut National de Recherche Et de Sécurité), 1 rue du Morvan, CS60027, 54519, Vandœuvre-lès-Nancy, France
| | - Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, 63310, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
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Loomis D, Dzhambov AM, Momen NC, Chartres N, Descatha A, Guha N, Kang SK, Modenese A, Morgan RL, Ahn S, Martínez-Silveira MS, Zhang S, Pega F. The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2022; 170:107565. [PMID: 36402034 DOI: 10.1016/j.envint.2022.107565] [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: 06/29/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are the producers of the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). Welding fumes have been classified as carcinogenic to humans (Group 1) by the WHO International Agency for Research on Cancer (IARC) in IARC Monograph 118; this assessment found sufficient evidence from studies in humans that welding fumes are a cause of lung cancer. In this article, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from trachea, bronchus, and lung cancer attributable to occupational exposure to welding fumes, to inform the development of WHO/ILO Joint Estimates on this burden of disease (if considered feasible). OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of any (or high) occupational exposure to welding fumes, compared with no (or low) occupational exposure to welding fumes, on trachea, bronchus, and lung cancer (three outcomes: prevalence, incidence, and mortality). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CENTRAL and CISDOC. We also searched grey literature databases, Internet search engines, and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any Member State of WHO and/or ILO but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies, and other non-randomized intervention studies with an estimate of the effect of any (or high) occupational exposure to welding fumes, compared with occupational exposure to no (or low) welding fumes, on trachea, bronchus, and lung cancer (prevalence, incidence, and mortality). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first review stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. If studies reported odds ratios, these were converted to risk ratios (RRs). We combined all RRs using random-effects meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence, and strength of evidence, using the Navigation Guide tools and approaches adapted to this project. Subgroup (e.g., by WHO region and sex) and sensitivity analyses (e.g., studies judged to be of "high"/"probably high" risk of bias compared with "low"/"probably low" risk of bias) were conducted. RESULTS Forty-one records from 40 studies (29 case control studies and 11 cohort studies) met the inclusion criteria, comprising over 1,265,512 participants (≥22,761 females) in 21 countries in three WHO regions (Region of the Americas, European Region, and Western Pacific Region). The exposure and outcome were generally assessed by job title or self-report, and medical or administrative records, respectively. Across included studies, risk of bias was overall generally probably low/low, with risk judged high or probably high for several studies in the domains for misclassification bias and confounding. Our search identified no evidence on the outcome of having trachea, bronchus, and lung cancer (prevalence). Compared with no (or low) occupational exposure to welding fumes, any (or high) occupational exposure to welding fumes increased the risk of acquiring trachea, bronchus, and lung cancer (incidence) by an estimated 48 % (RR 1.48, 95 % confidence interval [CI] 1.29-1.70, 23 studies, 57,931 participants, I2 24 %; moderate quality of evidence). Compared with no (or low) occupational exposure to welding fumes, any (or high) occupational exposure to welding fumes increased the risk dying from trachea, bronchus, and lung cancer (mortality) by an estimated 27 % (RR 1.27, 95 % CI 1.04-1.56, 3 studies, 8,686 participants, I2 0 %; low quality of evidence). Our subgroup analyses found no evidence for difference by WHO region and sex. Sensitivity analyses supported the main analyses. CONCLUSIONS Overall, for incidence and mortality of trachea, bronchus, and lung cancer, we judged the existing body of evidence for human data as "sufficient evidence of harmfulness" and "limited evidence of harmfulness", respectively. Occupational exposure to welding fumes increased the risk of acquiring and dying from trachea, bronchus, and lung cancer. Producing estimates for the burden of trachea, bronchus, and lung cancer attributable to any (or high) occupational exposure to welding fumes appears evidence-based, and the pooled effect estimates presented in this systematic review could be used as input data for the WHO/ILO Joint Estimates. PROTOCOL IDENTIFIER: https://doi.org/10.1016/j.envint.2020.106089.
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Affiliation(s)
- Dana Loomis
- School of Community Health Sciences, University of Nevada, Reno, Reno, NV, the United States of America; Plumas County Public Health Agency, Plumas County, CA, the United States of America.
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, the United States of America.
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France /Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, SFR ICAT, CAPTV CDC, Angers, France.
| | - Neela Guha
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, the United States of America.
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
| | - Seoyeon Ahn
- National Pension Research Institute, Jeonju-si, Republic of Korea.
| | | | - Siyu Zhang
- National Institute for Occupational Health and Poison Control, Center for Disease Control and Prevention, Beijing, People's Republic of China.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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Rayasam S, Koman PD, Axelrad DA, Woodruff TJ, Chartres N. Toxic Substances Control Act (TSCA) Implementation: How the Amended Law Has Failed to Protect Vulnerable Populations from Toxic Chemicals in the United States. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:11969-11982. [PMID: 35980084 PMCID: PMC9454241 DOI: 10.1021/acs.est.2c02079] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Exposures to industrial chemicals are widespread and can increase the risk of adverse health effects such as cancer, developmental disorders, respiratory effects, diabetes, and reproductive problems. The amended Toxic Substances Control Act (amended TSCA) requires the U.S. Environmental Protection Agency (EPA) to evaluate risks of chemicals in commerce, account for risk to potentially exposed and susceptible populations, and mitigate risks for chemicals determined to pose an unreasonable risk to human health and the environment. This analysis compares EPA's first 10 chemical risk evaluations under amended TSCA to best scientific practices for conducting risk assessments. We find EPA's risk evaluations underestimated human health risks of chemical exposures by excluding conditions of use and exposure pathways; not considering aggregate exposure and cumulative risk; not identifying all potentially exposed or susceptible subpopulations, and not quantifying differences in risk for susceptible groups; not addressing data gaps; and using flawed systematic review approaches to identify and evaluate the relevant evidence. We present specific recommendations for improving the implementation of amended TSCA using the best available science to ensure equitable, socially just safeguards to public health. Failing to remedy these shortcomings will result in continued systematic underestimation of risk for all chemicals evaluated under amended TSCA.
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Affiliation(s)
- Swati
D.G. Rayasam
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
| | - Patricia D. Koman
- Environmental
Health Sciences, University of Michigan
School of Public Health, Ann Arbor, Michigan 48109, United States
| | | | - Tracey J. Woodruff
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
- Environmental
Research and Translation for Health, Department of Obstetrics, Gynecology
and Reproductive Sciences, University of
California San Francisco School of Medicine, San Francisco, California 94143, United States
| | - Nicholas Chartres
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
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Krewski D, Saunders-Hastings P, Baan RA, Barton-Maclaren TS, Browne P, Chiu WA, Gwinn M, Hartung T, Kraft AD, Lam J, Lewis RJ, Sanaa M, Morgan RL, Paoli G, Rhomberg L, Rooney A, Sand S, Schünemann HJ, Straif K, Thayer KA, Tsaioun K. Development of an Evidence-Based Risk Assessment Framework. ALTEX 2022; 39:667-693. [PMID: 36098377 PMCID: PMC10080579 DOI: 10.14573/altex.2004041] [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: 04/07/2020] [Accepted: 06/29/2021] [Indexed: 11/23/2022]
Abstract
Assessment of potential human health risks associated with environmental and other agents requires careful evaluation of all available and relevant evidence for the agent of interest, including both data-rich and data-poor agents. With the advent of new approach methodologies in toxicological risk assessment, guidance on integrating evidence from mul-tiple evidence streams is needed to ensure that all available data is given due consideration in both qualitative and quantitative risk assessment. The present report summarizes the discussions among academic, government, and private sector participants from North America and Europe in an international workshop convened to explore the development of an evidence-based risk assessment framework, taking into account all available evidence in an appropriate manner in order to arrive at the best possible characterization of potential human health risks and associated uncertainty. Although consensus among workshop participants was not a specific goal, there was general agreement on the key consider-ations involved in evidence-based risk assessment incorporating 21st century science into human health risk assessment. These considerations have been embodied into an overarching prototype framework for evidence integration that will be explored in more depth in a follow-up meeting.
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Affiliation(s)
- Daniel Krewski
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
- Risk Sciences International, Ottawa, Canada
| | | | - Robert A. Baan
- The IARC Monographs Programme, International Agency for Research on Cancer, Lyon, France (retired)
| | | | - Patience Browne
- Organization for Economic Cooperation and Development, Paris, France
| | - Weihsueh A. Chiu
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas, USA
| | - Maureen Gwinn
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, USA
| | - Thomas Hartung
- Chair for Evidence-based Toxicology and Center for Alternatives to Animal Testing (CAAT), Johns Hopkins University, Baltimore, USA
- CAAT-Europe, University of Konstanz, Konstanz, Germany
| | - Andrew D. Kraft
- Center for Public Health and Environmental Assessment, Chemical & Pollutant Assessment Division, US EPA, DC, USA
| | - Juleen Lam
- Department of Public Health at California State University, East Bay, USA
| | - R. Jeffrey Lewis
- ExxonMobil Biomedical Sciences, Annandale, New Jersey, USA (retired)
| | - Moez Sanaa
- Agence Nationale Sécurité Sanitaire Alimentaire Nationale, Paris, France
| | | | - Greg Paoli
- Risk Sciences International, Ottawa, Canada
| | | | - Andrew Rooney
- Integrative Health Assessments Branch, National Toxicology Program, US National Institute of Environmental Health Sciences, Research Triangle Park, USA
| | - Salomon Sand
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | | | - Kurt Straif
- The IARC Monographs Programme, International Agency for Research on Cancer, Lyon, France (retired)
| | - Kristina A Thayer
- Center for Public Health and Environmental Assessment, Chemical & Pollutant Assessment Division, US EPA, NC, USA
| | - Katya Tsaioun
- Boston College, Chestnut Hill, MA, USA ISGlobal, Barcelona, Spain
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Marí-Bauset S, Peraita-Costa I, Donat-Vargas C, Llopis-González A, Marí-Sanchis A, Llopis-Morales J, Morales Suárez-Varela M. Systematic review of prenatal exposure to endocrine disrupting chemicals and autism spectrum disorder in offspring. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:6-32. [PMID: 34412519 DOI: 10.1177/13623613211039950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autism spectrum disorders comprise a complex group with many subtypes of behaviorally defined neurodevelopmental abnormalities in two core areas: deficits in social communication and fixated, restricted, repetitive, or stereotyped behaviors and interests each with potential unique risk factors and characteristics. The underlying mechanisms and the possible causes of autism spectrum disorder remain elusive and while increased prevalence is undoubtable, it is unclear if it is a reflection of diagnostic improvement or emerging risk factors such as endocrine disrupting chemicals. Epidemiological studies, which are used to study the relation between endocrine disrupting chemicals and autism spectrum disorder, can have inherent methodological challenges that limit the quality and strength of their findings. The objective of this work is to systematically review the treatment of these challenges and assess the quality and strength of the findings in the currently available literature. The overall quality and strength were "moderate" and "limited," respectively. Risk of bias due to the exclusion of potential confounding factors and the lack of accuracy of exposure assessment methods were the most prevalent. The omnipresence of endocrine disrupting chemicals and the biological plausibility of the association between prenatal exposure and later development of autism spectrum disorder highlight the need to carry out well-designed epidemiological studies that overcome the methodological challenges observed in the currently available literature in order to be able to inform public policy to prevent exposure to these potentially harmful chemicals and aid in the establishment of predictor variables to facilitate early diagnosis of autism spectrum disorder and improve long-term outcomes.
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Affiliation(s)
- Salvador Marí-Bauset
- Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
| | - Isabel Peraita-Costa
- Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Spain
| | | | - Agustín Llopis-González
- Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Spain
| | | | - Juan Llopis-Morales
- Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
| | - María Morales Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Spain
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Patti MA, Henderson NB, Gajjar P, Eliot M, Jackson-Browne M, Braun JM. Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 157:106854. [PMID: 34560323 PMCID: PMC8576608 DOI: 10.1016/j.envint.2021.106854] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/02/2021] [Accepted: 08/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all epidemiological studies. OBJECTIVES We conducted a systematic review and meta-analysis to characterize the relation of gestational triclosan exposure with infant birth weight and identify sources of heterogeneity between studies. METHODS We identified original studies measuring urinary triclosan concentrations during pregnancy and reporting their association with infant birth weight, gestational age (GA) adjusted birth weight (g), or GA-standardized birth weight z-scores. Using a random effects model, we estimated differences in these outcomes per 10-fold increase in triclosan concentrations and considered triclosan levels and infant sex as sources of heterogeneity. Using Navigation Guide Methods, we evaluated risk of bias within individual studies and across the body of evidence. RESULTS Among thirteen studies, median triclosan concentrations varied by almost 2-orders of magnitude (0.6-29 ng/mL), with higher concentrations in North American and some European studies compared to Asian ones. Associations between triclosan and birth weight (β:-20 g; 95% CI:-65, 26; n = 6) were stronger than those for GA-adjusted birth weight (β:-12 g; 95% CI:-29, 5; n = 9). Triclosan was not associated with GA-standardized birth weight z-scores (β:-0.04; 95% CI:-0.16, 0.07; n = 5). The association between triclosan and GA-adjusted birth weight was stronger in studies with median triclosan values ≥10 ng/mL compared to studies with median values < 10 ng/mL (β:-27 g; 95% CI:-61, 7; n = 4 vs. β:6g; 95% CI:-20, 31; n = 5). With a limited number of studies, we observed suggestive evidence that inverse associations were more apparent in studies with ≥ 2 prospective triclosan measures compared to those with one measure. DISCUSSION Available evidence, with "low" risk of bias, provides limited evidence that triclosan exposure and reduces infant birth weight. We observed stronger inverse associations between triclosan concentrations and birth weight in populations with higher triclosan exposure.
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Affiliation(s)
- Marisa A Patti
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Noelle B Henderson
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Priya Gajjar
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Melissa Eliot
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | | | - Joseph M Braun
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
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Teixeira LR, Pega F, Dzhambov AM, Bortkiewicz A, da Silva DTC, de Andrade CAF, Gadzicka E, Hadkhale K, Iavicoli S, Martínez-Silveira MS, Pawlaczyk-Łuszczyńska M, Rondinone BM, Siedlecka J, Valenti A, Gagliardi D. The effect of occupational exposure to noise on ischaemic heart disease, stroke and hypertension: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 154:106387. [PMID: 33612311 PMCID: PMC8204276 DOI: 10.1016/j.envint.2021.106387] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 12/24/2020] [Accepted: 01/07/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from mechanistic data suggests that occupational exposure to noise may cause cardiovascular disease (CVD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from CVD that are attributable to occupational exposure to noise, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of any (high) occupational exposure to noise (≥85 dBA), compared with no (low) occupational exposure to noise (<85 dBA), on the prevalence, incidence and mortality of ischaemic heart disease (IHD), stroke, and hypertension. DATA SOURCES A protocol was developed and published, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies up to 1 April 2019, including International Trials Register, Ovid MEDLINE, PubMed, Embase, Lilacs, Scopus, Web of Science, and CISDOC. The MEDLINE and Pubmed searches were updated on 31 January 2020. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to noise on CVD prevalence, incidence or mortality, compared with the theoretical minimum risk exposure level (<85 dBA). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We prioritized evidence from cohort studies and combined relative risk estimates using random-effect meta-analysis. To assess the robustness of findings, we conducted sensitivity analyses (leave-one-out meta-analysis and used as alternative fixed effects and inverse-variance heterogeneity estimators). At least two review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide tools and approaches adapted to this project. RESULTS Seventeen studies (11 cohort studies, six case-control studies) met the inclusion criteria, comprising a total of 534,688 participants (39,947 or 7.47% females) in 11 countries in three WHO regions (the Americas, Europe, and the Western Pacific). The exposure was generally assessed with dosimetry, sound level meter and/or official or company records. The outcome was most commonly assessed using health records. We are very uncertain (low quality of evidence) about the effect of occupational exposure to noise (≥85 dBA), compared with no occupational exposure to noise (<85 dBA), on: having IHD (0 studies); acquiring IHD (relative risk (RR) 1.29, 95% confidence interval (95% CI) 1.15 to 1.43, two studies, 11,758 participants, I2 0%); dying from IHD (RR 1.03, 95% CI 0.93-1.14, four studies, 198,926 participants, I2 26%); having stroke (0 studies); acquiring stroke (RR 1.11, 95% CI 0.82-1.65, two studies, 170,000 participants, I2 0%); dying from stroke (RR 1.02, 95% CI 0.93-1.12, three studies, 195,539 participants, I2 0%); having hypertension (0 studies); acquiring hypertension (RR 1.07, 95% CI 0.90-1.28, three studies, four estimates, 147,820 participants, I2 52%); and dying from hypertension (0 studies). Data for subgroup analyses were missing. Sensitivity analyses supported the main analyses. CONCLUSIONS For acquiring IHD, we judged the existing body of evidence from human data to provide "limited evidence of harmfulness"; a positive relationship is observed between exposure and outcome where chance, bias, and confounding cannot be ruled out with reasonable confidence. For all other included outcomes, the bodies of evidence were judged as "inadequate evidence of harmfulness". Producing estimates for the burden of CVD attributable to occupational exposure to noise appears to not be evidence-based at this time. PROTOCOL IDENTIFIER 10.1016/j.envint.2018.09.040. PROSPERO REGISTRATION NUMBER CRD42018092272.
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Affiliation(s)
- Liliane R Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
| | - Alicja Bortkiewicz
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Denise T Correa da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Carlos A F de Andrade
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil; School of Medicine, Universidade de Vassouras, Vassouras, RJ, Brazil.
| | - Elzbieta Gadzicka
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Kishor Hadkhale
- Faculty of Social Sciences, University of Tampere, Tampere, Finland.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
| | | | | | - Bruna M Rondinone
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
| | - Jadwiga Siedlecka
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Antonio Valenti
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy.
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9
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Sutton P, Chartres N, Rayasam SDG, Daniels N, Lam J, Maghrbi E, Woodruff TJ. Reviews in environmental health: How systematic are they? ENVIRONMENT INTERNATIONAL 2021; 152:106473. [PMID: 33798823 PMCID: PMC8118386 DOI: 10.1016/j.envint.2021.106473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Synthesizing environmental health science is crucial to taking action to protect public health. Procedures for evidence evaluation and integration are transitioning from "expert-based narrative" to "systematic" review methods. However, little is known about the methodology being utilized for either type of review. OBJECTIVES To appraise the methodological strengths and weaknesses of a sample of "expert-based narrative" and "systematic" reviews in environmental health. METHODS We conducted a comprehensive search of multiple databases and identified relevant reviews using pre-specified eligibility criteria. We applied a modified version of the Literature Review Appraisal Toolkit (LRAT) to three environmental health topics that assessed the utility, validity and transparency of reviews. RESULTS We identified 29 reviews published between 2003 and 2019, of which 13 (45%) were self-identified as systematic reviews. Across every LRAT domain, systematic reviews received a higher percentage of "satisfactory" ratings compared to non-systematic reviews. In eight of these domains, there was a statistically significant difference observed between the two types of reviews and "satisfactory" ratings. Non-systematic reviews performed poorly with the majority receiving an "unsatisfactory" or "unclear" rating in 11 of the 12 domains. Systematic reviews performed poorly in six of the 12 domains; 10 (77%) did not state the reviews objectives or develop a protocol; eight (62%) did not state the roles and contribution of the authors, or evaluate the internal validity of the included evidence consistently using a valid method; and only seven (54%) stated a pre-defined definition of the evidence bar on which their conclusions were based, or had an author disclosure of interest statement. DISCUSSION Systematic reviews produced more useful, valid, and transparent conclusions compared to non-systematic reviews, but poorly conducted systematic reviews were prevalent. Ongoing development and implementation of empirically based systematic review methods are required in environmental health to ensure transparent and timely decision making to protect the public's health.
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Affiliation(s)
- Patrice Sutton
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Nicholas Chartres
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Swati D G Rayasam
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Natalyn Daniels
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States
| | - Juleen Lam
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Eman Maghrbi
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Tracey J Woodruff
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
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10
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Pega F, Chartres N, Guha N, Modenese A, Morgan RL, Martínez-Silveira MS, Loomis D. The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A protocol for a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 145:106089. [PMID: 32950789 PMCID: PMC7569600 DOI: 10.1016/j.envint.2020.106089] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/12/2020] [Accepted: 08/22/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Welding fumes have been classified as carcinogenic to humans (Group 1) by the International Agency for Research on Cancer (IARC); this assessment found sufficient evidence from studies in humans that welding fumes are a cause of lung cancer. In this article, we present the protocol for a systematic review of parameters for estimating the number of deaths and disability-adjusted life years from trachea, bronchus and lung cancer attributable to occupational exposure to welding fumes, to inform the development of the WHO/ILO Joint Estimates. OBJECTIVES We aim to systematically review and meta-analyse estimates of the effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer, applying the Navigation Guide systematic review methodology as an organizing framework. DATA SOURCES We will search electronic bibliographic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any Member State of WHO and/or ILO but exclude children (<15 years) and unpaid domestic workers. The eligible risk factor will be occupational exposure to welding fumes, measured directly or indirectly (i.e., through proxy of relevant occupation, work task, job-exposure matrix, expert judgment or self-report). The eligible outcomes will be trachea, bronchus and lung cancer. We will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of any occupational exposure to welding fumes on the prevalence of, incidence of or mortality from trachea, bronchus and lung cancer, compared with the theoretical minimum risk exposure level of no occupational exposure to welding fumes. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Two or more review authors will assess risk of bias and the quality of evidence, using the Navigation Guide tool or approach. If feasible, we will combine relative risks using meta-analysis. We will report results using the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA).
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Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, United States
| | - Neela Guha
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, United States
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | | | - Dana Loomis
- School of Community Health Sciences, University of Nevada, Reno, Reno, NV, United States
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11
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Li J, Rugulies R, Morgan RL, Woodruff T, Siegrist J. Systematic review and meta-analysis on exposure to long working hours and risk of ischaemic heart disease - Conclusions are supported by the evidence. ENVIRONMENT INTERNATIONAL 2020; 144:106118. [PMID: 33051043 DOI: 10.1016/j.envint.2020.106118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, United States.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Hamilton, Canada.
| | - Tracey Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
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12
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Eick SM, Goin DE, Chartres N, Lam J, Woodruff TJ. Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools. Syst Rev 2020; 9:249. [PMID: 33121530 PMCID: PMC7596989 DOI: 10.1186/s13643-020-01490-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews are increasingly prevalent in environmental health due to their ability to synthesize evidence while reducing bias. Different systematic review methods have been developed by the US National Toxicology Program's Office of Health Assessment and Translation (OHAT), the US Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS), and by the US EPA under the Toxic Substances Control Act (TSCA), including the approach to assess risk of bias (ROB), one of the most vital steps which is used to evaluate internal validity of the studies. Our objective was to compare the performance of three tools (OHAT, IRIS, TSCA) in assessing ROB. METHODS We selected a systematic review on polybrominated diphenyl ethers and intelligence quotient and/or attention deficit hyperactivity disorder because it had been endorsed by the National Academy of Sciences. Two reviewers followed verbatim instructions from the tools and independently applied each tool to assess ROB in 15 studies previously identified. We documented the time to apply each tool and the impact the ROB ratings for each tool had on the final rating of the quality of the overall body of evidence. RESULTS The time to complete the ROB assessments varied widely (mean = 20, 32, and 40 min per study for the OHAT, IRIS, and TSCA tools, respectively). All studies were rated overall "low" or "uninformative" using IRIS, due to "deficient" or "critically deficient" ratings in one or two domains. Similarly, all studies were rated "unacceptable" using the TSCA tool because of one "unacceptable" rating in a metric related to statistical power. Approximately half of the studies had "low" or "probably low ROB" ratings across all domains with the OHAT and Navigation Guide tools. CONCLUSIONS Tools that use overall ROB or study quality ratings, such as IRIS and TSCA, may reduce the available evidence to assess the harms of environmental exposures by erroneously excluding studies, which leads to inaccurate conclusions about the quality of the body of evidence. We recommend using ROB tools that circumvents these issues, such as OHAT and Navigation Guide. SYSTEMATIC REVIEW REGISTRATION This review has not been registered as it is not a systematic review.
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Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.,Department of Health Sciences, California State University, East Bay, Hayward, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.
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13
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Li J, Pega F, Ujita Y, Brisson C, Clays E, Descatha A, Ferrario MM, Godderis L, Iavicoli S, Landsbergis PA, Metzendorf MI, Morgan RL, Pachito DV, Pikhart H, Richter B, Roncaioli M, Rugulies R, Schnall PL, Sembajwe G, Trudel X, Tsutsumi A, Woodruff TJ, Siegrist J. The effect of exposure to long working hours on ischaemic heart disease: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 142:105739. [PMID: 32505014 PMCID: PMC7339147 DOI: 10.1016/j.envint.2020.105739] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/06/2020] [Accepted: 04/11/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing Joint Estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that exposure to long working hours may cause ischaemic heart disease (IHD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from IHD that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on IHD (three outcomes: prevalence, incidence and mortality). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including MEDLINE, Scopus, Web of Science, CISDOC, PsycINFO, and WHO ICTRP. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (aged < 15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies which contained an estimate of the effect of exposure to long working hours (41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on IHD (prevalence, incidence or mortality). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined relative risks using random-effect meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project. RESULTS Thirty-seven studies (26 prospective cohort studies and 11 case-control studies) met the inclusion criteria, comprising a total of 768,751 participants (310,954 females) in 13 countries in three WHO regions (Americas, Europe and Western Pacific). The exposure was measured using self-reports in all studies, and the outcome was assessed with administrative health records (30 studies) or self-reported physician diagnosis (7 studies). The outcome was defined as incident non-fatal IHD event in 19 studies (8 cohort studies, 11 case-control studies), incident fatal IHD event in two studies (both cohort studies), and incident non-fatal or fatal ("mixed") event in 16 studies (all cohort studies). Because we judged cohort studies to have a relatively lower risk of bias, we prioritized evidence from these studies and treated evidence from case-control studies as supporting evidence. For the bodies of evidence for both outcomes with any eligible studies (i.e. IHD incidence and mortality), we did not have serious concerns for risk of bias (at least for the cohort studies). No eligible study was found on the effect of long working hours on IHD prevalence. Compared with working 35-40 h/week, we are uncertain about the effect on acquiring (or incidence of) IHD of working 41-48 h/week (relative risk (RR) 0.98, 95% confidence interval (CI) 0.91 to 1.07, 20 studies, 312,209 participants, I2 0%, low quality of evidence) and 49-54 h/week (RR 1.05, 95% CI 0.94 to 1.17, 18 studies, 308,405 participants, I2 0%, low quality of evidence). Compared with working 35-40 h/week, working ≥55 h/week may have led to a moderately, clinically meaningful increase in the risk of acquiring IHD, when followed up between one year and 20 years (RR 1.13, 95% CI 1.02 to 1.26, 22 studies, 339,680 participants, I2 5%, moderate quality of evidence). Compared with working 35-40 h/week, we are very uncertain about the effect on dying (mortality) from IHD of working 41-48 h/week (RR 0.99, 95% CI 0.88 to 1.12, 13 studies, 288,278 participants, I2 8%, low quality of evidence) and 49-54 h/week (RR 1.01, 95% CI 0.82 to 1.25, 11 studies, 284,474 participants, I2 13%, low quality of evidence). Compared with working 35-40 h/week, working ≥55 h/week may have led to a moderate, clinically meaningful increase in the risk of dying from IHD when followed up between eight and 30 years (RR 1.17, 95% CI 1.05 to 1.31, 16 studies, 726,803 participants, I2 0%, moderate quality of evidence). Subgroup analyses found no evidence for differences by WHO region and sex, but RRs were higher among persons with lower SES. Sensitivity analyses found no differences by outcome definition (exclusively non-fatal or fatal versus "mixed"), outcome measurement (health records versus self-reports) and risk of bias ("high"/"probably high" ratings in any domain versus "low"/"probably low" in all domains). CONCLUSIONS We judged the existing bodies of evidence for human evidence as "inadequate evidence for harmfulness" for the exposure categories 41-48 and 49-54 h/week for IHD prevalence, incidence and mortality, and for the exposure category ≥55 h/week for IHD prevalence. Evidence on exposure to working ≥55 h/week was judged as "sufficient evidence of harmfulness" for IHD incidence and mortality. Producing estimates for the burden of IHD attributable to exposure to working ≥55 h/week appears evidence-based, and the pooled effect estimates presented in this systematic review could be used as input data for the WHO/ILO Joint Estimates.
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Affiliation(s)
- Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, United States.
| | - Frank Pega
- Environment, Climate Change and Health Department, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City G1S 4L8, Quebec, Canada.
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Campus University Hospital Ghent (4K3 - entrance 42), 4K3, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Alexis Descatha
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France.
| | - Marco M Ferrario
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Paul A Landsbergis
- SUNY-Downstate Health Sciences University, School of Public Health, 450 Clarkson Ave., Brooklyn, NY 11238, United States.
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Hamilton, Canada.
| | - Daniela V Pachito
- Hospital Sírio-Libanês and Disciplina de Economia e Gestão em Saúde, Universidade Federal de São Paulo, 412 Barata Ribeiro, Sao Paulo, Brazil.
| | - Hynek Pikhart
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Bernd Richter
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
| | - Mattia Roncaioli
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Peter L Schnall
- Center for Occupational and Environmental Health, University of California-Irvine, 100 Theory Way, Irvine, CA, United States.
| | - Grace Sembajwe
- Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Donald and Barbara Zucker School of Medicine at Hofstra University, 175 Community Drive, NY 11021, United States; Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th Street, New York, NY 10027, United States.
| | - Xavier Trudel
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City G1S 4L8, Quebec, Canada.
| | - Akizumi Tsutsumi
- Department of Public Health, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan.
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
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14
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Censi S, Watutantrige-Fernando S, Groccia G, Manso J, Plebani M, Faggian D, Mion MM, Venturini R, Andrisani A, Casaro A, Vita P, Avogadro A, Camilot M, Scaroni C, Bertazza L, Barollo S, Mian C. The Effects of Iodine Supplementation in Pregnancy on Iodine Status, Thyroglobulin Levels and Thyroid Function Parameters: Results from a Randomized Controlled Clinical Trial in a Mild-to-Moderate Iodine Deficiency Area. Nutrients 2019; 11:nu11112639. [PMID: 31689890 PMCID: PMC6893432 DOI: 10.3390/nu11112639] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Iodine supplementation during pregnancy in areas with mild-to-moderate iodine deficiency is still debated. METHODS A single-center, randomized, single-blind and placebo-controlled (3:2) trial was conducted. We enrolled 90 women before 12 weeks of gestation. From enrollment up until 8 weeks after delivery, 52 women were given an iodine supplement (225 ug/day, potassium iodide tablets) and 38 were given placebo. At recruitment (T0), in the second (T1) and third trimesters (T2), and 8 weeks after delivery (T3), we measured participants' urinary iodine-to-creatinine ratio (UI/Creat), thyroid function parameters (thyroglobulin (Tg), TSH, FT3, and FT4), and thyroid volume (TV). The newborns' urinary iodine concentrations were evaluated in 16 cases. RESULTS Median UI/Creat at recruitment was 53.3 ug/g. UI/Creat was significantly higher in supplemented women at T1 and T2. Tg levels were lower at T1 and T2 in women with UI/Creat ≥ 150 ug/g, and in the Iodine group at T2 (p = 0.02). There was a negative correlation between Tg and UI/Creat throughout the study (p = 0.03, r = -0.1268). A lower TSH level was found in the Iodine group at T3 (p = 0.001). TV increased by +Δ7.43% in the Iodine group, and by +Δ11.17% in the Placebo group. No differences were found between the newborns' TSH levels on screening the two groups. CONCLUSION Tg proved a good parameter for measuring iodine intake in our placebo-controlled series. Iodine supplementation did not prove harmful to pregnancy in areas of mild-to-moderate iodine deficiency, with no appreciable harmful effect on thyroid function.
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Affiliation(s)
- Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | | | - Giulia Groccia
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Mario Plebani
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Diego Faggian
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Monica Maria Mion
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Roberta Venturini
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Alessandra Andrisani
- Department of Women's and Children's Health, University of Padua, Salus Pueri, 35128 Padua, Italy.
| | - Anna Casaro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Pietro Vita
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Alessandra Avogadro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Marta Camilot
- Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.
| | - Carla Scaroni
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
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15
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Costa O, Iñiguez C, Manzano-Salgado CB, Amiano P, Murcia M, Casas M, Irizar A, Basterrechea M, Beneito A, Schettgen T, Sunyer J, Vrijheid M, Ballester F, Lopez-Espinosa MJ. First-trimester maternal concentrations of polyfluoroalkyl substances and fetal growth throughout pregnancy. ENVIRONMENT INTERNATIONAL 2019; 130:104830. [PMID: 31247476 DOI: 10.1016/j.envint.2019.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Several studies have investigated the possible association between prenatal exposure to perfluoroalkyl substances (PFASs) and birth anthropometry. However, none has assessed fetal size longitudinally. We studied the possible association between PFASs and fetal biometry. METHODS In 1230 mother-child pairs of three cohorts from the Spanish INMA-Project, we analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in first-trimester maternal plasma (collection: 2003-2008). We measured abdominal circumference (AC), femur length (FL), biparietal diameter (BPD), and estimated fetal weight (EFW) by ultrasounds at 12, 20, and 34 gestational weeks. We conducted multivariable linear regression analyses between log2-transformed (PFASs) and SD-scores of fetal parameters in each cohort and subsequent meta-analysis. We also assessed effect modification by sex and maternal smoking. RESULTS PFHxS, PFOA, PFOS, and PFNA medians were: 0.58, 2.35, 6.05, and 0.65 ng/mL, respectively. There were no associations for the whole population in any trimester of pregnancy. However, we found an indication that maternal smoking modified the effect in different directions depending on the PFAS. Among smokers (31%), we found negative associations between both PFOA and PFNA and FL or EFW at week 20 (% change ranging between -6.8% and -5.7% per twofold PFAS increase) and positive associations between PFHxS or PFOS and BPD at week 34 (6.8% and 6.3%, respectively). CONCLUSIONS Results did not suggest an overall association between prenatal PFASs and fetal growth. The results among smokers should be taken with caution and further studies are warranted to elucidate the possible role of smoking in this association.
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Affiliation(s)
- Olga Costa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Carmen Iñiguez
- Department of Statistics and Computational Research, Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Cyntia B Manzano-Salgado
- ISGlobal, Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Maribel Casas
- ISGlobal, Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amaia Irizar
- Health Research Institute, Biodonostia, San Sebastian, Spain
| | - Mikel Basterrechea
- Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Andrea Beneito
- Department of Nursing and Chiropody, Universitat de València, Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Thomas Schettgen
- Institute for Occupational Medicine, RWTH Aachen University, Aachen, Germany
| | - Jordi Sunyer
- ISGlobal, Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ferran Ballester
- Department of Nursing and Chiropody, Universitat de València, Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria-Jose Lopez-Espinosa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Nursing and Chiropody, Universitat de València, Valencia, Spain.
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16
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Paulo MS, Adam B, Akagwu C, Akparibo I, Al-Rifai RH, Bazrafshan S, Gobba F, Green AC, Ivanov I, Kezic S, Leppink N, Loney T, Modenese A, Pega F, Peters CE, Prüss-Üstün AM, Tenkate T, Ujita Y, Wittlich M, John SM. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer. ENVIRONMENT INTERNATIONAL 2019; 126:804-815. [PMID: 30792021 DOI: 10.1016/j.envint.2018.09.039] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/20/2018] [Accepted: 09/23/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER CRD42018094817.
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Affiliation(s)
- Marilia Silva Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Balazs Adam
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Division of Occupational Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
| | - Cyril Akagwu
- Defence Health Maintenance Limited, Ministry of Defence, Nigeria
| | - Issaka Akparibo
- Division of Aerospace Medicine, Wright State University, OH, USA.
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy.
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, QLD 4029, Australia; CRUK Manchester Institute, University of Manchester, Manchester, UK.
| | - Ivan Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Sanja Kezic
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Tom Loney
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Cheryl E Peters
- Alberta Health Services & University of Calgary Calgary, Canada; CAREX Canada, Simon Fraser University, Vancouver, Canada.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Thomas Tenkate
- Ryerson University, School of Occupational & Public Health, Canada.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Marc Wittlich
- Institute for Occupational Safety and Health, German Social Accident Insurance (IFA), Sankt Augustin, Germany.
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany; Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Lower-Saxonian Institute of Occupational Dermatology, Osnabrück, Germany.
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17
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Zhao W, Li X, Xia X, Gao Z, Han C. Iodine Nutrition During Pregnancy: Past, Present, and Future. Biol Trace Elem Res 2019; 188:196-207. [PMID: 30218312 DOI: 10.1007/s12011-018-1502-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022]
Abstract
Iodine is a trace element that is important for the synthesis of thyroid hormones. During pregnancy, iodine requirements are increased by approximately 50% because of physiological changes. Adequate iodine status in pregnancy is crucial for maternal health and fetal growth. The World Health Organization (WHO) recommends a daily intake of 250 μg iodine for pregnant women to maintain adequate iodine status. Severe iodine deficiency during pregnancy can result in a series of detrimental effects on maternal and fetal health including hypothyroidism, goiter, stillbirth, abortion, increased neonatal mortality, neurological damage, and intellectual impairment. Correction of severe iodine deficiency can reduce the risk of adverse impacts. However, the influences of mild-to-moderate maternal iodine deficiency on fetal neural development and cognitive function are less clear. The safety and efficacy of iodine supplementation in mildly-to-moderately iodine-deficient women also remain uncertain. In addition, excess iodine during pregnancy carries a risk of adverse effects, and the recommended safe upper limits of iodine intake are controversial. Effective iodine supplementation should be implemented, and routine monitoring is necessary to guarantee adequate iodine status.
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Affiliation(s)
- Wei Zhao
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China
| | - Xinyu Li
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China
| | - Xinghai Xia
- Department of Cellular and Molecular Physiology, Pennsylvania State University, College of Medicine, 500 University Dr, Hershey, PA, 17033, USA
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China.
| | - Cheng Han
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Forchheimer 216, the Bronx, New York, NY, 10461, USA.
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18
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Marí-Bauset S, Donat-Vargas C, Llópis-González A, Marí-Sanchis A, Peraita-Costa I, Llopis-Morales J, Morales-Suárez-Varela M. Endocrine Disruptors and Autism Spectrum Disorder in Pregnancy: A Review and Evaluation of the Quality of the Epidemiological Evidence. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E157. [PMID: 30477137 PMCID: PMC6306747 DOI: 10.3390/children5120157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 11/13/2018] [Accepted: 11/19/2018] [Indexed: 12/23/2022]
Abstract
Exposure to environmental contaminants during pregnancy has been linked to adverse health outcomes later in life. Notable among these pollutants are the endocrine disruptors chemicals (EDCs), which are ubiquitously present in the environment and they have been measured and quantified in the fetus. In this systematic review, our objective was to summarize the epidemiological research on the potential association between prenatal exposure to EDCs and Autism Spectrum Disorder (ASD) published from 2005 to 2016. The Navigation Guide Systematic Review Methodology was applied. A total of 17 studies met the inclusion criteria for this review, including: five cohorts and 12 case-control. According to the definitions specified in the Navigation Guide, we rated the quality of evidence for a relationship between prenatal exposure to EDCs and ASD as "moderate". Although the studies generally showed a positive association between EDCs and ASD, after considering the strengths and limitations, we concluded that the overall strength of evidence supporting an association between prenatal exposure to EDCs and later ASD in humans remains "limited" and inconclusive. Further well-conducted prospective studies are warranted to clarify the role of EDCs on ASD development.
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Affiliation(s)
- Salvador Marí-Bauset
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
| | - Carolina Donat-Vargas
- Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 65 Solna, Sweden.
| | - Agustín Llópis-González
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
- Biomedical Research Center Network on Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Amelia Marí-Sanchis
- Clinical Nutrition and Dietetics Unit, Navarra Hospital Complex, Calle de Irunlarrea, 3, Pamplona, 31008 Navarre, Spain.
| | - Isabel Peraita-Costa
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
- Biomedical Research Center Network on Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Juan Llopis-Morales
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
| | - María Morales-Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
- Biomedical Research Center Network on Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
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19
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Buck Louis GM, Zhai S, Smarr MM, Grewal J, Zhang C, Grantz KL, Hinkle SN, Sundaram R, Lee S, Honda M, Oh J, Kannan K. Endocrine disruptors and neonatal anthropometry, NICHD Fetal Growth Studies - Singletons. ENVIRONMENT INTERNATIONAL 2018; 119:515-526. [PMID: 30055518 PMCID: PMC6267852 DOI: 10.1016/j.envint.2018.07.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Intrauterine exposure to endocrine disrupting chemicals (EDCs) has been equivocally associated with birth weight, length and head circumference with limited attention to anthropometric endpoints such as umbilical circumference and limb lengths. OBJECTIVE To explore 76 prenatal maternal plasma EDC concentrations in a healthy obstetric cohort and 7 neonatal anthropometric endpoints by maternal race/ethnicity. METHODS The study cohort comprised 2106 (564 White, 549 Black, 590 Hispanic, 403 Asian) healthy pregnant women recruited from 12 U.S. clinical sites between 2009 and 2012 who were followed through delivery. Neonates underwent standardized anthropometric assessment (weight, length, head and umbilical circumference, and mid- upper arm and thigh length). Plasma EDC concentrations were quantified using high resolution gas chromatography-high resolution mass spectrometry and liquid chromatography-tandem mass spectrometry. EDCs were log-transformed and rescaled by their deviations (SD) when modeled relative to neonatal endpoints using linear regression adjusting for age, education, pre-pregnancy body mass index (BMI), serum cotinine, serum lipids for lipophilic chemicals, and a race/ethnicity interaction term; p-values had false discovery rate correction (<0.05). RESULTS The cohort comprised women aged 28 (SD = 5) years with normal BMIs (23.6 kg/m2, SD = 3). Maternal EDC concentrations varied by self-identified race/ethnicity and neonatal outcomes, though no specific EDC was consistently associated with neonatal anthropometric outcomes across racial/ethnic groups. For the overall cohort, perfluorooctanoic acid was negatively associated with birth length per SD increase in concentration (β = -0.23 cm; 95% CI -0.35, -0.10), while perfluorohexanesulfonic acid was negatively associated with umbilical circumference (β = -0.26 cm; 95% CI -0.40, -0.13), perfluorodecanoic acid with arm length (-0.09 cm; 95% CI -0.14, -0.04), and PCBs congeners 118/106 (-0.12 cm; 95% CI -0.20, -0.04) and 146/161 (-0.14 cm; 95% CI -0.23, -0.05) with thigh length, as were 7 other poly-and-perfluorinated alkyl substances (PFASs). CONCLUSIONS Among healthy pregnant women with low risk antenatal profiles and relatively low EDC concentrations, reductions in umbilical circumference and bone lengths may be a sensitive marker of intrauterine EDC exposure, particularly for PFAS.
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Affiliation(s)
- Germaine M Buck Louis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA; College of Health and Human Services, George Mason University, 4400 University Drive, MS2G7, Fairfax, VA 22030, USA.
| | | | - Melissa M Smarr
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Jagteshwar Grewal
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710b Rockledge Drive, Bethesda, MD 20892, USA
| | - Sunmi Lee
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York 12201, USA
| | - Masato Honda
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York 12201, USA
| | - JungKeun Oh
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York 12201, USA
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York 12201, USA
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Descatha A, Sembajwe G, Baer M, Boccuni F, Di Tecco C, Duret C, Evanoff BA, Gagliardi D, Ivanov ID, Leppink N, Marinaccio A, Magnusson Hanson LL, Ozguler A, Pega F, Pell J, Pico F, Prüss-Üstün A, Ronchetti M, Roquelaure Y, Sabbath E, Stevens GA, Tsutsumi A, Ujita Y, Iavicoli S. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on stroke. ENVIRONMENT INTERNATIONAL 2018; 119:366-378. [PMID: 30005185 DOI: 10.1016/j.envint.2018.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from stroke attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (called Systematic Review 1 in the protocol) and systematically review and meta-analyse estimates of the effect of long working hours on stroke (called Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of occupational exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation, in the years 2005-2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of a relevant level of long working hours on the incidence of or mortality due to stroke, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017060124.
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Affiliation(s)
- Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches,), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States of America.
| | - Michael Baer
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Cristina Di Tecco
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Clément Duret
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), France; Inserm, U1168 UMS 011, Villejuif, France
| | - Bradley A Evanoff
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Alessandro Marinaccio
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | | | - Anna Ozguler
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France; Inserm UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - John Pell
- Hunter College Libraries, Social Work and Public Health Library, New York, NY, United States of America.
| | - Fernando Pico
- Neurology and Stroke Unit, Versailles Hospital, Le Chesnay, France.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Matteo Ronchetti
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Yves Roquelaure
- Irset - Inserm UMR 1085 - Equipe Ester, UFR Santé, Département de Médecine, Angers Cedex, France.
| | - Erika Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, United States of America.
| | - Gretchen A Stevens
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Akizumi Tsutsumi
- Kitasato University School of Medicine, Minami, Sagamihara, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
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Govarts E, Iszatt N, Trnovec T, de Cock M, Eggesbø M, Palkovicova Murinova L, van de Bor M, Guxens M, Chevrier C, Koppen G, Lamoree M, Hertz-Picciotto I, Lopez-Espinosa MJ, Lertxundi A, Grimalt JO, Torrent M, Goñi-Irigoyen F, Vermeulen R, Legler J, Schoeters G. Prenatal exposure to endocrine disrupting chemicals and risk of being born small for gestational age: Pooled analysis of seven European birth cohorts. ENVIRONMENT INTERNATIONAL 2018; 115:267-278. [PMID: 29605679 DOI: 10.1016/j.envint.2018.03.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND AIMS There is evidence that endocrine disrupting chemicals (EDCs) have developmental effects at environmental concentrations. We investigated whether some EDCs are associated with the adverse birth outcome Small for Gestational Age (SGA). METHODS We used PCB 153, p,p'-DDE, HCB, PFOS and PFOA measured in maternal, cord blood or breast milk samples of 5446 mother-child pairs (subset of 693 for the perfluorinated compounds) from seven European birth cohorts (1997-2012). SGA infants were those with birth weight below the 10th percentile for the norms defined by gestational age, country and infant's sex. We modelled the association between measured or estimated cord serum EDC concentrations and SGA using multiple logistic regression analyses. We explored effect modification by child's sex and maternal smoking during pregnancy. RESULTS Among the 5446 newborns, 570 (10.5%) were SGA. An interquartile range (IQR) increase in PCB 153 was associated with a modestly increased risk of SGA (odds ratio (OR) of 1.05 [95% CI: 1.04-1.07]) that was stronger in girls (OR of 1.09 [95% CI: 1.04-1.14]) than in boys (OR of 1.03 [95% CI: 1.03-1.04]) (p-interaction = 0.025). For HCB, we found a modestly increased odds of SGA in girls (OR of 1.04 [95% CI: 1.01-1.07] per IQR increase), and an inverse association in boys (OR of 0.90 [95% CI: 0.85-0.95]) (p-interaction = 0.0003). Assessment of the HCB-sex-smoking interaction suggested that the increased odds of SGA associated with HCB exposure was only in girls of smoking mothers (OR of 1.18 [95% CI: 1.11-1.25]) (p-interaction = 0.055). Higher concentrations of PFOA were associated with greater risk of SGA (OR of 1.64 [95% CI: 0.97-2.76]). Elevated PFOS levels were associated with increased odds of SGA in newborns of mothers who smoked during pregnancy (OR of 1.63 [95% CI: 1.02-2.59]), while an inverse association was found in those of non-smoking mothers (OR of 0.66 [95% CI: 0.61-0.72]) (p-interaction = 0.0004). No significant associations were found for p,p'-DDE. CONCLUSIONS Prenatal environmental exposure to organochlorine and perfluorinated compounds with endocrine disrupting properties may contribute to the prevalence of SGA. We found indication of effect modification by child's sex and smoking during pregnancy. The direction of the associations differed by chemical and these effect modifiers, suggesting diverse mechanisms of action and biological pathways.
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Affiliation(s)
- Eva Govarts
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
| | - Nina Iszatt
- Department of Contaminants, Diet and Microbiota, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Tomas Trnovec
- Slovak Medical University, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - Marijke de Cock
- Department of Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Merete Eggesbø
- Department of Contaminants, Diet and Microbiota, Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lubica Palkovicova Murinova
- Slovak Medical University, Faculty of Public Health, Department of Environmental Medicine, Bratislava, Slovakia
| | - Margot van de Bor
- Department of Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Gudrun Koppen
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Marja Lamoree
- Institute for Environmental Studies (IVM), VU University, Amsterdam, The Netherlands
| | - Irva Hertz-Picciotto
- Department of Health Sciences, School of Medicine, University of California, Davis, USA
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Aitana Lertxundi
- Department of Preventive Medicine and Public Health, University of Basque Country (UPV/EHU), Bilbao, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain
| | - Joan O Grimalt
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Servicio de Salud de las Islas Baleares (IB-Salut), Area de Salut de Menorca, Balearic Islands, Spain
| | - Fernando Goñi-Irigoyen
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Research Institute, Biodonostia, San Sebastian, Spain; Public Health Laboratory in Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Juliette Legler
- Institute for Environmental Studies (IVM), VU University, Amsterdam, The Netherlands; Division of Toxicology and Veterinary Pharmacology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Greet Schoeters
- Unit Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; University of Southern Denmark, Institute of Public Health, Department of Environmental Medicine, Odense, Denmark
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Malits J, Blustein J, Trasande L, Attina TM. Perfluorooctanoic acid and low birth weight: Estimates of US attributable burden and economic costs from 2003 through 2014. Int J Hyg Environ Health 2018; 221:269-275. [DOI: 10.1016/j.ijheh.2017.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/03/2017] [Accepted: 11/20/2017] [Indexed: 11/29/2022]
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Nachman KE, Lam J, Schinasi LH, Smith TC, Feingold BJ, Casey JA. O'Connor et al. systematic review regarding animal feeding operations and public health: critical flaws may compromise conclusions. Syst Rev 2017; 6:179. [PMID: 28859697 PMCID: PMC5580209 DOI: 10.1186/s13643-017-0575-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/22/2017] [Indexed: 12/27/2022] Open
Abstract
In this comment, we summarize several scientific concerns with the recently published systematic review from O'Connor and colleagues that examined the relationship between proximity to animal-feeding operations and health of individuals in nearby communities. The authors utilized a bias tool not designed for environmental health research, erroneously excluded important studies, and incorrectly interpreted others. As a result, the conclusions drawn in the review misrepresent the evidence from the published literature, limiting its value to policymakers, researchers, and the public.
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Affiliation(s)
- Keeve E Nachman
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD, USA.
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Suite W7010-E, Baltimore, MD, 21205, USA.
- Johns Hopkins Risk Sciences and Public Policy Institute, Baltimore, MD, USA.
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of OB/GYN & RS, University of California, San Francisco, CA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Tara C Smith
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, USA
- Center for Emerging Infectious Diseases, University of Iowa College of Public Health, Coralville, IA, USA
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH, USA
| | - Beth J Feingold
- Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA
| | - Joan A Casey
- School of Public Health, University of California, Berkeley, CA, USA
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24
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Lam J, Lanphear BP, Bellinger D, Axelrad DA, McPartland J, Sutton P, Davidson L, Daniels N, Sen S, Woodruff TJ. Developmental PBDE Exposure and IQ/ADHD in Childhood: A Systematic Review and Meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:086001. [PMID: 28799918 PMCID: PMC5783655 DOI: 10.1289/ehp1632] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. OBJECTIVE We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit/Hyperactivity Disorder (ADHD) and attention-related behavioral conditions in humans. METHODS We searched articles published up to 26 September 2016, and included original studies that quantified exposures to PBDEs incurred any time in proximity to conception or during in utero, perinatal, or childhood time periods. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. We established criteria in advance to identify studies that could be combined using random effects meta-analyses (DerSimonian-Laird method). RESULTS Fifteen studies met the inclusion criteria; 10 studies met the criteria for intelligence and nine for attention-related problems. We rated studies generally with "low" to "probably low" risk of bias and rated the overall body of evidence as "moderate" quality with "sufficient" evidence for an association between Intelligence Quotient (IQ) and PBDEs. Our meta-analysis of four studies estimated a 10-fold increase (in other words, times 10) in PBDE exposure associated with a decrement of 3.70 IQ points (95% confidence interval: 0.83, 6.56). We concluded the body of evidence was of "moderate" quality for ADHD with "limited" evidence for an association with PBDEs, based on the heterogeneity of association estimates reported by a small number of studies and the fact that chance, bias, and confounding could not be ruled out with reasonable confidence. CONCLUSION We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence. https://doi.org/10.1289/EHP1632.
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Affiliation(s)
- Juleen Lam
- Program on Reproductive Health and the Environment, University of California , San Francisco, San Francisco, California, USA
| | | | - David Bellinger
- Harvard School of Public Health, Harvard University , Boston, Massachusetts, USA
| | - Daniel A Axelrad
- Office of Policy, U.S. Environmental Protection Agency , Washington, District of Columbia, USA
| | | | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California , San Francisco, San Francisco, California, USA
| | - Lisette Davidson
- Department of Obstetrics and Gynecology, Kaiser Permanente , Oakland, California, USA
| | - Natalyn Daniels
- Program on Reproductive Health and the Environment, University of California , San Francisco, San Francisco, California, USA
| | - Saunak Sen
- University of Tennessee Health Science Center , Memphis, Tennessee, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California , San Francisco, San Francisco, California, USA
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Mora AM, Oken E, Rifas-Shiman SL, Webster TF, Gillman MW, Calafat AM, Ye X, Sagiv SK. Prenatal Exposure to Perfluoroalkyl Substances and Adiposity in Early and Mid-Childhood. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:467-473. [PMID: 27352404 PMCID: PMC5332178 DOI: 10.1289/ehp246] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/19/2016] [Accepted: 05/31/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Few studies have examined whether prenatal exposure to perfluoroalkyl substances (PFASs) is associated with childhood adiposity. OBJECTIVE We examined associations of prenatal exposure to PFASs with adiposity in early and mid-childhood. METHODS We measured plasma PFAS concentrations in 1,645 pregnant women (median, 9.6 weeks gestation) enrolled in Project Viva, a prospective pre-birth cohort study in Massachusetts (USA), between 1999 and 2002. We assessed overall and central adiposity in 1,006 children in early childhood (median, 3.2 years) and 876 in mid-childhood (median, 7.7 years) using anthropometric and dual X-ray absorptiometry (DXA) measurements. We fitted multivariable linear regression models to estimate exposure-outcome associations and evaluated effect modification by child sex. RESULTS Median (25-75th percentiles) prenatal plasma perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA) concentrations in children assessed in early childhood were 5.6 (4.1-7.7), 24.8 (18.4-33.9), 2.4 (1.6-3.8), and 0.6 (0.5-0.9) ng/mL, respectively. Among girls, each interquartile range increment of prenatal PFOA concentrations was associated with 0.21 kg/m2 (95% CI: -0.05, 0.48) higher body mass index, 0.76 mm (95% CI: -0.17, 1.70) higher sum of subscapular and triceps skinfold thickness, and 0.17 kg/m2 (95% CI: -0.02, 0.36) higher DXA total fat mass index in mid-childhood. Similar associations were observed for PFOS, PFHxS, and PFNA. We observed null associations for boys and early-childhood adiposity measures. CONCLUSIONS In this cohort, prenatal exposure to PFASs was associated with small increases in adiposity measurements in mid-childhood, but only among girls. Citation: Mora AM, Oken E, Rifas-Shiman SL, Webster TF, Gillman MW, Calafat AM, Ye X, Sagiv SK. 2017. Prenatal exposure to perfluoroalkyl substances and adiposity in early and mid-childhood. Environ Health Perspect 125:467-473; http://dx.doi.org/10.1289/EHP246.
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Affiliation(s)
- Ana María Mora
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Thomas F. Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon K. Sagiv
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, California, USA
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26
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Pan Y, Zhu Y, Zheng T, Cui Q, Buka SL, Zhang B, Guo Y, Xia W, Yeung LWY, Li Y, Zhou A, Qiu L, Liu H, Jiang M, Wu C, Xu S, Dai J. Novel Chlorinated Polyfluorinated Ether Sulfonates and Legacy Per-/Polyfluoroalkyl Substances: Placental Transfer and Relationship with Serum Albumin and Glomerular Filtration Rate. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:634-644. [PMID: 27931097 DOI: 10.1021/acs.est.6b04590] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Per- and polyfluoroalkyl substances (PFASs) may cross the placental barrier and lead to fetal exposure. However, little is known about the factors that influence maternal-fetal transfer of these chemicals. PFAS concentrations were analyzed in 100 paired samples of human maternal sera collected in each trimester and cord sera at delivery; these samples were collected in Wuhan, China, 2014. Linear regression was used to estimate associations of transfer efficiencies with factors. Chlorinated polyfluorinated ether sulfonates (Cl-PFAESs, 6:2 and 8:2) were frequently detected (>99%) in maternal and cord sera. A significant decline in PFAS levels during the three trimesters was observed. A U-shape trend for transfer efficiency with increasing chain length was observed for both carboxylates and sulfonates. Higher transfer efficiencies of PFASs were associated with advancing maternal age, higher education, and lower glomerular filtration rate (GFR). Cord serum albumin was a positive factors for higher transfer efficiency (increased 1.1-4.1% per 1g/L albumin), whereas maternal serum albumin tended to reduce transfer efficiency (decreased 2.4-4.3% per 1g/L albumin). Our results suggest that exposure to Cl-PFAESs may be widespread in China. The transfer efficiencies among different PFASs were structure-dependent. Physiological factors (e.g., GFR and serum albumin) were observed for the first time to play critical roles in PFAS placental transfer.
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Affiliation(s)
- Yitao Pan
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences , Beijing 100101, P. R. China
| | - Yingshuang Zhu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University , Providence, Rhode Island 02912, United States
| | - Qianqian Cui
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences , Beijing 100101, P. R. China
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University , Providence, Rhode Island 02912, United States
| | - Bin Zhang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
- Women and Children Medical and Healthcare Center of Wuhan , Wuhan 430030, Hubei, P. R. China
| | - Yong Guo
- Key Laboratory of Organofluorine Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences , Shanghai 200032, P. R. China
| | - Wei Xia
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Leo W Y Yeung
- Man-Technology-Environment Research Centre (MTM), School of Science and Technology, Örebro University , SE-70182, Örebro, Sweden
| | - Yuanyuan Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Aifen Zhou
- Women and Children Medical and Healthcare Center of Wuhan , Wuhan 430030, Hubei, P. R. China
| | - Lin Qiu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
- Women and Children Medical and Healthcare Center of Wuhan , Wuhan 430030, Hubei, P. R. China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Minmin Jiang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Chuansha Wu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Shunqing Xu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Hubei, P. R. China
| | - Jiayin Dai
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences , Beijing 100101, P. R. China
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Igra AM, Harari F, Lu Y, Casimiro E, Vahter M. Boron exposure through drinking water during pregnancy and birth size. ENVIRONMENT INTERNATIONAL 2016; 95:54-60. [PMID: 27502898 DOI: 10.1016/j.envint.2016.07.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/19/2016] [Accepted: 07/28/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Boron is a metalloid found at highly varying concentrations in soil and water. Experimental data indicate that boron is a developmental toxicant, but the few human toxicity data available concern mostly male reproduction. OBJECTIVES To evaluate potential effects of boron exposure through drinking water on pregnancy outcomes. METHODS In a mother-child cohort in northern Argentina (n=194), 1-3 samples of serum, whole blood and urine were collected per woman during pregnancy and analyzed for boron and other elements to which exposure occurred, using inductively coupled plasma mass spectrometry. Infant weight, length and head circumference were measured at birth. RESULTS Drinking water boron ranged 377-10,929μg/L. The serum boron concentrations during pregnancy ranged 0.73-605μg/L (median 133μg/L) and correlated strongly with whole-blood and urinary boron, and, to a lesser extent, with water boron. In multivariable-adjusted linear spline regression analysis (non-linear association), we found that serum boron concentrations above 80μg/L were inversely associated with birth length (B-0.69cm, 95% CI -1.4; -0.024, p=0.043, per 100μg/L increase in serum boron). The impact of boron appeared stronger when we restricted the exposure to the third trimester, when the serum boron concentrations were the highest (0.73-447μg/L). An increase in serum boron of 100μg/L in the third trimester corresponded to 0.9cm shorter and 120g lighter newborns (p=0.001 and 0.021, respectively). CONCLUSIONS Considering that elevated boron concentrations in drinking water are common in many areas of the world, although more screening is warranted, our novel findings warrant additional research on early-life exposure in other populations.
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Affiliation(s)
- Annachiara Malin Igra
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
| | - Florencia Harari
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Ying Lu
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
| | - Esperanza Casimiro
- Atención Primaria de la Salud, Área Operativa XXIX, Hospital Dr. Nicolás Cayetano Pagano, San Antonio de los Cobres, 4411, Salta, Argentina
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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Sheehan MC, Lam J, Navas-Acien A, Chang HH. Ambient air pollution epidemiology systematic review and meta-analysis: A review of reporting and methods practice. ENVIRONMENT INTERNATIONAL 2016; 92-93:647-56. [PMID: 26923218 DOI: 10.1016/j.envint.2016.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 01/12/2016] [Accepted: 02/11/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Systematic review and meta-analysis (SRMA) are increasingly employed in environmental health (EH) epidemiology and, provided methods and reporting are sound, contribute to translating science evidence to policy. Ambient air pollution (AAP) is both among the leading environmental causes of mortality and morbidity worldwide, and of growing policy relevance due to health co-benefits associated with greenhouse gas emissions reductions. OBJECTIVES We reviewed the published AAP SRMA literature (2009 to mid-2015), and evaluated the consistency of methods, reporting and evidence evaluation using a 22-point questionnaire developed from available best-practice consensus guidelines and emerging recommendations for EH. Our goal was to contribute to enhancing the utility of AAP SRMAs to EH policy. RESULTS AND DISCUSSION We identified 43 studies that used both SR and MA techniques to examine associations between the AAPs PM2.5, PM10, NO2, SO2, CO and O3, and various health outcomes. On average AAP SRMAs partially or thoroughly addressed 16 of 22 questions (range 10-21), and thoroughly addressed 13 of 22 (range 5-19). We found evidence of an improving trend over the period. However, we observed some weaknesses, particularly infrequent formal reviews of underlying study quality and risk-of-bias that correlated with lower frequency of thorough evaluation for key study quality parameters. Several other areas for enhanced reporting are highlighted. CONCLUSIONS The AAP SRMA literature, in particular more recent studies, indicate broad concordance with current and emerging best practice guidance. Development of an EH-specific SRMA consensus statement including a risk-of-bias evaluation tool, would be a contribution to enhanced reliability and robustness as well as policy utility.
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Affiliation(s)
- Mary C Sheehan
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, United States.
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of OB/GYN & RS, University of California, San Francisco, United States.
| | - Ana Navas-Acien
- Environmental Health Sciences Department, Johns Hopkins Bloomberg School of Public Health, United States.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Emory University, United States.
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Zlatnik MG. Endocrine-Disrupting Chemicals and Reproductive Health. J Midwifery Womens Health 2016; 61:442-55. [PMID: 27391253 PMCID: PMC6701840 DOI: 10.1111/jmwh.12500] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/21/2016] [Accepted: 05/03/2016] [Indexed: 12/15/2022]
Abstract
This review discusses the evidence linking industrial chemicals to a variety of health and reproductive outcomes. Industrial chemical production has increased over the past 30 to 40 years. Basic science, animal models, and epidemiologic data suggest that certain chemicals may act as endocrine disruptors (substances that interfere with normal hormonal action) and may play an etiologic role in a number of conditions whose incidence has also increased during this same period. These include low birth weight, gestational diabetes, obesity, certain cancers, certain birth defects, and neurodevelopmental disorders such as attention deficit disorder and autism. In addition, some environmental chemicals may have epigenetic effects, resulting in transgenerational health impacts. The epidemiologic and experimental evidence that links chemicals such as plasticizers (eg, phthalates and phenols), flame retardants, perfluorinated compounds, and pesticides with adverse reproductive health outcomes is reviewed. Women's health care providers are the liaison between scientific research and their patients; they should educate themselves on the significance of environmental toxins to health. They are ideally positioned, not only to counsel and reassure pregnant women, but also to suggest practicable changes in dietary and lifestyle habits to improve their health. Furthermore, women's health care providers should advocate for regulatory changes that protect women and their families from the health effects of environmental toxins.
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Woodruff TJ. Making it real--the environmental burden of disease. What does it take to make people pay attention to the environment and health? J Clin Endocrinol Metab 2015; 100:1241-4. [PMID: 25844765 PMCID: PMC6693198 DOI: 10.1210/jc.2015-1622] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143
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