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Orangzeb S, Desalegn A, Trinh NTH, Zhao J, Nordeng H, Lupattelli A. COVID-19 vaccine uptake among children and adolescents in Norway: A comprehensive registry-based cohort study of over 800,000 individuals. Vaccine 2024:S0264-410X(24)00464-X. [PMID: 38641494 DOI: 10.1016/j.vaccine.2024.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
Factors related with COVID-19 vaccine uptake in children and adolescents in Norway remain unclear, despite this being useful knowledge for future pandemic preparedness. This study aimed to comprehensively examine individual and familial factors associated with vaccine uptake in children and adolescents in Norway. We utilized nationwide registry-data from various health registries and Statistics Norway, encompassing all children and adolescents living in Norway during the pandemic, until 31-Dec-2022. Vaccine uptake is defined as receiving at least one dose of COVID-19 vaccine. We employed a forward stepwise logistic regression model and a random forest machine-learning algorithm to explore the relationship between vaccine uptake and socio-cultural, demographic, and health-related factors. We included 423,548 5-11-year-olds, 269,830 12-15-year-olds, and 120,854 16-17-year-olds. Vaccine uptake in these three groups was respectively 2.6 %, 73.3 %, and 87.3 %. Factors associated with vaccine uptake varied by age group. In youngest children, immigrant background (Odds-ratio (OR) = 1.58, 95 % confidence interval (CI) (1.14-2.19)), born extremely preterm (OR = 2.38, 95 % CI (1.60-3.54)), having risk of severe COVID-19 (OR = 5.40, 95 % CI (4.69-6.23) and maternal COVID-19 vaccination (OR = 6.34, 95 % CI (5.35-7.53)) were positively associated with vaccine uptake. The latter two factors were also strongly, positively associated with vaccine uptake in 12-15-year-olds, while previous SARS-CoV-2 infection was negatively associated (OR = 0.12, 95 % CI (0.11-0.14). Similar findings were observed in 16-17-year-olds. COVID-19 vaccine uptake differed markedly by age group, and major associated factors included socio-demographics and parental COVID-19 vaccination status, prior SARS-CoV-2 infection, but also being born premature and having moderate or high risk of severe COVID-19.
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Affiliation(s)
- Saima Orangzeb
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Anteneh Desalegn
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Jing Zhao
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
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Rodríguez-Carrillo A, Remy S, Koppen G, Wauters N, Mustieles V, Desalegn A, Iszatt N, den Hond E, Verheyen VJ, Fábelová L, Murinova LP, Pedraza-Díaz S, Esteban M, Poyatos RM, Govarts E, van Nuijs ALN, Covaci A, Schoeters G, Olea N, Fernández MF. Urinary phthalate/DINCH metabolites associations with kisspeptin and reproductive hormones in teenagers: A cross-sectional study from the HBM4EU aligned studies. Sci Total Environ 2024; 929:172426. [PMID: 38631641 DOI: 10.1016/j.scitotenv.2024.172426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Exposure to phthalate/DINCH metabolites can induce human reproductive toxicity, however, their endocrine-disrupting mechanisms are not fully elucidated. OBJECTIVE To investigate the association between concentrations of phthalate/DINCH metabolites, serum kisspeptin, and reproductive hormones among European teenagers from three of the HBM4EU Aligned Studies. METHODS In 733 Belgian (FLEHS IV study), Slovak (PCB cohort follow-up), and Spanish (BEA study) teenagers, ten phthalate and two DINCH metabolites were measured in urine by high-performance liquid chromatography-tandem mass spectrometry. Serum kisspeptin (kiss54) protein, follicle-stimulating hormone (FSH), total testosterone (TT), estradiol (E2), and sex hormone-binding globulin (SHBG) levels were measured by immunosorbent assays. Free Androgen Index (FAI) was calculated as a proxy of free testosterone. Adjusted sex-stratified linear regression models for individual studies, mixed effect models (LME) accounting for random effects for pooled studies, and g-computation and Bayesian kernel machine regression (BKMR) models for the phthalate/DINCH mixture were performed. RESULTS The LME suggested that each IQR increase in ln-transformed levels of several phthalates was associated with lower kisspeptin [MnBP: %change (95%CI): -2.8 (-4.2;-0.4); MEHP: -1.4 (-3.4,0.2)] and higher FSH [∑DINP: 11.8 (-0.6;25.1)] levels in females from pooled studies. G-computation showed that the phthalates/DINCH mixture was associated with lower kisspeptin [-4.28 (-8.07;-0.34)] and higher FSH [22.13 (0.5;48.4)] also in females; BKMR showed similar although non-significant pattern. In males, higher phthalates metabolites [MEHP: -12.22 (-21.09;-1.18); oxo-MEHP: -12.73 (-22.34;-1.93)] were associated with lower TT and FAI, although higher DINCH [OH-MINCH: 16.31 (6.23;27.35), cx-MINCH: 16.80 (7.03;27.46), ∑DINCH: 17.37 (7.26;29.74)] were associated with higher TT levels. No mixture associations were found in males. CONCLUSION We observed sex-specific associations between urinary concentrations of phthalate/DINCH metabolites and the panel of selected effect biomarkers (kisspeptin and reproductive hormones). This suggests that exposure to phthalates would be associated with changes in kisspeptin levels, which would affect the HPG axis and thus influence reproductive health. However, further research is needed, particularly for phthalate replacements such as DINCH.
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Affiliation(s)
- Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Natasha Wauters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Vicente Mustieles
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Anteneh Desalegn
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | | | - Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Esteban
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael M Poyatos
- Unidad de Gestión Clínica de Laboratorios, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | | | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Greet Schoeters
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Nicolás Olea
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Mariana F Fernández
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain.
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3
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Rodríguez-Carrillo A, Remy S, Koppen G, Wauters N, Freire C, Olivas-Martínez A, Schillemans T, Åkesson A, Desalegn A, Iszatt N, den Hond E, Verheyen V, Fábelová L, Murinova LP, Pedraza-Díaz S, Castaño A, García-Lario JV, Cox B, Govarts E, Baken K, Tena-Sempere M, Olea N, Schoeters G, Fernández MF. PFAS association with kisspeptin and sex hormones in teenagers of the HBM4EU aligned studies. Environ Pollut 2023; 335:122214. [PMID: 37482334 DOI: 10.1016/j.envpol.2023.122214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/18/2023] [Accepted: 07/15/2023] [Indexed: 07/25/2023]
Abstract
Exposure to Perfluoroalkyl acids (PFAS) can impair human reproductive function, e.g., by delaying or advancing puberty, although their mechanisms of action are not fully understood. We therefore set out to evaluate the relationship between serum PFAS levels, both individually and as a mixture, on the Hypothalamic-Pituitary-Gonadal (HPG) axis by analyzing serum levels of reproductive hormones and also kisspeptin in European teenagers participating in three of the HBM4EU Aligned Studies. For this purpose, PFAS compounds were measured in 733 teenagers from Belgium (FLEHS IV study), Slovakia (PCB cohort follow-up), and Spain (BEA study) by high performance liquid chromatography-tandem mass spectrometry (HPLC/MS) in laboratories under the HBM4EU quality assurance quality control (QA/QC) program. In the same serum samples, kisspeptin 54 (kiss-54) protein, follicle-stimulating hormone (FSH), total testosterone (TT), estradiol (E2), and sex hormone-binding globulin (SHBG) levels were also measured using immunosorbent assays. Sex-stratified single pollutant linear regression models for separate studies, mixed single pollutant models accounting for random effects for pooled studies, and g-computation and Bayesian kernel machine regression (BKMR) models for the mixture of the three most available (PFNA, PFOA, and PFOS) were fit. PFAS associations with reproductive markers differed according to sex. Each natural log-unit increase of PFOA, PFNA, and PFOS were associated with higher TT [18.41 (6.18; 32.31), 15.60 (7.25; 24.61), 14.68 (6.18; 24.61), respectively] in girls, in the pooled analysis (all studies together). In males, G-computation showed that PFAS mixture was associated with lower FSH levels [-10.51 (-18.81;-1.36)]. The BKMR showed the same patterns observed in G-computation, including a significant increase on male Kiss-54 and SHBG levels. Overall, effect biomarkers may enhance the current epidemiological knowledge regarding the adverse effect of PFAS in human HPG axis, although further research is warranted.
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Affiliation(s)
- Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium; Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610, Wilrijk, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Natasha Wauters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Carmen Freire
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | | | - Tessa Schillemans
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Agneta Åkesson
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Anteneh Desalegn
- Division of Food Safety, Norwegian Institute of Public Health, Norway
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | | | - Veerle Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Bianca Cox
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Kirsten Baken
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium
| | - Manuel Tena-Sempere
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Menéndez Pidal s/n. 14004., Córdoba, Spain; Department of Cell Biology, Physiology and Immunology, University of Córdoba, Campus de Rabanales, Ctra. Madrid-Cádiz, Km. 396. 14071. Córdoba, Spain; University Hospital Reina Sofía, Menéndez Pidal s/n. 14004, Córdoba, Spain; CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Menéndez Pidal s/n. 14004. Córdoba, Spain
| | - Nicolás Olea
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Mariana F Fernández
- Biomedical Research Center (CIBM), University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain.
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Cox B, Wauters N, Rodríguez-Carrillo A, Portengen L, Gerofke A, Kolossa-Gehring M, Lignell S, Lindroos AK, Fabelova L, Murinova LP, Desalegn A, Iszatt N, Schillemans T, Åkesson A, Colles A, Den Hond E, Koppen G, Van Larebeke N, Schoeters G, Govarts E, Remy S. PFAS and Phthalate/DINCH Exposure in Association with Age at Menarche in Teenagers of the HBM4EU Aligned Studies. Toxics 2023; 11:711. [PMID: 37624216 PMCID: PMC10459167 DOI: 10.3390/toxics11080711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
Early puberty has been found to be associated with adverse health outcomes such as metabolic and cardiovascular diseases and hormone-dependent cancers. The decrease in age at menarche observed during the past decades has been linked to an increased exposure to endocrine-disrupting compounds (EDCs). Evidence for the association between PFAS and phthalate exposure and menarche onset, however, is inconsistent. We studied the association between PFAS and phthalate/DINCH exposure and age at menarche using data of 514 teenagers (12 to 18 years) from four aligned studies of the Human Biomonitoring for Europe initiative (HBM4EU): Riksmaten Adolescents 2016-2017 (Sweden), PCB cohort (follow-up; Slovakia), GerES V-sub (Germany), and FLEHS IV (Belgium). PFAS concentrations were measured in blood, and phthalate/DINCH concentrations in urine. We assessed the role of each individual pollutant within the context of the others, by using different multi-pollutant approaches, adjusting for age, age- and sex-standardized body mass index z-score and household educational level. Exposure to di(2-ethylhexyl) phthalate (DEHP), especially mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), was associated with an earlier age at menarche, with estimates per interquartile fold change in 5OH-MEHP ranging from -0.34 to -0.12 years in the different models. Findings from this study indicated associations between age at menarche and some specific EDCs at concentrations detected in the general European population, but due to the study design (menarche onset preceded the chemical measurements), caution is needed in the interpretation of causality.
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Affiliation(s)
- Bianca Cox
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Natasha Wauters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
- Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Antje Gerofke
- German Environment Agency, Umweltbundesamt (UBA), 14195 Berlin, Germany; (A.G.); (M.K.-G.)
| | - Marike Kolossa-Gehring
- German Environment Agency, Umweltbundesamt (UBA), 14195 Berlin, Germany; (A.G.); (M.K.-G.)
| | - Sanna Lignell
- Swedish Food Agency, 751 26 Uppsala, Sweden; (S.L.); (A.K.L.)
| | | | - Lucia Fabelova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 01 Bratislava, Slovakia; (L.F.); (L.P.M.)
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 01 Bratislava, Slovakia; (L.F.); (L.P.M.)
| | - Anteneh Desalegn
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.D.); (N.I.)
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.D.); (N.I.)
| | - Tessa Schillemans
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (T.S.); (A.Å.)
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (T.S.); (A.Å.)
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Elly Den Hond
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, 2023 Antwerp, Belgium;
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
- Department of Biomedical Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (N.W.); (A.R.-C.); (A.C.); (G.K.); (G.S.); (E.G.); (S.R.)
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5
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Schillemans T, Iszatt N, Remy S, Schoeters G, Fernández MF, D'Cruz SC, Desalegn A, Haug LS, Lignell S, Lindroos AK, Fábelová L, Murinova LP, Kosjek T, Tkalec Ž, Gabriel C, Sarigiannis D, Pedraza-Díaz S, Esteban-López M, Castaño A, Rambaud L, Riou M, Pauwels S, Vanlarebeke N, Kolossa-Gehring M, Vogel N, Uhl M, Govarts E, Åkesson A. Cross-sectional associations between exposure to per- and polyfluoroalkyl substances and body mass index among European teenagers in the HBM4EU aligned studies. Environ Pollut 2023; 316:120566. [PMID: 36334774 DOI: 10.1016/j.envpol.2022.120566] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 05/26/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are widespread pollutants that may impact youth adiposity patterns. We investigated cross-sectional associations between PFAS and body mass index (BMI) in teenagers/adolescents across nine European countries within the Human Biomonitoring for Europe (HBM4EU) initiative. We used data from 1957 teenagers (12-18 yrs) that were part of the HBM4EU aligned studies, consisting of nine HBM studies (NEBII, Norway; Riksmaten Adolescents 2016-17, Sweden; PCB cohort (follow-up), Slovakia; SLO CRP, Slovenia; CROME, Greece; BEA, Spain; ESTEBAN, France; FLEHS IV, Belgium; GerES V-sub, Germany). Twelve PFAS were measured in blood, whilst weight and height were measured by field nurse/physician or self-reported in questionnaires. We assessed associations between PFAS and age- and sex-adjusted BMI z-scores using linear and logistic regression adjusted for potential confounders. Random-effects meta-analysis and mixed effects models were used to pool studies. We assessed mixture effects using molar sums of exposure biomarkers with toxicological/structural similarities and quantile g-computation. In all studies, the highest concentrations of PFAS were PFOS (medians ranging from 1.34 to 2.79 μg/L). There was a tendency for negative associations with BMI z-scores for all PFAS (except for PFHxS and PFHpS), which was borderline significant for the molar sum of [PFOA and PFNA] and significant for single PFOA [β-coefficient (95% CI) per interquartile range fold change = -0.06 (-0.17, 0.00) and -0.08 (-0.15, -0.01), respectively]. Mixture assessment indicated similar negative associations of the total mixture of [PFOA, PFNA, PFHxS and PFOS] with BMI z-score, but not all compounds showed associations in the same direction: whilst [PFOA, PFNA and PFOS] were negatively associated, [PFHxS] associated positively with BMI z-score. Our results indicated a tendency for associations of relatively low PFAS concentrations with lower BMI in European teenagers. More prospective research is needed to investigate this potential relationship and its implications for health later in life.
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Affiliation(s)
- Tessa Schillemans
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden.
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Mariana F Fernández
- Centre for Biomedical Research (CIBM) and School of Medicine, University of Granada, Granada, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Shereen Cynthia D'Cruz
- Univ Rennes, EHESP, Inserm, Irset (Institut de Recherche en Santé, Environnement et Travail), Rennes, France
| | - Anteneh Desalegn
- Division of Food Safety, Norwegian Institute of Public Health, Norway
| | - Line S Haug
- Division of Food Safety, Norwegian Institute of Public Health, Norway
| | | | | | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Tina Kosjek
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Žiga Tkalec
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Catherine Gabriel
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece; HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th Km Thessaloniki-Thermi Road, 57001, Greece
| | - Denis Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece; HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th Km Thessaloniki-Thermi Road, 57001, Greece; Environmental Health Engineering, Institute of Advanced Study, Palazzo Del Broletto - Piazza Della Vittoria 15, 27100, Pavia, Italy
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Loïc Rambaud
- Department of Environmental and Occupational Health, Santé Publique France, Saint-Maurice, France
| | - Margaux Riou
- Department of Environmental and Occupational Health, Santé Publique France, Saint-Maurice, France
| | - Sara Pauwels
- Department of Public Health and Primary Care, KU, Leuven, Belgium
| | - Nik Vanlarebeke
- Department of Analytical and Environmental Chemistry, Free University of Brussels, Belgium
| | | | - Nina Vogel
- German Environment Agency, Umweltbundesamt (UBA), Berlin, Germany
| | - Maria Uhl
- Environment Agency Austria, Vienna, Austria
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
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Desalegn A, Bopp S, Asturiol D, Lamon L, Worth A, Paini A. Role of Physiologically Based Kinetic modelling in addressing environmental chemical mixtures - A review. ACTA ACUST UNITED AC 2019; 10:158-168. [PMID: 31218267 PMCID: PMC6559215 DOI: 10.1016/j.comtox.2018.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 06/24/2018] [Accepted: 09/26/2018] [Indexed: 11/21/2022]
Abstract
The availability and applicability of Physiologically Based Kinetic (PBK) models for mixtures is reviewed. PBK models can support risk assessment of mixtures by incorporating the toxicokinetic processes. Quantitative structure-activity relationship (QSAR) models can be used to fill data gaps in PBK modelling. PBK models for mixtures can be improved by including various types of interactions.
The role of Physiologically Based Kinetic (PBK) modelling in assessing mixture toxicology has been growing for the last three decades. It has been widely used to investigate and address interactions in mixtures. This review describes the current state-of-the-art of PBK models for chemical mixtures and to evaluate the applications of PBK modelling for mixtures with emphasis on their role in chemical risk assessment. A total of 35 mixture PBK models were included after searching web resources (Scopus, PubMed, Web of Science, and Google Scholar), screening for duplicates, and excluding articles based on eligibility criteria. Binary mixtures and volatile organic compounds accounted for two-thirds of the chemical mixtures identified. The most common exposure route and modelled system were found to be inhalation and rats respectively. Twenty two (22) models were for binary mixtures, 5 for ternary mixtures, 3 for quaternary mixtures, and 5 for complex mixtures. Both bottom-up and top-down PBK modelling approaches are described. Whereas bottom-up approaches are based on a series of binary interactions, top-down approaches are based on the lumping of mixture components. Competitive inhibition is the most common type of interaction among the various types of mixtures, and usually becomes a concern at concentrations higher than environmental exposure levels. It leads to reduced biotransformation that either means a decrease in the amount of toxic metabolite formation or an increase in toxic parent chemical accumulation. The consequence is either lower or higher toxicity compared to that estimated for the mixture based on the additivity principle. Therefore, PBK modelling can play a central role in predicting interactions in chemical mixture risk assessment.
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Affiliation(s)
| | | | | | | | | | - Alicia Paini
- Corresponding author at: European Commission, Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy.
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Paini A, Leonard J, Joossens E, Bessems J, Desalegn A, Dorne J, Gosling J, Heringa M, Klaric M, Kliment T, Kramer N, Loizou G, Louisse J, Lumen A, Madden J, Patterson E, Proença S, Punt A, Setzer R, Suciu N, Troutman J, Yoon M, Worth A, Tan Y. Next generation physiologically based kinetic (NG-PBK) models in support of regulatory decision making. Comput Toxicol 2019; 9:61-72. [PMID: 31008414 PMCID: PMC6472623 DOI: 10.1016/j.comtox.2018.11.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/02/2018] [Accepted: 11/08/2018] [Indexed: 02/06/2023]
Abstract
The fields of toxicology and chemical risk assessment seek to reduce, and eventually replace, the use of animals for the prediction of toxicity in humans. In this context, physiologically based kinetic (PBK) modelling based on in vitro and in silico kinetic data has the potential to a play significant role in reducing animal testing, by providing a methodology capable of incorporating in vitro human data to facilitate the development of in vitro to in vivo extrapolation of hazard information. In the present article, we discuss the challenges in: 1) applying PBK modelling to support regulatory decision making under the toxicology and risk-assessment paradigm shift towards animal replacement; 2) constructing PBK models without in vivo animal kinetic data, while relying solely on in vitro or in silico methods for model parameterization; and 3) assessing the validity and credibility of PBK models built largely using non-animal data. The strengths, uncertainties, and limitations of PBK models developed using in vitro or in silico data are discussed in an effort to establish a higher degree of confidence in the application of such models in a regulatory context. The article summarises the outcome of an expert workshop hosted by the European Commission Joint Research Centre (EC-JRC) - European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM), on "Physiologically-Based Kinetic modelling in risk assessment - reaching a whole new level in regulatory decision-making" held in Ispra, Italy, in November 2016, along with results from an international survey conducted in 2017 and recently reported activities occurring within the PBK modelling field. The discussions presented herein highlight the potential applications of next generation (NG)-PBK modelling, based on new data streams.
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Affiliation(s)
- A. Paini
- European Commission Joint Research Centre, Ispra, Italy
| | - J.A. Leonard
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN 37830, USA
| | - E. Joossens
- European Commission Joint Research Centre, Ispra, Italy
| | - J.G.M. Bessems
- European Commission Joint Research Centre, Ispra, Italy
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - A. Desalegn
- European Commission Joint Research Centre, Ispra, Italy
| | - J.L. Dorne
- European Food Safety Authority, 1a, Via Carlo Magno, 1A, 43126 Parma PR, Italy
| | - J.P. Gosling
- School of Mathematics, University of Leeds, Leeds, UK
| | - M.B. Heringa
- RIVM - The National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - T. Kliment
- European Commission Joint Research Centre, Ispra, Italy
| | - N.I. Kramer
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80177, 3508TD Utrecht, The Netherlands
| | - G. Loizou
- Health and Safety Executive, Buxton, UK
| | - J. Louisse
- Division of Toxicology, Wageningen University, Tuinlaan 5, 6703 HE Wageningen, The Netherlands
- RIKILT Wageningen University and Research, Akkermaalsbos 2, 6708 WB Wageningen, The Netherlands
| | - A. Lumen
- Division of Biochemical Toxicology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR 72079, USA
| | - J.C. Madden
- School of Pharmacy and Bimolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK
| | - E.A. Patterson
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| | - S. Proença
- European Commission Joint Research Centre, Ispra, Italy
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80177, 3508TD Utrecht, The Netherlands
| | - A. Punt
- RIKILT Wageningen University and Research, Akkermaalsbos 2, 6708 WB Wageningen, The Netherlands
| | - R.W. Setzer
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, 109 TW Alexander Drive, Research Triangle Park, NC 27709, USA
| | - N. Suciu
- DiSTAS, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - J. Troutman
- Central Product Safety, The Procter & Gamble Company, Cincinnati, OH, USA
| | - M. Yoon
- ScitoVation, 6 Davis Drive, PO Box 110566, Research Triangle Park, NC 27709, USA
- ToxStrategies, Research Triangle Park Office, 1249 Kildaire Farm Road 134, Cary, NC 27511, USA
| | - A. Worth
- European Commission Joint Research Centre, Ispra, Italy
| | - Y.M. Tan
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
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Geathun GM, Desalegn A. Changes in postoperative infections following implementation of safe surgery checklist and hand hygiene in University of Gondar Hospital. BMC Proc 2011. [PMCID: PMC3239616 DOI: 10.1186/1753-6561-5-s6-p195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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