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Conejo-Bolaños LD, Mora AM, Hernández-Bonilla D, Cano JC, Menezes-Filho JA, Eskenazi B, Lindh CH, van Wendel de Joode B. Prenatal current-use pesticide exposure and children's neurodevelopment at one year of age in the Infants' Environmental Health (ISA) birth cohort, Costa Rica. Environ Res 2024; 249:118222. [PMID: 38272290 PMCID: PMC11065598 DOI: 10.1016/j.envres.2024.118222] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Pesticide exposure may affect young children's neurodevelopment, but only few cohort studies have addressed possible effects of non-organophosphate pesticides. OBJECTIVE We evaluated associations between prenatal current-use pesticide exposure and neurodevelopmental outcomes among 1-year-old children from the Infants' Environmental Health (ISA) birth cohort. METHODS To determine prenatal pesticide exposure, we measured biomarkers of pyrimethanil, chlorpyrifos, synthetic pyrethroids, and 2,4-D in urine samples among 355 women, 1-3 times during pregnancy. One-year post-partum, we evaluated children's neurodevelopment with the Bayley Scales of Infant and Toddler Development 3rd edition (BSID-III). We assessed associations between exposures and neurodevelopmental outcomes (composite and z-scores) using single-chemical linear regression models adjusted for possible confounders (maternal education, parity, sex, gestational age at birth, child age, HOME-score, location of assessment, biomarkers of mancozeb), and studied effect-modification by sex. We evaluated non-linear associations of multiple pesticide exposures with Bayesian kernel machine regression (BKMR). RESULTS We found higher prenatal urinary 2,4-D concentrations were associated with lower language (βper ten-fold increase = -2.0, 95 % confidence interval (CI) = -3.5, -0.5) and motor (βper ten-fold increase = -2.2, 95 %CI = -4.2, -0.1) composite scores among all children. Also, higher chlorpyrifos exposure [measured as urinary 3,5,6-trichloro-2-pyridinol (TCPy)] was associated with lower cognitive composite scores (βper ten-fold increase = -1.9, 95 %CI = -4.7, 0.8), and lower motor composite scores among boys (βper ten-fold increase = -3.8, 95 % CI = -7.7, 0.1) but not girls (βper ten-fold increase = 2.3, 95 %CI = -1.6, 6.3, pINT = 0.11). Finally, higher pyrimethanil was associated with lower language abilities among girls, but not boys. Pyrethroid metabolite concentrations did not explain variability in BSID-III composite scores. Associations were similar for BSID-III z-scores, and we found no evidence for non-linear associations or mixture effects. DISCUSSION Prenatal exposure to common-use pesticides may affect children's neurodevelopment at 1-year of age, some effects may be sex-specific.
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Affiliation(s)
- L Diego Conejo-Bolaños
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Institute for Interdisciplinary Studies in Childhood and Adolescence (INEINA), Universidad Nacional, Heredia, Costa Rica
| | - Ana M Mora
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Community Health (CERCH), University of California at Berkeley, United States
| | | | - Juan Camilo Cano
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - José A Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Av. Barão de Jeremoabo s/n Campus, Universitário de Ondina, 40170-115, Salvador, Bahia, Brazil
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), University of California at Berkeley, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
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van Wendel de Joode B, Peñaloza-Castañeda J, Mora AM, Corrales-Vargas A, Eskenazi B, Hoppin JA, Lindh CH. Pesticide exposure, birth size, and gestational age in the ISA birth cohort, Costa Rica. Environ Epidemiol 2024; 8:e290. [PMID: 38617432 PMCID: PMC11008631 DOI: 10.1097/ee9.0000000000000290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/18/2023] [Indexed: 04/16/2024] Open
Abstract
Purpose To examine associations of prenatal biomarkers of pesticide exposure with birth size measures and length of gestation among newborns from the Infants' Environmental Health (ISA) birth cohort, Costa Rica. Methods We included 386 singleton liveborn newborns with data on birth size measures, length of gestation, and maternal urinary biomarkers of chlorpyrifos, synthetic pyrethroids, mancozeb, pyrimethanil, and 2, 4-D during pregnancy. We associated biomarkers of exposure with birth outcomes using multivariate linear regression and generalized additive models. Results Concentrations were highest for ethylene thiourea (ETU, metabolite of mancozeb), median = 3.40; p10-90 = 1.90-6.79 µg/L, followed by 3,5,6-trichloro-2-pyridinol (TCP, metabolite of chlorpyrifos) p50 = 1.76 p10-90 = 0.97-4.36 µg/L, and lowest for 2,4-D (p50 = 0.33 p10-90 = 0.18-1.07 µg/L). Among term newborns (≥37 weeks), higher prenatal TCP was associated with lower birth weight and smaller head circumference (e.g., β per 10-fold-increase) during the second half of pregnancy = -129.6 (95% confidence interval [CI] = -255.8, -3.5) grams, and -0.61 (95% CI = -1.05, -0.17) centimeters, respectively. Also, among term newborns, prenatal 2,4-D was associated with lower birth weight (β per 10-fold-increase = -125.1; 95% CI = -228.8, -21.5), smaller head circumference (β = -0.41; 95% CI = -0.78, -0.03), and, during the second half of pregnancy, with shorter body length (β = -0.58; 95% CI = -1.09, -0.07). Furthermore, ETU was nonlinearly associated with head circumference during the second half of pregnancy. Biomarkers of pyrethroids and pyrimethanil were not associated with birth size, and none of the biomarkers explained the length of gestation. Conclusions Prenatal exposure to chlorpyrifos and 2,4-D, and, possibly, mancozeb/ETU, may impair fetal growth.
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Affiliation(s)
- Berna van Wendel de Joode
- Infants’ Environmental Health (ISA) Program, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Jorge Peñaloza-Castañeda
- Infants’ Environmental Health (ISA) Program, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Ana M. Mora
- Infants’ Environmental Health (ISA) Program, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
- Center for Environmental Research and Community Health (CERCH), University of California at Berkeley
| | - Andrea Corrales-Vargas
- Infants’ Environmental Health (ISA) Program, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), University of California at Berkeley
| | - Jane A. Hoppin
- Center for Human Health and the Environment, North Carolina State University, North Carolina
- Department of Biological Sciences, North Carolina State University, North Carolina
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Lund University, Sweden
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Rosa MJ, Armendáriz-Arnez C, Gudayol-Ferré E, Prehn M, Fuhrimann S, Eskenazi B, Lindh CH, Mora AM. Association of pesticide exposure with neurobehavioral outcomes among avocado farmworkers in Mexico. Int J Hyg Environ Health 2024; 256:114322. [PMID: 38219443 PMCID: PMC10956701 DOI: 10.1016/j.ijheh.2024.114322] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/06/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIM To date, few studies have focused on the health effects of pesticide exposure among avocado farmworkers. We examined the association of exposure to insecticides, fungicides, and herbicides with cognitive and mental health outcomes among these avocado workers from Michoacan, Mexico. MATERIALS AND METHODS We conducted a cross-sectional study of 105 avocado farmworkers between May and August 2021. We collected data on self-reported pesticide use during the 12 months prior to the baseline survey and estimated annual exposure-intensity scores (EIS) using a semi-quantitative exposure algorithm. We calculated specific gravity adjusted average concentrations of 12 insecticide, fungicide, or herbicide metabolites measured in urine samples collected during two study visits (8-10 weeks apart). We assessed participants' cognitive function and psychological distress using the NIH Toolbox Cognition Battery and the Brief Symptom Inventory 18 (BSI-18), respectively. We examined individual associations of EIS and urinary pesticide metabolites with neurobehavioral outcomes using generalized linear regression models. We also implemented Bayesian Weighted Quantile Sum (BWQS) regression to evaluate the association between a pesticide metabolite mixture and neurobehavioral outcomes. RESULTS In individual models, after adjusting for multiple comparisons, higher concentrations of hydroxy-tebuconazole (OH-TEB, metabolite of fungicide tebuconazole) were associated with higher anxiety (IRR per two-fold increase in concentrations = 1.26, 95% CI:1.08, 1.48) and Global Severity Index (GSI) (IRR = 1.89, 95% CI:1.36, 2.75) scores, whereas higher concentrations of 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos) were associated with lower GSI scores (IRR = 0.69, 95% CI: 0.56, 0.85). In BWQS analyses, we found evidence of a mixture association of urinary pesticide metabolites with higher anxiety (IRR = 1.72, 95% CrI: 1.12, 2.55), depression (IRR = 4.60, 95% CrI: 2.19, 9.43), and GSI (IRR = 1.99, 95% CrI: 1.39, 2.79) scores. OH-TEB and hydroxy-thiabendazole (metabolite of fungicide thiabendazole) combined contributed 54%, 40%, and 54% to the mixture effect in the anxiety symptoms, depression symptoms, and overall psychological distress models, respectively. CONCLUSIONS We found that exposure to tebuconazole and thiabendazole, fungicides whose effects have been rarely studied in humans, may be associated with increased psychological distress among avocado farmworkers. We also observed that exposure to chlorpyrifos may be associated with decreased psychological distress.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Cynthia Armendáriz-Arnez
- Escuela Nacional de Estudios Superiores (ENES) Unidad Morelia, Universidad Nacional Autónoma de México (UNAM), Morelia, Mexico
| | - Esteve Gudayol-Ferré
- Facultad de Psicología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - Manuela Prehn
- Escuela Nacional de Estudios Superiores (ENES) Unidad Morelia, Universidad Nacional Autónoma de México (UNAM), Morelia, Mexico
| | - Samuel Fuhrimann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden
| | - Ana M Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, United States
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Schillemans T, Yan Y, Ribbenstedt A, Donat-Vargas C, Lindh CH, Kiviranta H, Rantakokko P, Wolk A, Landberg R, Åkesson A, Brunius C. OMICs Signatures Linking Persistent Organic Pollutants to Cardiovascular Disease in the Swedish Mammography Cohort. Environ Sci Technol 2024; 58:1036-1047. [PMID: 38174696 PMCID: PMC10795192 DOI: 10.1021/acs.est.3c06388] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
Cardiovascular disease (CVD) development may be linked to persistent organic pollutants (POPs), including organochlorine compounds (OCs) and perfluoroalkyl and polyfluoroalkyl substances (PFAS). To explore underlying mechanisms, we investigated metabolites, proteins, and genes linking POPs with CVD risk. We used data from a nested case-control study on myocardial infarction (MI) and stroke from the Swedish Mammography Cohort - Clinical (n = 657 subjects). OCs, PFAS, and multiomics (9511 liquid chromatography-mass spectrometry (LC-MS) metabolite features; 248 proteins; 8110 gene variants) were measured in baseline plasma. POP-related omics features were selected using random forest followed by Spearman correlation adjusted for confounders. From these, CVD-related omics features were selected using conditional logistic regression. Finally, 29 (for OCs) and 12 (for PFAS) unique features associated with POPs and CVD. One omics subpattern, driven by lipids and inflammatory proteins, associated with MI (OR = 2.03; 95% CI = 1.47; 2.79), OCs, age, and BMI, and correlated negatively with PFAS. Another subpattern, driven by carnitines, associated with stroke (OR = 1.55; 95% CI = 1.16; 2.09), OCs, and age, but not with PFAS. This may imply that OCs and PFAS associate with different omics patterns with opposite effects on CVD risk, but more research is needed to disentangle potential modifications by other factors.
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Affiliation(s)
- Tessa Schillemans
- Cardiovascular
and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Yingxiao Yan
- Food
and Nutrition Sciences, Department of Life Sciences, Chalmers University of Technology, Gothenburg 412 96, Sweden
| | - Anton Ribbenstedt
- Food
and Nutrition Sciences, Department of Life Sciences, Chalmers University of Technology, Gothenburg 412 96, Sweden
| | - Carolina Donat-Vargas
- Cardiovascular
and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
- Barcelona
Institute for Global Health (ISGlobal), Barcelona 08036, Spain
| | - Christian H. Lindh
- Division
of Occupational and Environmental Medicine, Lund University, Lund 221 00, Sweden
| | - Hannu Kiviranta
- Department
of Health Security, National Institute for
Health and Welfare, Kuopio 70701, Finland
| | - Panu Rantakokko
- Department
of Health Security, National Institute for
Health and Welfare, Kuopio 70701, Finland
| | - Alicja Wolk
- Cardiovascular
and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Rikard Landberg
- Food
and Nutrition Sciences, Department of Life Sciences, Chalmers University of Technology, Gothenburg 412 96, Sweden
- Department
of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden
| | - Agneta Åkesson
- Cardiovascular
and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Carl Brunius
- Food
and Nutrition Sciences, Department of Life Sciences, Chalmers University of Technology, Gothenburg 412 96, Sweden
- Chalmers
Mass Spectrometry Infrastructure, Department of Life Sciences, Chalmers University of Technology, Gothenburg 412 96, Sweden
- Medical
Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala 751 05, Sweden
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Vilhelmsson A, Rylander L, Jöud A, Lindh CH, Mattsson K, Liew Z, Guo P, Ritz B, Källén K, Thacher JD. Exposure to per- and polyfluoroalkyl substances in early pregnancy and risk of cerebral palsy in children. Sci Total Environ 2023; 899:165622. [PMID: 37474063 DOI: 10.1016/j.scitotenv.2023.165622] [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: 05/12/2023] [Revised: 06/30/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Most cerebral palsy (CP) cases have an unexplained etiology, but a role for environmental exposures has been suggested. One purported environmental risk factor is exposure to endocrine-disrupting pollutants specifically per- and polyfluoroalkyl substances (PFAS). OBJECTIVES We investigated the association between prenatal PFAS exposures and CP in Swedish children. METHODS In this case-control study, 322 CP cases, 343 population controls, and 258 preterm controls were identified from a birth registry in combination with a CP follow-up program from 1995 to 2014 and linked to a biobank which contains serum samples from week 10-14 of pregnancy. Maternal serum concentrations of four PFAS compounds: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorooctane sulfonate (PFOS) were analyzed using liquid chromatography-tandem-mass-spectrometry. We estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for CP and each PFAS in quartiles and as continuous variables controlling for various sociodemographic and lifestyle factors. RESULTS In crude and adjusted analyses, we did not find consistent evidence of associations between serum PFHxS, PFOA, PFNA, PFOS and concentrations in early pregnancy and CP, except in preterm infants. The ORs comparing the highest PFAS quartiles to the lowest were 1.05 (95 % CI: 0.63-1.76), 0.96 (95 % CI: 0.55-1.68), 0.71 (95 % CI: 0.41-1.25), and 1.17 (95 % CI: 0.61-2.26), for PFHxS, PFOA, PFNA, and PFOS, respectively. Some positive associations were observed for preterm infants, but the results were imprecise. Similar patterns were observed in analyses treating PFAS as continuous variables. CONCLUSIONS In this study, we found little evidence that early pregnancy prenatal exposure to PFHxS, PFOA, PFNA, or PFOS increases the risk of CP. However, some positive associations were observed for preterm cases and warrant further investigation.
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Affiliation(s)
- Andreas Vilhelmsson
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Anna Jöud
- Division of Occupational and Environmental Medicine, Lund University, Sweden; Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, Sweden; Health Technology Assessment Skåne, Skåne University Hospital, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Kristina Mattsson
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA
| | - Pengfei Guo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, USA; Department of Neurology, School of Medicine, UCLA, Los Angeles, USA
| | - Karin Källén
- Division of Occupational and Environmental Medicine, Lund University, Sweden; Tornblad Institute, Lund University, Sweden
| | - Jesse D Thacher
- Division of Occupational and Environmental Medicine, Lund University, Sweden.
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Uldbjerg CS, Sørensen KM, Lindh CH, Rantakokko P, Hauser R, Juul A, Andersson AM, Bräuner EV. Evaporation of serum after long-term biobank storage: A chemical analysis of maternal serum from a large Danish pregnancy screening registry. PLoS One 2023; 18:e0293527. [PMID: 37883412 PMCID: PMC10602309 DOI: 10.1371/journal.pone.0293527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Relying on freezer stored biospecimens is preferred in epidemiolocal studies exploring environmental pregnancy exposures and later offspring health. Storage duration may increase the pre-analytical variability, potentially adding measurement uncertainty. We investigated evaporation of maternal serum after long-term biobank storage using ions (sodium, Na+; chloride, Cl-) recognized for stability and relatively narrow normal biological reference ranges in human serum. METHODS A chemical analysis study of 275 biobanked second trimester maternal serum from a large Danish pregnancy screening registry. Serum samples were collected between 1985-1995 and stored at -20°C. Ion concentrations were quantified with indirect potentiometry using a Roche Cobas 6000 analyzer and compared according to storage time and normal biological ranges in second trimester. Ion concentrations were also compared with normal biological variation assessed by baseline Na+ and Cl- serum concentrations from a separate cohort of 24,199 non-pregnant women measured before freezing with the same instrument. RESULTS The overall mean ion concentrations in biobanked serum were 147.5 mmol/L for Na+ and 109.7 for Cl-. No marked linear storage effects were observed according to storage time. Ion concentrations were consistently high across sampling years, especially for specific sampling years, and a relatively large proportion were outside respective normal ranges in second trimester: 38.9% for Na+ and 43.6% for Cl-. Some variation in concentrations was also evident in baseline serum used as quality controls. CONCLUSIONS Elevated ion concentrations suggest evaporation, but independent of storage duration in the present study (27-37 years). Any evaporation may have occurred prior to freezer storage or during the first 27 years. Other pre-analytical factors such as low serum volume have likely influenced the concentrations, particularly given the high within year variability. Overall, we consider the biobanked serum samples internally comparable to enable their use in epidemiological studies.
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Affiliation(s)
- Cecilie S. Uldbjerg
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | | | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Elvira V. Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
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7
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Krais AM, de Joode BVW, Liljedahl ER, Blomberg AJ, Rönnholm A, Bengtsson M, Cano JC, Hoppin JA, Littorin M, Nielsen C, Lindh CH. Correction to: Detection of the fungicide transformation product 4-hydroxychlorothalonil in serum of pregnant women from Sweden and Costa Rica. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00604-3. [PMID: 37739996 DOI: 10.1038/s41370-023-00604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Affiliation(s)
- Annette M Krais
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Annelise J Blomberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anna Rönnholm
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Marie Bengtsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Juan Camilo Cano
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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8
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Malm E, Vilhelmsson A, Högfeldt H, Deshayes I, Källén K, Hansson SR, Lindh CH, Rylander L. Maternal Serum Concentrations of Per- and Polyfluoroalkyl Substances in Early Pregnancy and Small for Gestational Age in Southern Sweden. Toxics 2023; 11:750. [PMID: 37755760 PMCID: PMC10534445 DOI: 10.3390/toxics11090750] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
Small for gestational age (SGA) is considered an adverse birth outcome. Per- and polyfluoralkyl substances (PFAS) have become increasingly investigated as contributing environmental factors, thus far with inconclusive results. The current study aimed to investigate the hypothesized association between increased maternal PFAS levels in early pregnancy and an increased risk for SGA birth. This population-based study used data from a sample of children born in Scania, Southern Sweden, between 1995 and 2009. Two groups were compared: cases born with SGA (n = 298) and non-SGA controls (n = 580). The cases consisted of two subgroups: one included women whose children's growth in late pregnancy was in the lowest quartile, and another included women from the remaining growth quartiles. Corresponding maternal serum samples were collected from a biobank and analyzed for concentrations of four types of PFAS: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) using liquid chromatography-tandem mass spectrometry (LC/MS/MS). The results were combined with information from birth registers and analyzed using Mann-Whitney U-tests and logistic regression-unadjusted as well as adjusted for potential confounders. In conclusion, elevated maternal concentrations of PFAS were not associated with an increased risk of SGA birth. However, significant ORs were observed in a subgroup analysis restricted to women of Nordic origin (unadjusted OR 3.2 and adjusted OR 2.4) for PFHxS.
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Affiliation(s)
- Ellen Malm
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
| | - Andreas Vilhelmsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
| | - Hannah Högfeldt
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
| | - Isabelle Deshayes
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
| | - Karin Källén
- Tornblad Institute, Lund University, Biskopsgatan 7, 223 62 Lund, Sweden;
| | - Stefan R. Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, 221 85 Lund, Sweden;
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (A.V.); (H.H.); (I.D.); (C.H.L.); (L.R.)
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9
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Andersson AG, Lundgren A, Xu Y, Nielsen C, Lindh CH, Pineda D, Cederlund J, Pataridou E, Søgaard Tøttenborg S, Ugelvig Petersen K, Fletcher T, Lagging M, Bemark M, Jakobsson K, Li Y. High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden. Environ Health Perspect 2023; 131:87007. [PMID: 37578904 PMCID: PMC10424820 DOI: 10.1289/ehp11847] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 05/01/2023] [Accepted: 07/03/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS. OBJECTIVES Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2. METHODS Adults age 20-60 y from Ronneby (n = 309 , median PFOS serum level 47 ng / mL , fifth to 95th percentile 4 - 213 ng / mL ) and a group with background exposure (n = 47 , median PFOS serum level 4 ng / mL ) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (n = 350 ) and 6 months (n = 329 ) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection. RESULTS PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: - 0.5 % S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): - 8 , 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: - 6 , 12) after COVID-19 vaccination. DISCUSSION Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. https://doi.org/10.1289/EHP11847.
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Affiliation(s)
- Axel G Andersson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Lundgren
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | | | | | - Sandra Søgaard Tøttenborg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital -Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kajsa Ugelvig Petersen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital -Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Tony Fletcher
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Lagging
- Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Bemark
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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10
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Derakhshan A, Shu H, Broeren MAC, Kortenkamp A, Lindh CH, Demeneix B, Peeters RP, Bornehag CG, Korevaar TIM. Association of endocrine disrupting chemicals exposure with human chorionic gonadotropin concentrations in pregnancy. Environ Int 2023; 178:108091. [PMID: 37459690 DOI: 10.1016/j.envint.2023.108091] [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: 02/09/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Human chorionic gonadotropin (hCG) is produced by the placenta and plays an essential role in the maintenance of pregnancy. Endocrine disrupting chemicals (EDCs) have the potential to interfere with functions related to the production and secretion of hCG; however associations between exposure to EDCs and hCG concentrations in humans remain to be elucidated. OBJECTIVES To investigate the association of urinary, serum and plasma concentrations of EDCs during pregnancy with serum hCG concentrations. METHODS We utilized data form the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study. We investigated the association of 26 EDCs measured in early pregnancy urine or blood with serum hCG concentrations using multi-variable adjusted linear regression models per EDC and Weighted Quantile Sum (WQS) regression with repeated holdout validation for the EDCs mixture. RESULTS In 2,039 included women, higher exposure to bisphenol A was associated with lower hCG (beta [95% CI]: -0.06 [-0.11 to -0.002]) while higher triclosan exposure was associated with a higher hCG (0.02 [0.003 to 0.04]). Higher exposure to several phthalates, including mono-ethyl and mono-butyl phthalates (MEP and MBP) as well as metabolites of di-2-ethylhexyl phthalate (DEHP) was associated with a lower hCG (beta [95% CI] for sum of DEHP metabolites: -0.13 [-0.19 to -0.07]). Likewise, higher exposure to several polychlorinated biphenyls (PCBs) was associated with a lower hCG. In the WQS regression, each quartile increase in the EDCs mixture was associated with -0.27 lower hCG (95% CI: -0.34 to -0.19). DISCUSSION Higher exposure to several EDCs during pregnancy was associated with a lower hCG; and despite the small effect sizes, still indicating that the exposure may negatively affect production or secretion of hCG by the placenta. Our results provide the impetus for future experimental studies to investigate the placenta as a target organ for adverse effects of EDCs.
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Affiliation(s)
- Arash Derakhshan
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Huan Shu
- Department of Public Health, Karlstad University, Sweden
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run 4600, The Netherlands
| | - Andreas Kortenkamp
- Division of Environmental Sciences, College of Health, Medicine and Life Sciences, Brunel University, London, Uxbridge, UK
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Barbara Demeneix
- Laboratoire d'Evolution des Régulations Endocriniennes, CNRS/Muséum National d'Histoire Naturelle, 57 Rue Cuvier, 75005 Paris, France
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Carl-Gustaf Bornehag
- Department of Public Health, Karlstad University, Sweden; Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands.
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11
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Krais AM, de Joode BVW, Liljedahl ER, Blomberg AJ, Rönnholm A, Bengtsson M, Cano JC, Hoppin JA, Littorin M, Nielsen C, Lindh CH. Detection of the fungicide transformation product 4-hydroxychlorothalonil in serum of pregnant women from Sweden and Costa Rica. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00580-8. [PMID: 37474645 DOI: 10.1038/s41370-023-00580-8] [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: 01/19/2023] [Revised: 06/15/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND 4-hydroxychlorothalonil (HCT, R182281), a transformation product of the fungicide chlorothalonil, was recently identified in human serum and breast milk. There are indications that HCT may be more toxic and environmentally persistent than chlorothalonil. OBJECTIVE Our aim was to investigate serum concentrations of HCT in pregnant women in Sweden and Costa Rica. METHODS We developed a quantitative analytical method for HCT using liquid chromatography tandem mass spectrometry. We measured HCT in 1808 serum samples from pregnant women from the general population in Sweden (1997-2015) and in 632 samples from 393 pregnant women from an agricultural population in Costa Rica (2010-2011). In Swedish samples, we assessed time trends and investigated seasonality. In the Costa Rican samples, we evaluated variability between and within women and explanatory variables of HCT concentrations. RESULTS HCT was detected in all serum samples, and the limit of detection was 0.1 µg/L. The median HCT concentration in the Swedish samples was 4.1 µg/L (interquartile range [IQR] of 2.9 - 5.8 µg/L), and 3.9 times higher in the Costa Rican samples (median: 16.1 µg/L; IQR: 10.6 - 25.0 µg/L). We found clear seasonal variation with higher concentrations in the first half of each year among Swedish women. In the Costa Rican study, women working in agriculture and living near banana plantations had higher HCT concentrations, whilst higher parity and having a partner working in agriculture were associated with decreased HCT, and no clear seasonal pattern was observed. IMPACT STATEMENT For the first time, this study quantifies human exposure to the fungicide chlorothalonil and/or its transformation product 4-hydroxychlorothalonil (HCT, R182281) and finds higher serum concentrations in women from a tropical agricultural setting as compared with women from the general population in Sweden.
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Affiliation(s)
- Annette M Krais
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Annelise J Blomberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anna Rönnholm
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Marie Bengtsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Juan Camilo Cano
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Divison of Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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12
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Malm G, Lindh CH, Hansson SR, Källén K, Malm J, Rylander L. Maternal serum vitamin D level in early pregnancy and risk for preeclampsia: A case-control study in Southern Sweden. PLoS One 2023; 18:e0281234. [PMID: 36749741 PMCID: PMC9904465 DOI: 10.1371/journal.pone.0281234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 01/18/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Preeclampsia is considered a major cause of maternal and fetal morbidity and mortality. The aim of the present case-control study in Sweden was to assess the hypothesized association between low serum vitamin D concentrations in early pregnancy and the risk of developing preeclampsia since vitamin D may play a role in early placental development. METHODS The study included 296 women diagnosed with preeclampsia (cases) and 580 healthy pregnant women (controls). Serum samples were obtained from a biobank of samples collected in early pregnancy including almost all pregnancies in Southern Sweden. Concentrations of 25-hydroxyvitamin D3 (vitamin D) were analyzed using liquid chromatography-tandem-mass-spectrometry (LC/MS/MS). The cases were divided into two categories: i) infants were born before gestational week 34 (early onset) and/or born small-for-gestational age (SGA)(n = 51), ii) and others defined as late onset (n = 245). Vitamin D concentrations were analyzed both as a continuous and a categorized variable. RESULTS When all preeclampsia cases were included in the analyses no consistent patterns were observed. However, the median serum concentrations of vitamin D were significantly lower among the cases who were early onset and/or were born SGA (median 39.2 nmol/L, range 1.2-93.6) as compared to the controls (49.0 nmol/L, 0.1-219; p = 0.01). In addition, high concentrations were statistically significantly associated with a decreased risk of preeclampsia (>66.9 vs ≤30.1 nmol/L; crude OR 0.39, 95% CI 0.16-0.96). When potential confounders were included in the models the associations were even more pronounced. CONCLUSIONS Our results support the hypothesis that vitamin D deficiency is a risk factor for preeclampsia, but only in preeclampsia cases who were early-onset and/or were born SGA. Preeclampsia is not a homogenous condition and more studies are needed before vitamin D supplementation during pregnancy can be recommended.
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Affiliation(s)
- Gunilla Malm
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden,* E-mail:
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Stefan R. Hansson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Karin Källén
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden,Tornblad Institute, Lund University, Lund, Sweden
| | - Johan Malm
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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13
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Derakhshan A, Kortenkamp A, Shu H, Broeren MAC, Lindh CH, Peeters RP, Bornehag CG, Demeneix B, Korevaar TIM. Association of per- and polyfluoroalkyl substances with thyroid homeostasis during pregnancy in the SELMA study. Environ Int 2022; 167:107420. [PMID: 35870378 DOI: 10.1016/j.envint.2022.107420] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To investigate the association of exposure to per- and polyfluoroalkyl substances (PFAS) during early pregnancy with markers of the maternal thyroid system. METHODS Serum concentrations of seven PFAS as well as thyroid stimulating hormone (TSH), free and total thyroxine (FT4 and TT4), free and total triiodothyronine (FT3 and TT3) were measured in pregnant women in early pregnancy in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study. Outcomes were concentrations of TSH and thyroid hormones, FT4/FT3 or TT4/TT3 ratios, TSH/FT4 ratio as a marker of the negative feedback loop, TT4/FT4 or TT3/FT3 ratios as markers of the binding of thyroid hormones to binding proteins. RESULTS The study population comprised 2,008 women with median (95% range) gestational age of 10 (6-14) weeks. There was no association between PFAS and TSH. Higher PFNA, PFDA, PFHpA and PFOA levels were associated with a higher FT4 (largest effect estimate for PFDA: β [95% CI]: 0.27 [0.10 to 0.45], P = 0.002). Higher PFUnDA levels, but no other PFAS, were associated with a lower FT3 (β [95% CI]: -0.05 [-0.09 to -0.01], P = 0.005). Higher PFUnDA levels were associated with lower TT4 (β [95% CI]: -1.58 [-3.07 to -0.09]) and there was an inverted U-shaped association of PFOS with TT4 (P = 0.03). Higher PFDA, PFUnDA, PFHpA levels were associated with a lower TT3. Overall, higher PFAS concentrations were associated with a higher FT4/FT3 ratio and a higher TT4/TT3 ratio. There was no association of PFAS with the TSH/FT4 ratio. Higher concentrations of several PFAS were associated with lower TT4/FT4 and TT3/FT3 ratios. CONCLUSIONS These findings translate results from experimental studies suggesting that exposure to PFAS may interfere with the thyroid system during pregnancy. Further experimental studies should take into account human evidence to better understand the potential underlying mechanisms of thyroid disruption by PFAS exposure.
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Affiliation(s)
- Arash Derakhshan
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, The Netherlands; Department of internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, the Netherlands
| | - Andreas Kortenkamp
- Division of Environmental Sciences, College of Health, Medicine and Life Sciences, Brunel University, London, Uxbridge, UK
| | - Huan Shu
- Department of Public Health, Karlstad University, Sweden
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run, 4600, The Netherlands
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, 22363 Lund, Sweden
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, The Netherlands; Department of internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, the Netherlands
| | - Carl-Gustaf Bornehag
- Department of Public Health, Karlstad University, Sweden; Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Barbara Demeneix
- Laboratoire d'Evolution des Régulations Endocriniennes, CNRS/Muséum National d'Histoire Naturelle, 57 Rue Cuvier, 75005 Paris, France
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, The Netherlands; Department of internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE, Rotterdam, the Netherlands.
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14
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Barrón Cuenca J, Tirado N, Vikström M, Lindh CH, Stenius U, Leander K, Berglund M, Dreij K. Correction: Pesticide exposure among Bolivian farmers: associations between worker protection and exposure biomarkers. J Expo Sci Environ Epidemiol 2022; 32:782. [PMID: 34912028 PMCID: PMC9481453 DOI: 10.1038/s41370-021-00402-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Jessika Barrón Cuenca
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246, Miraflores, La Paz, Bolivia.
| | - Noemi Tirado
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246, Miraflores, La Paz, Bolivia
| | - Max Vikström
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, 22363, Lund, Sweden
| | - Ulla Stenius
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Kristian Dreij
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
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15
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Kimblad A, Ollvik G, Lindh CH, Axelsson J. Decreased sperm counts in Swedish users of oral tobacco. Andrology 2022; 10:1181-1188. [PMID: 35642735 PMCID: PMC9543234 DOI: 10.1111/andr.13198] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
Background Smoke‐free tobacco via moist oral snuff (snus) is used daily in more than 20% of Swedish men. Negative effects of cigarette smoking on sperm parameters are well documented, unlike for snuff, despite relevance also for other smoke‐free nicotine products. Objectives We wanted to investigate whether reproductive parameters differed between users and non‐users of snuff, and whether the amount of snuff and nicotine exposure mattered. Materials and methods Men (n = 613) from the general population, recruited 2000–2010, were physically examined, answered questions on smoking and snuff use, and delivered urine, blood and semen samples. Sperm concentration, total sperm count, semen volume, percent morphologically normal and progressively motile sperm, and DNA fragmentation index (by the Sperm Chromatin Structure Assay) and reproductive hormones were analysed. Nicotine exposure was measured through urinary levels of cotinine. We used general linear models, with adjustments including cigarette smoking, and for semen parameters also abstinence time. Results After adjustments, total sperm count was 24% lower (P = 0.03) and testosterone 14% higher (P < 0.001) in 109 users of snuff than in non‐users, whereas cotinine was positively associated with testosterone and oestradiol (P < 0.001). Numbers of boxes of snuff used per week were associated with testosterone and FSH (P < 0.001). Discussion Applied to the general population, the consumption of smoke‐free tobacco by the use of snuff was associated with a lower sperm count and a higher testosterone, for which the extent seemed to play a role. Conclusions Independent of smoking, consumption of snuff was associated with lower total sperm count and different hormone levels. Applying these results to a reported association between sperm count and the chance of pregnancy, men who used snuff would have about a 10% lower chance of fathering a child.
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Affiliation(s)
- Agnes Kimblad
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Gustav Ollvik
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Jonatan Axelsson
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.,Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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16
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Björvang RD, Hallberg I, Pikki A, Berglund L, Pedrelli M, Kiviranta H, Rantakokko P, Ruokojärvi P, Lindh CH, Olovsson M, Persson S, Holte J, Sjunnesson Y, Damdimopoulou P. Follicular fluid and blood levels of persistent organic pollutants and reproductive outcomes among women undergoing assisted reproductive technologies. Environ Res 2022; 208:112626. [PMID: 34973191 DOI: 10.1016/j.envres.2021.112626] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 11/15/2021] [Revised: 12/14/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Persistent organic pollutants (POPs) are industrial chemicals resistant to degradation and have been shown to have adverse effects on reproductive health in wildlife and humans. Although regulations have reduced their levels, they are still ubiquitously present and pose a global concern. Here, we studied a cohort of 185 women aged 21-43 years with a median of 2 years of infertility who were seeking assisted reproductive technology (ART) treatment at the Carl von Linné Clinic in Uppsala, Sweden. We analyzed the levels of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenyl ethers (PBDEs), and 8 perfluoroalkyl substances (PFASs) in the blood and follicular fluid (FF) samples collected during ovum pick-up. Impact of age on chemical transfer from blood to FF was analyzed. Associations of chemicals, both individually and as a mixture, to 10 ART endpoints were investigated using linear, logistic, and weighted quantile sum regression, adjusted for age, body mass index, parity, fatty fish intake and cause of infertility. Out of the 30 chemicals, 20 were detected in more than half of the blood samples and 15 in FF. Chemical transfer from blood to FF increased with age. Chemical groups in blood crossed the blood-follicle barrier at different rates: OCPs > PCBs > PFASs. Hexachlorobenzene, an OCP, was associated with lower anti-Müllerian hormone, clinical pregnancy, and live birth. PCBs and PFASs were associated with higher antral follicle count and ovarian response as measured by ovarian sensitivity index, but also with lower embryo quality. As a mixture, similar findings were seen for the sum of PCBs and PFASs. Our results suggest that age plays a role in the chemical transfer from blood to FF and that exposure to POPs significantly associates with ART outcomes. We strongly encourage further studies to elucidate the underlying mechanisms of reproductive effects of POPs in humans.
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Affiliation(s)
- Richelle D Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Ida Hallberg
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Anne Pikki
- Carl von Linnékliniken, 751 83 Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Lars Berglund
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, 751 22 Uppsala, Sweden
| | - Matteo Pedrelli
- Cardio Metabolic Unit, Department of Laboratory Medicine and Department of Medicine, Karolinska Institutet, Huddinge, 141 52 Stockholm, Sweden; Medicine Unit Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Hannu Kiviranta
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Päivi Ruokojärvi
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 223 61 Lund, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Sara Persson
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Jan Holte
- Carl von Linnékliniken, 751 83 Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Ylva Sjunnesson
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
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Li Y, Andersson A, Xu Y, Pineda D, Nilsson CA, Lindh CH, Jakobsson K, Fletcher T. Determinants of serum half-lives for linear and branched perfluoroalkyl substances after long-term high exposure-A study in Ronneby, Sweden. Environ Int 2022; 163:107198. [PMID: 35447437 DOI: 10.1016/j.envint.2022.107198] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [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: 09/09/2021] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are persistent substances with surfactant and repellent properties. Municipal drinking water contaminated with PFAS had been distributed for decades to one third of households in Ronneby, Sweden. The source was firefighting foam used in a nearby airfield since the mid-1980s. Clean water was provided from December 16, 2013. AIMS The purpose was to estimate serum half-lives and their determinants in the study population for different PFAS. METHODS Up to ten blood samples were collected between 2014 and 2018 from 114 participants (age 4-84 years at entry, 53% female). 19 PFAS were analysed. Linear mixed models were used to estimate the half-lives. RESULTS Eight PFAS were increased in Ronneby: perfluorooctanoic acid (PFOA), perfluoropentane sulfonate (PFPeS), perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), linear perfluorooctane sulfonate (L-PFOS) and three branched perfluorooctane sulfonates (1 m-PFOS, 3/4/5m-PFOS and 2/6m-PFOS). The mean estimated half-lives (in years) were 0.94 (95 %CI 0.86-1.02) for PFPeS, 2.47 (2.27-2.7) for PFOA, 2.67 (2.51-2.85) for 2/6m-PFOS, 2.73 (2.55-2.92) for L-PFOS, 3.43 (3.19-3.71) for 3/4/5m-PFOS, 4.52 (4.14-4.99) for PFHxS, 4.55 (4.14-5.06) for PFHpS, and 5.01 (4.56-5.55) for 1 m-PFOS. The most important determinants of a shorter half-life were young age, and better kidney function measured by estimated glomerular filtration rate and ratio of paired urine and serum PFAS levels, followed by female sex during their fertile period aged 15-50. Markers of gut inflammation and reduced permeability i.e. zonulin and calprotectin were also possibly associated with shorter half-life. The results also suggested a time-dependent PFAS elimination process, with more rapid elimination in the first year after the end of exposure. CONCLUSION The half-life estimates are in line with past estimates for some PFAS such as PFOA, and the novel results for different PFOS isomers. These results provide observational support for elimination routes - renal, fecal and maternal.
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Affiliation(s)
- Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Axel Andersson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Carina A Nilsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
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Axelsson J, Lindh CH, Giwercman A. Exposure to polycyclic aromatic hydrocarbons and nicotine, and associations with sperm DNA fragmentation. Andrology 2022; 10:740-748. [PMID: 35234353 PMCID: PMC9310791 DOI: 10.1111/andr.13170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/01/2021] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 12/03/2022]
Abstract
Background Tobacco smoking has been reported to cause DNA fragmentation and has been suggested to cause mutations in spermatozoa. These effects have been ascribed to the action of polycyclic aromatic hydrocarbons (PAH) present in the smoke. Simultaneously, DNA fragmentation has been associated with mutagenesis. Objective The aim of this study was to investigate whether levels of urinary biomarkers of PAH and nicotine exposure were associated with sperm DNA fragmentation. Methods In the urine of 381 men recruited from two cohorts of young men (17–21 years old) from the general Swedish population, the PAH metabolites 1‐hydroxypyrene and 2‐hydroxyphenanthrene, as well as the nicotine metabolite cotinine, were measured. The sperm DNA fragmentation index (DFI) was analysed using the sperm chromatin structure assay. Associations between the DFI, and PAH metabolite levels as continuous variables as well as in quartiles, were studied by general linear models adjusted for abstinence time. A similar analysis was carried out for cotinine levels, according to which the men were categorised as “non‐smoking” (n = 216) and “smoking” (n = 165). Results No association was found between levels of any of the three biomarkers and DFI, either as a continuous variable (p = 0.87–0.99), or when comparing the lowest and the highest quartiles (p = 0.11–0.61). The same was true for comparison of men categorised as non‐smoking or smoking (DFI 11.1% vs. 11.8%, p = 0.31). Discussion We found no evidence of PAH or nicotine exposure to be associated with DFI, which does not exclude that these exposures may have other effects on sperm DNA. Conclusion In these young men, levels of biomarkers of nicotine and PAH exposure were not associated with DFI.
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Affiliation(s)
- Jonatan Axelsson
- Reproductive Medicine Centre, Skåne University Hospital, and Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.,Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden
| | - Christian H Lindh
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Skåne University Hospital, and Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
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Corrales Vargas A, Peñaloza Castañeda J, Rietz Liljedahl E, Mora AM, Menezes-Filho JA, Smith DR, Mergler D, Reich B, Giffin A, Hoppin JA, Lindh CH, van Wendel de Joode B. Exposure to common-use pesticides, manganese, lead, and thyroid function among pregnant women from the Infants' Environmental Health (ISA) study, Costa Rica. Sci Total Environ 2022; 810:151288. [PMID: 34756903 PMCID: PMC9162492 DOI: 10.1016/j.scitotenv.2021.151288] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/03/2021] [Accepted: 10/23/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Pesticides and metals may disrupt thyroid function, which is key to fetal brain development. OBJECTIVES To evaluate if current-use pesticide exposures, lead and excess manganese alter free thyroxine (FT4), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH) concentrations in pregnant women from the Infants' Environmental Health Study (ISA). METHODS At enrollment, we determined women's (n = 400) specific-gravity corrected urinary pesticide (μg/L) metabolite concentrations of mancozeb (ethylene thiourea (ETU)), pyrimethanil, thiabendazole, chlorpyrifos, synthetic pyrethroids, and 2,4-D. We also measured manganese hair (MnH) (μg/g) and blood (MnB) (μg/L), and blood lead (PbB) (μg/L) concentrations. To detect an immediate and late effect on thyroid homeostasis, we determined TSH, FT4 and FT3 in serum obtained at the same visit (n = 400), and about ten weeks afterwards (n = 245). We assessed associations between exposures and outcomes with linear regression and general additive models, Bayesian multivariate linear regression, and Bayesian kernel machine regression. RESULTS About 80%, 94%, and 100% of the women had TSH, FT4, and FT3 within clinical reference ranges, respectively. Women with higher urinary ETU, and pyrimethanil-metabolites, had lower FT4: β = -0.79 (95%CI = -1.51, -0.08) and β = -0.29 (95%CI = -0.62, -0.03), respectively, for each tenfold increase in exposure. MnB was positively associated with FT4 (β = 0.04 (95%CI = 0.00, 0.07 per 1 μg/L increase), and women with high urinary pyrethroid-metabolite concentrations had decreased TSH (non-linear effects). For the late-effect analysis, metabolites of pyrethroids and chlorpyrifos, as well as MnH, and PbB were associated decreased TSH, or increased FT4 and/or FT3. DISCUSSION Mancozeb (ETU) and pyrimethanil may inhibit FT4 secretion (hypothyroidism-like effect), while chlorpyrifos, pyrethroids, MnB, MnH, PbB and Mn showed hyperthyroidism-like effects. Some effects on thyroid homeostasis seemed to be immediate (mancozeb (ETU), pyrimethanil, MnB), others delayed (chlorpyrifos, MnH, PbB), or both (pyrethroids), possibly reflecting different mechanisms of action.
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Affiliation(s)
- Andrea Corrales Vargas
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Jorge Peñaloza Castañeda
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Ana María Mora
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Children's Health (CERCH), University of California at Berkeley, United States
| | - Jose Antonio Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Av. Barão de Jeremoabo s/n Campus Universitário de Ondina, 40170-115 Salvador, Bahia, Brazil
| | - Donald R Smith
- Microbiology and Environmental Toxicology, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, United States
| | - Donna Mergler
- Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (CINBIOSE), Université du Québec à Montréal, Montreal, Canada
| | - Brian Reich
- Department of Statistics, North Carolina State University, United States; Center for Human Health and the Environment, North Carolina State University, United States
| | - Andrew Giffin
- Department of Statistics, North Carolina State University, United States; Center for Human Health and the Environment, North Carolina State University, United States
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, United States; Department of Biological Sciences, North Carolina State University, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Berna van Wendel de Joode
- Infants' Environmental Health Study (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica.
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20
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Preece AS, Knutz M, Lindh CH, Bornehag CG, Shu H. Prenatal phthalate exposure and early childhood wheeze in the SELMA study. J Expo Sci Environ Epidemiol 2022; 32:303-311. [PMID: 34475495 DOI: 10.1038/s41370-021-00382-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 02/22/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prenatal maternal phthalate exposure has been associated with wheeze and asthma in children, but results are inconclusive. Previous studies typically assessed exposure in late pregnancy, included only a small number of old phthalates, and assessed outcomes in children aged 5 years or older. OBJECTIVE We explored associations between 1st trimester prenatal maternal exposure to a wider range of phthalates and wheeze in early childhood. METHODS First trimester concentrations of 14 metabolites from 8 phthalates and one alternative plasticizer were quantified in first-morning void urine from 1148 mothers in the Swedish SELMA study. Associations between log-transformed metabolite concentrations and parental reported ever wheeze among 24-month-old children were investigated with logistic regression models adjusted for parental asthma/rhinitis, sex of child, maternal education, smoking, and creatinine. RESULTS Metabolites of replacement phthalates di-iso-decyl phthalate (DiDP) and di-2-propylheptyl phthalate (DPHP) were associated with increased risk for wheeze (aOR 1.47, 95% CI 1.08-2.01 and aOR 1.49, 95% CI 1.04-2.15, respectively). The associations with DiDP and DPHP were stronger among children whose parents did not have asthma or rhinitis. In this group, wheeze was also associated with metabolites of butyl-benzyl phthalate (BBzP) and di-iso-nonyl phthalate (DiNP). SIGNIFICANCE Maternal phthalate exposure during early pregnancy may be a risk factor for wheeze in early childhood, especially among children whose parents do not have asthma or rhinitis symptoms.
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Affiliation(s)
- Anna-Sofia Preece
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Malin Knutz
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Huan Shu
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.
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21
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Schillemans T, Donat-Vargas C, Lindh CH, de Faire U, Wolk A, Leander K, Åkesson A. Per- and Polyfluoroalkyl Substances and Risk of Myocardial Infarction and Stroke: A Nested Case-Control Study in Sweden. Environ Health Perspect 2022; 130:37007. [PMID: 35285690 PMCID: PMC8919955 DOI: 10.1289/ehp9791] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are widespread and persistent pollutants that have been associated with elevated cholesterol levels. However, data on incident cardiovascular disease (CVD) is lacking. OBJECTIVES We investigated the association of exposure to PFAS with risk of myocardial infarction and stroke and, subsidiary, with baseline blood lipids. METHODS This population-based nested case-control study included first incident myocardial infarction and stroke cases with matched controls from two Swedish cohorts: the Swedish Mammography Cohort-Clinical (SMC-C) and the Cohort of 60-year-olds (60YO). Baseline blood sampling occurred during 2003-2009 and 1997-1999 with follow-up through 2017 and 2014 for the SMC-C and the 60YO, respectively. Eight plasma PFAS concentrations were measured using targeted liquid chromatography-triple quadrupole mass spectrometry. Five of these were quantifiable in both cohorts; individual values and their standardized sum were categorized into tertiles based on the controls. First incident myocardial infarction (n=345) and ischemic stroke (n=354) cases were ascertained via linkage to the National Inpatient Register and the Cause of Death Register. Controls were randomly selected from each cohort after matching for age, sex, and sample date. Baseline blood lipids were measured in plasma or serum after overnight fasting. RESULTS Among the 1,528 case-control subjects, the mean (standard deviation) age was 66 (7.7) y and 67% of them were women. In multivariable-adjusted analyses, the third tertile of the standardized sum of five PFAS associated with higher cholesterol and lower triglyceride levels among controls at baseline (n=631). The corresponding results were odds ratios=0.70 [95% confidence interval (CI): 0.53, 0.93] for CVD, 0.60 (95% CI: 0.39, 0.92) for myocardial infarction, and 0.83 (95% CI: 0.46, 1.50) for stroke. DISCUSSION This study indicated that exposure to PFAS, although associated with increased cholesterol levels, did not associate with an increased risk of myocardial infarction, stroke, or their composite end point. The findings improve our knowledge on potential health effects of environmental contaminants in the CVD context. https://doi.org/10.1289/EHP9791.
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Affiliation(s)
- Tessa Schillemans
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Carolina Donat-Vargas
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
- Department of Preventive Medicine and Public Health, School of Medicine, Campus of International Excellence, Universidad Autónoma de Madrid y Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Ulf de Faire
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Karin Leander
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
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22
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Xu Y, Lindh CH, Fletcher T, Jakobsson K, Engström K. Perfluoroalkyl substances influence DNA methylation in school-age children highly exposed through drinking water contaminated from firefighting foam: a cohort study in Ronneby, Sweden. Environ Epigenet 2022; 8:dvac004. [PMID: 35308102 PMCID: PMC8931254 DOI: 10.1093/eep/dvac004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/04/2022] [Indexed: 05/31/2023]
Abstract
Perfluoroalkyl substances (PFASs) are widespread synthetic substances with various adverse health effects. A potential mechanism of toxicity for PFASs is via epigenetic changes, such as DNA methylation. Previous studies have evaluated associations between PFAS exposure and DNA methylation among newborns and adults. However, no study has evaluated how PFASs influence DNA methylation among children of school age. In this exploratory study with school-age children exposed to PFASs through drinking water highly contaminated from firefighting foams, we aimed to investigate whether exposure to PFASs was associated with alteration in DNA methylation and epigenetic age acceleration. Sixty-three children aged 7-11 years from the Ronneby Biomarker Cohort (Sweden) were included. The children were either controls with only background exposure (n = 32; perfluorooctane sulfonic acid: median 2.8 and range 1-5 ng/ml) or those exposed to very high levels of PFASs (n = 31; perfluorooctane sulfonic acid: median 295 and range 190-464 ng/ml). These two groups were matched on sex, age, and body mass index. Genome-wide methylation of whole-blood DNA was analyzed using the Infinium MethylationEPIC BeadChip kit. Epigenetic age acceleration was derived from the DNA methylation data. Twelve differentially methylated positions and seven differentially methylated regions were found when comparing the high-exposure group to the control group. There were no differences in epigenetic age acceleration between these two groups (P = 0.66). We found that PFAS exposure was associated with DNA methylation at specific genomic positions and regions in children at school age, which may indicate a possible mechanism for linking PFAS exposure to health effects.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Medicinaregatan 18A, Gothenburg 413 90, Sweden
| | - Christian H Lindh
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Scheelevägen 2, Lund 223 63, Sweden
| | - Tony Fletcher
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Medicinaregatan 18A, Gothenburg 413 90, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Medicinaregatan 16 A, Gothenburg 413 90, Sweden
| | - Karin Engström
- **Correspondence address. Department of Laboratory Medicine, EPI@LUND, Division of Occupational and Environmental Medicine, Lund University, Biskopsgatan 9, Lund 223 62, Sweden. Tel: +46 46 222 16 38; E-mail:
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23
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De Loma J, Krais AM, Lindh CH, Mamani J, Tirado N, Gardon J, Broberg K. Arsenic exposure and biomarkers for oxidative stress and telomere length in indigenous populations in Bolivia. Ecotoxicol Environ Saf 2022; 231:113194. [PMID: 35051766 DOI: 10.1016/j.ecoenv.2022.113194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/31/2020] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Women living in the Bolivian Andes are environmentally exposed to arsenic, yet there is scarce information about arsenic-related effects in this region. Several biomarkers for telomere length and oxidative stress (mitochondrial DNA copy number, mtDNAcn; 8-Oxo-2'-deoxyguanosine, 8-oxo-dG; and 4-hydroxy nonenal mercapturic acid, 4-HNE-MA) have been previously linked to arsenic, and some of which are prospective biomarkers for cancer risk. OBJECTIVE AND HYPOTHESIS To evaluate associations between arsenic exposure and telomere length, mtDNAcn, 8-oxo-dG, and 4-HNE-MA in Bolivians. Arsenic exposure was hypothesized to be positively associated with all four toxicity biomarkers, particularly in individuals with a less efficient arsenic metabolism. METHODS The study encompassed 193 indigenous women. Arsenic exposure was assessed in urine as the sum of inorganic arsenic metabolite concentrations (U-As) measured by HPLC-HG-ICP-MS, and in whole blood as total arsenic (B-As) measured by ICP-MS. Efficiency of arsenic metabolism was evaluated by a polymorphism (rs3740393) in the main arsenic methylating gene AS3MT measured by TaqMan allelic discrimination, and by the relative fractions of urinary inorganic arsenic metabolites. Telomere length and mtDNAcn were determined in peripheral blood leukocytes by quantitative PCR, and urinary 8-oxo-dG and 4-HNE-MA by LC-MS/MS. RESULTS U-As and B-As were associated with longer telomeres and higher mtDNAcn, particularly in women with a less efficient arsenic metabolism. Urinary 8-oxo-dG and 4-HNE-MA were positively associated with U-As, but only 4-HNE-MA was associated with B-As. Arsenic metabolism efficiency did not have a clear effect on the concentrations of either of these biomarkers. CONCLUSION Bolivian women showed indications of arsenic toxicity, measured by four different biomarkers. Telomere length, mtDNAcn, and 4-HNE-MA were positively associated with both U-As and B-As. The association of arsenic exposure with telomere length and mtDNAcn was only present in Bolivian women with a less efficient metabolism. These findings call for additional efforts to evaluate and reduce arsenic exposure in Bolivia.
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Affiliation(s)
- Jessica De Loma
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Annette M Krais
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Josue Mamani
- Genetics Institute, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Noemi Tirado
- Genetics Institute, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Jacques Gardon
- Hydrosciences Montpellier, Université de Montpellier, Institut de Recherche pour le Développement, Centre National de la Recherche Scientifique, Montpellier, France
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Alhanti B, van Wendel de Joode B, Soto Martinez M, Mora AM, Córdoba Gamboa L, Reich B, Lindh CH, Quirós Lépiz M, Hoppin JA. Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica. Occup Environ Med 2021; 79:469-476. [PMID: 34969778 PMCID: PMC9198003 DOI: 10.1136/oemed-2021-107611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/04/2021] [Accepted: 12/09/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This research evaluates whether environmental exposures (pesticides and smoke) influence respiratory and allergic outcomes in women living in a tropical, agricultural environment. METHODS We used data from 266 mothers from the Infants' Environmental Health cohort study in Costa Rica. We evaluated environmental exposures in women by measuring seven pesticide and two polycyclic aromatic hydrocarbons metabolites in urine samples. We defined 'high exposure' as having a metabolite value in the top 75th percentile. We collected survey data on respiratory and allergic outcomes in mothers as well as on pesticides and other environmental exposures. Using logistic regression models adjusted for obesity, we assessed the associations of pesticide exposure with multiple outcomes (wheeze, doctor-diagnosed asthma, high (≥2) asthma score based on symptoms, rhinitis, eczema and itchy rash). RESULTS Current pesticide use in the home was positively associated with diagnosed asthma (OR=1.99 (95% CI=1.05 to 3.87)). High urinary levels of 5-hydroxythiabendazole (thiabendazole metabolite) and living in a neighbourhood with frequent smoke from waste burning were associated with a high asthma score (OR=1.84 (95%CI=1.05 to 3.25) and OR=2.31 (95%CI=1.11 to 5.16), respectively). Women who worked in agriculture had a significantly lower prevalence of rhinitis (0.19 (0.01 to 0.93)), but were more likely to report eczema (OR=2.54 (95%CI=1.33 to 4.89)) and an itchy rash (OR=3.17 (95%CI=1.24 to 7.73)). CONCLUSIONS While limited by sample size, these findings suggest that environmental exposure to both pesticides and smoke may impact respiratory and skin-related allergic outcomes in women.
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Affiliation(s)
- Brooke Alhanti
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA.,Center for Human Health and the Environment, North Carolina State University, Raleigh, North Carolina, USA
| | - Berna van Wendel de Joode
- Infants' Environmental Health (ISA) Study, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | | | - Ana M Mora
- Infants' Environmental Health (ISA) Study, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica.,Center for Environmental Research and Children's Health (CERCH), University of California Berkeley, Berkeley, California, USA
| | - Leonel Córdoba Gamboa
- Infants' Environmental Health (ISA) Study, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Brian Reich
- Center for Human Health and the Environment, North Carolina State University, Raleigh, North Carolina, USA.,Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden
| | - Marcela Quirós Lépiz
- Infants' Environmental Health (ISA) Study, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, Raleigh, North Carolina, USA .,Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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25
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Derakhshan A, Shu H, Broeren MAC, Lindh CH, Peeters RP, Kortenkamp A, Demeneix B, Bornehag CG, Korevaar TIM. Association of phthalate exposure with thyroid function during pregnancy. Environ Int 2021; 157:106795. [PMID: 34358912 DOI: 10.1016/j.envint.2021.106795] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 02/18/2021] [Revised: 07/01/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The extent of thyroid disruptive effects of phthalates during pregnancy remains unclear. AIM To investigate the association of maternal urinary phthalates with markers of the thyroid system during early pregnancy. METHODS Urinary concentrations of phthalate metabolites and serum concentrations of thyroid stimulating hormone (TSH), free and total thyroxine (FT4 and TT4) and free and total triiodothyronine (FT3 and TT3) were measured in pregnant women in early pregnancy in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (2007-ongoing), a population-based prospective cohort. RESULTS In the 1,996 included women, higher di-ethyl-hexyl phthalate (DEHP) metabolites were associated with a lower FT4 (β [SE] for the molar sum: -0.13 [0.06], P = 0.03) and a higher TSH/FT4 ratio (0.003 [0.001], P = 0.03). Higher concentrations of di-iso-nonyl phthalate (DINP) metabolites were associated with a lower TT4 (β [SE] for the molar sum: 0.93 [0.44], P = 0.03) as well as with lower TT4/FT4 and TT4/TT3 ratios. Higher metabolites of both dibutyl and butyl-benzyl phthalate (DBP and BBzP) were associated with lower T4/T3 ratio (free and total) and higher FT4/TT4 and FT3/TT3 ratios. A higher diisononyl cyclohexane dicarboxylate (DINCH) metabolite concentration was associated with a higher TT3. CONCLUSIONS These results translate results from experimental studies suggesting that exposure to phthalates may interfere with the thyroid system during pregnancy. This is also true for compounds that have been introduced to replace known disruptive phthalates. Further experimental studies should take into account the human evidence to better investigate the potential underlying mechanisms of thyroid disruption by phthalates.
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Affiliation(s)
- Arash Derakhshan
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Huan Shu
- Department of Health Sciences, Karlstad University, 651 88 Karlstad, Sweden
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, De Run 4600, the Netherlands
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, 22363 Lund, Sweden
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Andreas Kortenkamp
- Division of Environmental Sciences, College of Health, Medicine and Life Sciences, Brunel University, London, Uxbridge, UK
| | - Barbara Demeneix
- Laboratoire d'Evolution des Régulations Endocriniennes, CNRS/Muséum National d'Histoire Naturelle, 57 Rue Cuvier, 75005 Paris, France
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, 651 88 Karlstad, Sweden; Icahn School of Medicine at Mount Sinai, New York City, NY 10029-6574, USA
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands.
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26
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Björvang RD, Vinnars MT, Papadogiannakis N, Gidlöf S, Mamsen LS, Mucs D, Kiviranta H, Rantakokko P, Ruokojärvi P, Lindh CH, Andersen CY, Damdimopoulou P. Mixtures of persistent organic pollutants are found in vital organs of late gestation human fetuses. Chemosphere 2021; 283:131125. [PMID: 34467953 DOI: 10.1016/j.chemosphere.2021.131125] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 03/19/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
Persistent organic pollutants (POPs) are industrial chemicals with long half-lives. Early life exposure to POPs has been associated with adverse effects. Fetal exposure is typically estimated based on concentrations in maternal serum or placenta and little is known on the actual fetal exposure. We measured the concentrations of nine organochlorine pesticides (OCPs), ten polychlorinated biphenyl (PCB) congeners, and polybrominated diphenyl ether (PBDE) congeners by gas chromatography - tandem mass spectrometry in maternal serum, placenta, and fetal tissues (adipose tissue, liver, heart, lung and brain) in 20 pregnancies that ended in stillbirth (gestational weeks 36-41). The data were combined with our earlier data on perfluoroalkyl substances (PFASs) in the same cohort (Mamsen et al. 2019). HCB, p,p'-DDE, PCB 138 and PCB 153 were quantified in all samples of maternal serum, placenta and fetal tissues. All 22 POPs were detected in all fetal adipose tissue samples, even in cases where they could not be detected in maternal serum or placenta. Tissue:serum ratios were significantly higher in later gestations, male fetuses, and pregnancies with normal placental function. OCPs showed the highest tissue:serum ratios and PFAS the lowest. The highest chemical burden was found in adipose tissue and lowest in the brain. Overall, all studied human fetuses were intrinsically exposed to mixtures of POPs. Tissue:serum ratios were significantly modified by gestational age, fetal sex and placental function. Importantly, more chemicals were detected in fetal tissues compared to maternal serum and placenta, implying that these proxy samples may provide a misleading picture of actual fetal exposures.
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Affiliation(s)
- Richelle D Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden; Swetox, Karolinska Institute, Unit of Toxicology Sciences, 151 36, Södertälje, Sweden.
| | - Marie-Therese Vinnars
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden; Division of Obstetrics and Gynecology Örnsköldsviks Hospital, Department of Clinical Sciences, Umeå University, Örnsköldsvik/Umeå, Sweden.
| | - Nikos Papadogiannakis
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 83, Stockholm, Sweden.
| | - Sebastian Gidlöf
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden; Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, 141 86, Stockholm, Sweden.
| | - Linn Salto Mamsen
- Laboratory of Reproductive Biology, Section 5712, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen and University of Copenhagen, Rigshospitalet, 2100, Copenhagen, Denmark.
| | - Daniel Mucs
- Swetox, Karolinska Institute, Unit of Toxicology Sciences, 151 36, Södertälje, Sweden.
| | - Hannu Kiviranta
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.
| | - Päivi Ruokojärvi
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 223 61, Lund, Sweden.
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Section 5712, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen and University of Copenhagen, Rigshospitalet, 2100, Copenhagen, Denmark.
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden; Swetox, Karolinska Institute, Unit of Toxicology Sciences, 151 36, Södertälje, Sweden.
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27
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Björvang RD, Hassan J, Stefopoulou M, Gemzell-Danielsson K, Pedrelli M, Kiviranta H, Rantakokko P, Ruokojärvi P, Lindh CH, Acharya G, Damdimopoulou P. Persistent organic pollutants and the size of ovarian reserve in reproductive-aged women. Environ Int 2021; 155:106589. [PMID: 33945905 DOI: 10.1016/j.envint.2021.106589] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 02/07/2021] [Revised: 04/07/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
Industrial chemicals such as persistent organic pollutants (POPs) have been associated with reduced fertility in women, including longer time-to-pregnancy (TTP), higher odds for infertility, and earlier reproductive senescence. Fertility is highly dependent on the ovarian reserve, which is composed of a prenatally determined stock of non-growing follicles. The quantity and quality of the follicles decline with age, thereby eventually leading to menopause. In the clinical setting, assessing ovarian reserve directly through the histological analysis of follicular density in ovaries is not practical. Therefore, surrogate markers of ovarian reserve, such as serum anti-Müllerian hormone (AMH) are typically used. Here, we studied associations between chemical exposure and ovarian reserve in a cohort of pregnant women undergoing elective caesarean section (n = 145) in Stockholm, Sweden. Full data (histological, clinical, serum) were available for 50 women. We estimated the size of the reserve both directly by determining the density of follicles in ovarian cortical tissue samples, and indirectly by measuring AMH in associated serum samples. Concentrations of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenylethers (PBDEs) and 9 perfluoroalkyl substances (PFAS) were determined in serum, and clinical data were retrieved from electronic medical records. Healthy follicle densities (median 0, range 0-193 follicles/mm3) and AMH levels (median 2.33 ng/mL, range 0.1-14.8 ng/mL) varied substantially. AMH correlated with the density of growing follicles. Twenty-three chemicals detected in more than half of the samples were included in the analyses. None of the chemicals, alone or as a mixture, correlated with AMH, growing or atretic follicles. However, HCB, transnonachlor, PCBs 74 and 99 were associated with decreased non-growing follicle densities. HCB and transnonachlor were also negatively associated with healthy follicle density. Further, mixture of lipophilic POPs (PBDE 99, p,p'-DDE, and PCB 187) was associated with lower non-growing follicle densities. In addition, exposure to HCB, p,p'-DDE, and mixture of OCPs were significantly associated with higher odds of infertility. The results suggest that exposure to chemicals may reduce the size of ovarian reserve in humans, and strongly encourage to study mechanisms behind POP-associated infertility in women in more detail.
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Affiliation(s)
- Richelle D Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Jasmin Hassan
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Maria Stefopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
| | - Matteo Pedrelli
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, 141 52 Stockholm, Sweden.
| | - Hannu Kiviranta
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland.
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland.
| | - Päivi Ruokojärvi
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 223 61 Lund, Sweden.
| | - Ganesh Acharya
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
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28
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Krais AM, Essig JY, Gren L, Vogs C, Assarsson E, Dierschke K, Nielsen J, Strandberg B, Pagels J, Broberg K, Lindh CH, Gudmundsson A, Wierzbicka A. Biomarkers after Controlled Inhalation Exposure to Exhaust from Hydrogenated Vegetable Oil (HVO). Int J Environ Res Public Health 2021; 18:6492. [PMID: 34208511 PMCID: PMC8296316 DOI: 10.3390/ijerph18126492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 01/23/2023]
Abstract
Hydrogenated vegetable oil (HVO) is a renewable diesel fuel used to replace petroleum diesel. The organic compounds in HVO are poorly characterized; therefore, toxicological properties could be different from petroleum diesel exhaust. The aim of this study was to evaluate the exposure and effective biomarkers in 18 individuals after short-term (3 h) exposure to HVO exhaust and petroleum diesel exhaust fumes. Liquid chromatography tandem mass spectrometry was used to analyze urinary biomarkers. A proximity extension assay was used for the measurement of inflammatory proteins in plasma samples. Short-term (3 h) exposure to HVO exhaust (PM1 ~1 µg/m3 and ~90 µg/m3 for vehicles with and without exhaust aftertreatment systems, respectively) did not increase any exposure biomarker, whereas petroleum diesel exhaust (PM1 ~300 µg/m3) increased urinary 4-MHA, a biomarker for p-xylene. HVO exhaust from the vehicle without exhaust aftertreatment system increased urinary 4-HNE-MA, a biomarker for lipid peroxidation, from 64 ng/mL urine (before exposure) to 141 ng/mL (24 h after exposure, p < 0.001). There was no differential expression of plasma inflammatory proteins between the HVO exhaust and control exposure group. In conclusion, short-term exposure to low concentrations of HVO exhaust did not increase urinary exposure biomarkers, but caused a slight increase in lipid peroxidation associated with the particle fraction.
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Affiliation(s)
- Annette M. Krais
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Julie Y. Essig
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Louise Gren
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden; (L.G.); (J.P.); (A.G.); (A.W.)
- NanoLund, Center for Nanoscience, Lund University, SE-22100 Lund, Sweden
| | - Carolina Vogs
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden;
| | - Eva Assarsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Katrin Dierschke
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Jörn Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Bo Strandberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Joakim Pagels
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden; (L.G.); (J.P.); (A.G.); (A.W.)
- NanoLund, Center for Nanoscience, Lund University, SE-22100 Lund, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-22363 Lund, Sweden; (J.Y.E.); (E.A.); (K.D.); (J.N.); (B.S.); (K.B.); (C.H.L.)
| | - Anders Gudmundsson
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden; (L.G.); (J.P.); (A.G.); (A.W.)
- NanoLund, Center for Nanoscience, Lund University, SE-22100 Lund, Sweden
| | - Aneta Wierzbicka
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden; (L.G.); (J.P.); (A.G.); (A.W.)
- NanoLund, Center for Nanoscience, Lund University, SE-22100 Lund, Sweden
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29
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Alhamdow A, Zettergren A, Kull I, Hallberg J, Andersson N, Ekström S, Berglund M, Wheelock CE, Essig YJ, Krais AM, Georgelis A, Lindh CH, Melén E, Bergström A. Low-level exposure to polycyclic aromatic hydrocarbons is associated with reduced lung function among Swedish young adults. Environ Res 2021; 197:111169. [PMID: 33857464 DOI: 10.1016/j.envres.2021.111169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/27/2020] [Revised: 03/15/2021] [Accepted: 04/08/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse pulmonary effects. However, the impact of low-level environmental PAH exposure on lung function in early adulthood remains uncertain. OBJECTIVES To evaluate the associations between urinary PAH metabolites and lung function parameters in young adults. METHODS Urinary metabolites of pyrene, phenanthrene, and fluorene were analysed in 1000 young adults from Sweden (age 22-25 years) using LC-MS/MS. Lung function and eosinophilic airway inflammation were measured by spirometry and exhaled nitric oxide fraction (FeNO), respectively. Linear regression analysis was used to evaluate associations between PAH metabolites and the outcomes. RESULTS Median urinary concentrations of 1-OH-pyrene, ∑OH-phenanthrene, and ∑OH-fluorene were 0.066, 0.36, 0.22 μg/L, respectively. We found inverse associations of ∑OH-phenanthrene and ∑OH-fluorene with FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC ratio (adjusted P < 0.05; all participants). An increase of 1% in ∑OH-fluorene was associated with a decrease of 73 mL in FEV1 and 59 mL in FVC. In addition, ∑OH-phenanthrene concentrations were, in a dose-response manner, inversely associated with FEV1 (B from -109 to -48 compared with the lowest quartile of ∑OH-phenanthrene; p trend 0.004) and FVC (B from -159 to -102 compared with lowest quartile; p-trend <0.001). Similar dose-response associations were also observed between ∑OH-fluorene and FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC (p-trend <0.05). There was no association between PAH exposure and FeNO, nor was there an interaction with smoking, sex, or asthma. CONCLUSION Low-level PAH exposure was, in a dose-response manner, associated with reduced lung function in young adults. Our findings have public health implications due to i) the widespread occurrence of PAHs in the environment and ii) the clinical relevance of lung function in predicting all-cause and cardiovascular disease mortality.
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Affiliation(s)
- Ayman Alhamdow
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institute, SE-171 77, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, SE, 17165, Stockholm, Sweden
| | - Yona J Essig
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Annette M Krais
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden.
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30
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Li Y, Xu Y, Fletcher T, Scott K, Nielsen C, Pineda D, Lindh CH, Olsson DS, Andersson EM, Jakobsson K. Associations between perfluoroalkyl substances and thyroid hormones after high exposure through drinking water. Environ Res 2021; 194:110647. [PMID: 33358873 DOI: 10.1016/j.envres.2020.110647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/18/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The reported associations for several per- and polyfluoroalkyl substance (PFAS) with thyroid hormones are inconsistent in epidemiological studies. The purpose of the current study was to investigate the possible association of thyroid hormones in relation to serum levels of perfluorohexane sulfonate, perfluorooctane sulfonate and perfluorooctanoic acid, in a Swedish general population, highly exposed through contaminated drinking water, and if the associations with PFAS remained in a comparison to a reference group based only on residency in areas with contrasting PFAS levels. METHOD 3297 participants from Ronneby, a municipality with drinking water highly contaminated by PFAS (exposed group), and a reference group (N = 226) from a nearby municipality with non-contaminated drinking water supply were included. Regression analysis was used to investigate the associations between PFAS exposure, assessed as exposure groups (Ronneby and reference groups) and measured serum PFAS levels, and thyroid hormone levels, with adjustments for age, sex and BMI. RESULT No cross-sectional associations were found between PFAS and thyroid hormones in adults and seniors except for a positive association between PFAS and fT4 in males over 50. Higher thyroid hormone levels were found in the preteen children from Ronneby compared to the reference group. In contrast, within Ronneby, there was weak evidence of associations between increased PFAS levels and decreased fT3 in preteen boys, and decreased TSH in teenage males. No such pattern was found in preteen and teenage girls. CONCLUSION The present study found no consistent evidence to support association of PFAS with thyroid hormones.
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Affiliation(s)
- Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kristin Scott
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Daniel S Olsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva M Andersson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Xu Y, Nielsen C, Li Y, Hammarstrand S, Andersson EM, Li H, Olsson DS, Engström K, Pineda D, Lindh CH, Fletcher T, Jakobsson K. Serum perfluoroalkyl substances in residents following long-term drinking water contamination from firefighting foam in Ronneby, Sweden. Environ Int 2021; 147:106333. [PMID: 33360412 DOI: 10.1016/j.envint.2020.106333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 08/28/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND In December 2013, it was discovered that drinking water supplied to one third of the households in Ronneby, southern Sweden, was highly contaminated by PFAS (sum level >10,000 ng/L) originated from firefighting foams used at a nearby military airport. OBJECTIVES To report serum PFAS levels of Ronneby residents participating in a biomonitoring program, and to describe the variation by age, sex and calendar period for residential exposure. In addition, a reference group living in a neighboring municipality without PFAS contaminated drinking water was examined. METHODS Blood samples and demographic data were collected for 3297 Ronneby residents and 226 individuals from the reference group. Yearly residence addresses were available for 3086 Ronneby residents from the national population registry. Serum concentrations of PFHxS, PFOS and PFOA were determined in all participants, with additional PFHpA, PFNA and PFDA in subsets of the participants. RESULTS The population geometric means for serum PFHxS, PFOS and PFOA were 114, 135 and 6.8 ng/mL for all Ronneby residents, i.e.135, 35 and 4.5 times higher than for the reference group. Ronneby residents who resided in the area with contaminated water supply during 2005-2013 showed much higher PFAS levels in 2014 than those exposed only before 2005. Ronneby residents who never resided in the area with contaminated water supply also had higher serum PFAS levels than the reference group. All three PFAS were highly correlated (rs > 0.9 for each pair). Serum PFAS levels were lowest in teenage years and then increased with age. Adult females had lower PFAS levels on average than males under the age of 60 but higher above 60. DISCUSSION The results reveal high serum PFAS levels dominated by PFHxS and PFOS in the Ronneby residents highly exposed to PFAS originated from firefighting foams. The PFAS exposure in Ronneby permits studies of associations to a range of health parameters, as well as studies of the toxicokinetics of PFAS exposure.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Sofia Hammarstrand
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Eva M Andersson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Daniel S Olsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Karin Engström
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Faniband MH, Norén E, Littorin M, Lindh CH. Human experimental exposure to glyphosate and biomonitoring of young Swedish adults. Int J Hyg Environ Health 2021; 231:113657. [PMID: 33130428 DOI: 10.1016/j.ijheh.2020.113657] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/30/2022]
Abstract
Glyphosate (GLY), N-(phosphonomethyl) glycine, is the most widely used herbicide in the world. It is a broad-spectrum herbicide, also used in crop desiccation. Agricultural workers may be occupationally exposed and general populations may be exposed to GLY mainly through diet. We studied the kinetics of GLY by measuring the parent compound and its metabolite aminomethylphosphonic acid (AMPA) in urine samples of three volunteers after an experimental oral exposure. We further examined GLY exposure by measuring GLY and AMPA in spot urine samples of 197 young adults in the general population in Scania, southern Sweden. Urine samples were analyzed using LC-MS/MS. In the experimental exposure, three healthy volunteers received an oral dose equivalent to 50% of the ADI for GLY. Urinary samples were collected up to 100 h after the exposure. The excretion of GLY to urine seemed to follow first-order kinetics and a two-phase excretion. The excretion half-life of GLY (density adjusted) was 6-9 h in the rapid phase and 18-33 h in the slower phase. The total dose recovered as unchanged GLY in the urine samples of volunteers was 1-6%. The metabolite AMPA was found to be 0.01-0.04% of the total dose of GLY. In the population of young adults, the median concentration was below 0.1 μg/L and a maximum concentration being 3.39 μg/L (density adjusted). AMPA was generally detected in lower concentrations (maximum = 0.99 μg/L). A moderate correlation (Spearman's ρ = 0.56) was observed between GLY and AMPA concentrations. Overall, the results may suggest that GLY and AMPA partly originate from separate exposures and that unchanged GLY is a more suitable biomarker of exposure.
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Affiliation(s)
- Moosa H Faniband
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Erika Norén
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85, Lund, Sweden
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Xu Y, Jurkovic-Mlakar S, Lindh CH, Scott K, Fletcher T, Jakobsson K, Engström K. Associations between serum concentrations of perfluoroalkyl substances and DNA methylation in women exposed through drinking water: A pilot study in Ronneby, Sweden. Environ Int 2020; 145:106148. [PMID: 33007577 DOI: 10.1016/j.envint.2020.106148] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 06/29/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are widespread synthetic substances with various adverse health effects. A potential mechanism of toxicity for PFAS is via epigenetic changes, such as DNA methylation. However, few studies have evaluated associations between PFAS exposure and DNA methylation among adults, and data is especially scarce for women. Furthermore, exposure to environmental pollutants has been associated with epigenetic age acceleration, but no studies have yet evaluated whether PFAS is associated with epigenetic age acceleration. OBJECTIVES To investigate whether exposure to PFAS is associated with alteration of DNA methylation and epigenetic age acceleration among women. METHODS In this observational pilot study, 59 women (aged 20-47 years at enrollment in 2014) from Ronneby, Sweden, an area with historically high PFAS exposure due to local drinking water contamination, were divided into three PFAS exposure groups (low, medium, and high). Genome-wide methylation of whole-blood DNA was analyzed using the Infinium MethylationEPIC BeadChip. Ingenuity Pathway Analysis was used for in silico functional assessment. Epigenetic age acceleration was derived from the DNA methylation data using Horvath's epigenetic skin and blood clock. RESULTS 117 differentially methylated positions (q < 0.017) and one near-significantly differentially methylated region (S100A13, FWER = 0.020) were identified. In silico functional analyses suggested that genes with altered DNA methylation (q < 0.05) were annotated to cancer, endocrine system disorders, reproductive system disease, as well as pathways such as estrogen receptor signaling, cardiac hypertrophy signaling, PPARα/RXRα activation and telomerase signaling. No differences in epigenetic age acceleration between PFAS exposure groups were noted (p = 0.43). CONCLUSION The data suggests that PFAS exposure alters DNA methylation in women highly exposed to PFAS from drinking water. The observed associations should be verified in larger cohorts, and it should also be further investigated whether these changes in methylation also underlie potential phenotypic changes and/or adverse health effects of PFAS.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Simona Jurkovic-Mlakar
- CANSEARCH Research Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Christian H Lindh
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Kristin Scott
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Karin Engström
- EPI@LUND, Department of Laboratory Medicine, Lund University, Lund, Sweden.
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Axelsson J, Scott K, Dillner J, Lindh CH, Zhang H, Rylander L, Rignell-Hydbom A. Exposure to polychlorinated compounds and cryptorchidism; A nested case-control study. PLoS One 2020; 15:e0236394. [PMID: 32702712 PMCID: PMC7377911 DOI: 10.1371/journal.pone.0236394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/06/2020] [Indexed: 12/19/2022] Open
Abstract
Background Maldescended testes or cryptorchidism is a genital birth defect that affects 2–9% of all male new-borns. Over the last 40 years there have been reports of increased prevalence in countries like the US, the UK and the Scandinavian countries. This possible increase has in some studies been linked to a foetal exposure to chemical pollutants. In this matched case-control study, we analysed maternal serum samples in early pregnancy for three different organochlorine compounds, to investigate whether the levels were associated with the risk of cryptorchidism. Method Maternal serum samples taken during the first trimester of pregnancy from 165 cases (boys born with cryptorchidism) and 165 controls, matched for birth year and maternal age, parity and smoking habits during the pregnancy, were retrieved from the Southern Sweden Maternity Biobank. The samples were analysed for 2,2’,4,4’,5,5’-hexachlorobiphenyl (PCB-153), dichlorodiphenyltrichloroethane (p,p’-DDE) and hexachlorobenzene (HCB), using gas chromatography mass spectrometry. Associations between exposure and cryptorchidism were evaluated by conditional logistic regression. Results We found no statistically significantly associations between exposure to these compounds and cryptorchidism, either when the exposure variables were used as a continuous variable, or when the exposure levels were divided in quartiles. Conclusion We found no evidence of an association between maternal levels of PCB-153, p,p’-DDE or HCB during the pregnancy and the risk of having cryptorchidism in the sons.
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Affiliation(s)
- Jonatan Axelsson
- Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
- * E-mail:
| | - Kristin Scott
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Joakim Dillner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - He Zhang
- Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anna Rignell-Hydbom
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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Barrón Cuenca J, Tirado N, Vikström M, Lindh CH, Stenius U, Leander K, Berglund M, Dreij K. Pesticide exposure among Bolivian farmers: associations between worker protection and exposure biomarkers. J Expo Sci Environ Epidemiol 2020; 30:730-742. [PMID: 30787424 PMCID: PMC8608618 DOI: 10.1038/s41370-019-0128-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/18/2019] [Accepted: 01/26/2019] [Indexed: 05/21/2023]
Abstract
The use of pesticides has increased during the past decades, also increasing the risk of exposure to toxic pesticides that can cause detrimental health effects in the future. This is of special concern among farmers in low-to-middle-income countries that may lack proper training in the safe use of these chemicals. To assess the situation in Bolivia a cross-sectional study in three agricultural communities was performed (n = 297). Handling, use of personal protective equipment (PPE) and pesticide exposure were assessed by a questionnaire and measurements of urinary pesticide metabolites (UPMs). Results showed that methamidophos (65%) and paraquat (52%) were the most commonly used pesticides and that 75% of the farmers combined several pesticides while spraying. Notably, only 17% of the farmers used recommended PPEs while 84% reported to have experienced symptoms of acute pesticide poisoning after spraying. UPM measurements indicated high levels of exposure to chlorpyrifos, pyrethroids and 2,4D and that men generally were more highly exposed compared to women. Our study demonstrates that farmers who are better at following recommendations for pesticide handling and use of PPE had a significantly lower risk of having high UPM levels of most measured pesticides. Our results thus confirm the need of proper training of farmers in low-to-middle-income countries in proper protection and pesticide handling in order to reduce exposure levels and health problems.
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Affiliation(s)
- Jessika Barrón Cuenca
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246, Miraflores, La Paz, Bolivia.
| | - Noemi Tirado
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246, Miraflores, La Paz, Bolivia
| | - Max Vikström
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, 22363, Lund, Sweden
| | - Ulla Stenius
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Kristian Dreij
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
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Cuenca JB, Tirado N, Vikström M, Lindh CH, Stenius U, Leander K, Berglund M, Dreij K. Correction to: Pesticide exposure among Bolivian farmers: associations between worker protection and exposure biomarkers. J Expo Sci Environ Epidemiol 2020; 30:768. [PMID: 31201360 PMCID: PMC9119229 DOI: 10.1038/s41370-019-0149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.In the original Article, co-author Ulla Stenius' surname was misspelled as Ulla Steinus. This has been corrected in the PDF, HTML and XML versions of this Article.
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Affiliation(s)
- Jessika Barrón Cuenca
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246 Miraflores, La Paz, Bolivia.
| | - Noemi Tirado
- Genetic Institute, Medicine Faculty, Mayor of San Andres University, Saavedra Av., #2246 Miraflores, La Paz, Bolivia
| | - Max Vikström
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, 22363, Lund, Sweden
| | - Ulla Stenius
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
| | - Kristian Dreij
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
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Xu Y, Fletcher T, Pineda D, Lindh CH, Nilsson C, Glynn A, Vogs C, Norström K, Lilja K, Jakobsson K, Li Y. Serum Half-Lives for Short- and Long-Chain Perfluoroalkyl Acids after Ceasing Exposure from Drinking Water Contaminated by Firefighting Foam. Environ Health Perspect 2020; 128:77004. [PMID: 32648786 PMCID: PMC7351026 DOI: 10.1289/ehp6785] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Firefighting foam-contaminated ground water, which contains high levels of perfluoroalkyl substances (PFAS), is frequently found around airports. In 2018 it was detected that employees at a municipal airport in northern Sweden had been exposed to high levels of short-chain PFAS along with legacy PFAS (i.e., PFOA, PFHxS, and PFOS) through drinking water. OBJECTIVES In this study, we aimed to describe the PFAS profile in drinking water and biological samples (paired serum and urine) and to estimate serum half-lives of the short-chain PFAS together with legacy PFAS. METHODS Within 2 weeks after provision of clean water, blood sampling was performed in all 26 airport employees. Seventeen of them were then followed up monthly for 5 months. PFHxA, PFHpA, PFBS, PFPeS, and PFHpS together with legacy PFAS in water and biological samples were quantified using LC/MS/MS. Half-lives were estimated by assuming one compartment, first-order elimination kinetics. RESULTS The proportions of PFHxA, PFHpA, and PFBS were higher in drinking water than in serum. The opposite was found for PFHxS and PFOS. The legacy PFAS accounted for about 50% of total PFAS in drinking water and 90% in serum. Urinary PFAS levels were very low compared with serum. PFBS showed the shortest half-life {average 44 d [95% confidence interval (CI): 37, 55 d]}, followed by PFHpA [62 d (95% CI: 51, 80 d)]. PFPeS and PFHpS showed average half-lives as 0.63 and 1.46 y, respectively. Branched PFOS isomers had average half-lives ranging from 1.05 to 1.26 y for different isomers. PFOA, PFHxS, and linear PFOS isomers showed average half-lives of 1.77, 2.87, and 2.93 y, respectively. DISCUSSION A general pattern of increasing half-lives with increasing chain length was observed. Branched PFOS isomers had shorter half-lives than linear PFOS isomers. https://doi.org/10.1289/EHP6785.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Carina Nilsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anders Glynn
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Carolina Vogs
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Karin Norström
- Swedish Environmental Protection Agency, Stockholm, Sweden
| | - Karl Lilja
- Swedish Environmental Protection Agency, Stockholm, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Rylander L, Lindh CH, Hansson SR, Broberg K, Källén K. Per- and Polyfluoroalkyl Substances in Early Pregnancy and Risk for Preeclampsia: A Case-Control Study in Southern Sweden. Toxics 2020; 8:toxics8020043. [PMID: 32560030 PMCID: PMC7355444 DOI: 10.3390/toxics8020043] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022]
Abstract
Preeclampsia is one of the most common causes of perinatal and maternal morbidity/mortality. One suggested environmental risk factor is exposure to endocrine-disrupting pollutants such as per- and polyfluoroalkyl substances (PFAS). The present case-control study in southern Sweden aims to investigate the hypothesized association between serum concentrations of PFAS in early pregnancy and the risk of developing preeclampsia. The study included 296 women diagnosed with preeclampsia (cases) and 580 healthy pregnant women (controls). Maternal serum samples were obtained from a biobank of samples collected in early pregnancy in connection with screening for infections. Serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS) were analyzed using liquid chromatography-tandem-mass-spectrometry (LC/MS/MS). Among primiparous women, there were no differences in PFAS concentrations in early pregnancy between the cases and the controls whereas among multipara women, the cases had significantly higher concentrations of PFNA (median concentrations were 0.44 and 0.38 ng/mL, p = 0.04). When individual PFAS were categorized into quartiles and adjustment for potential confounders was performed, the women in the highest quartiles had no significant increased risks of developing preeclampsia as compared with women in the lowest category. In conclusion, the present study provides limited support for the hypothesized association between PFAS and preeclampsia in a population with relatively low exposure levels.
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Affiliation(s)
- Lars Rylander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (C.H.L.); (K.B.); (K.K.)
- Correspondence: ; Tel.: +46-46-222-1631
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (C.H.L.); (K.B.); (K.K.)
| | - Stefan R. Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, 221 85 Lund, Sweden;
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (C.H.L.); (K.B.); (K.K.)
- Institute of Environmental Medicine, Karolinska Institute, Nobels väg 13, 171 65 Solna, Sweden
| | - Karin Källén
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, MV (Building 402a), 223 81 Lund, Sweden; (C.H.L.); (K.B.); (K.K.)
- Tornblad Institute, Lund University, Biskopsgatan 7, 223 62 Lund, Sweden
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Björvang RD, Gennings C, Lin PI, Hussein G, Kiviranta H, Rantakokko P, Ruokojärvi P, Lindh CH, Damdimopoulou P, Bornehag CG. Persistent organic pollutants, pre-pregnancy use of combined oral contraceptives, age, and time-to-pregnancy in the SELMA cohort. Environ Health 2020; 19:67. [PMID: 32539770 PMCID: PMC7294652 DOI: 10.1186/s12940-020-00608-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND We are exposed to several chemicals such as persistent organic pollutants (POPs) in our everyday lives. Prior evidence has suggested that POPs may have adverse effects on reproductive function by disrupting hormone synthesis and metabolism. While there is age-related decline of fertility, the use of hormonal combined oral contraceptives (COCs) and its association to return of fertility remains controversial. The goal of this study is to investigate the association between exposure to POPs, both individually and as a mixture, and fecundability measured as time-to-pregnancy (TTP) according to pre-pregnancy use of COCs and age. METHODS Using the SELMA (Swedish Environmental Longitudinal Mother and Child, Allergy and Asthma) study, we have identified 818 pregnant women aged 18-43 years (mean 29 years) with data on how long they tried to get pregnant and what was their most recently used contraceptive method. These data were collected at enrollment to the study (median week 10 of pregnancy). Concentrations of 22 POPs and cotinine were analyzed in the blood samples collected at the same time as the questions on TTP and pre-pregnancy use of contraceptive. Analyses were done on the association between POPs exposure and TTP measured as continuous (months) and binary (infertile for those with TTP > 12 months). To study the chemicals individually, Cox regression and logistic regression were used to estimate fecundability ratios (FRs) and odds ratios (ORs), respectively. Weighted quantile sum (WQS) regression was used to investigate the chemicals as a mixture where chemicals of concern were identified above the 7.6% threshold of equal weights. To perform the subgroup analysis, we stratified the sample according to use of COCs as the most recent pre-pregnancy contraception method and age (< 29 years, and ≥ 29 years). The models were adjusted for parity, regularity of menses, maternal body mass index (BMI) and smoking status, and stratified as described above. RESULTS Prior to stratification, none of the POPs were associated with fecundability while increased exposure to HCB, PCB 74 and 118 had higher odds of infertility. Upon stratification, POP exposure was significantly associated with longer TTP in women aged ≥29 years who did not use COC. Specifically, PCBs 156, 180, 183, and 187 were associated with reduced fecundability while PCBs 99, 153, 156, 180, 183, and 187 had higher odds of infertility. As a mixture, we identified the chemicals of concern for a longer TTP include PCBs 118, 156, 183, and 187. Moreover, chemicals of concern identified with increased odds of infertility were PCB 74, 156, 183, 187, and transnonachlor. CONCLUSION Serum concentrations of selected POPs, both as individual chemicals and as a mixture, were significantly associated with lower fecundability and increased odds of infertility in women aged 29 years and above not using COC as their most recent pre-pregnancy contraceptive. Our findings suggest that pre-pregnancy use of oral contraceptive and age may modify the link between POPs and fecundability. The differences of specific chemicals in the individual analysis and as a mixture support the need to study combination effects of chemicals when evaluating reproductive outcomes.
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Affiliation(s)
- Richelle D. Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Unit of Toxicology Sciences, Swetox, Karolinska Institute, Södertälje, Sweden
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ping-I Lin
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Ghada Hussein
- Department of Obstetrics and Gynecology, Karlstad Central Hospital, Karlstad, Sweden
| | - Hannu Kiviranta
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Panu Rantakokko
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Päivi Ruokojärvi
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Christian H. Lindh
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund, Sweden
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Unit of Toxicology Sciences, Swetox, Karolinska Institute, Södertälje, Sweden
| | - Carl-Gustaf Bornehag
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
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Alhamdow A, Essig YJ, Krais AM, Gustavsson P, Tinnerberg H, Lindh CH, Hagberg J, Graff P, Albin M, Broberg K. Fluorene exposure among PAH-exposed workers is associated with epigenetic markers related to lung cancer. Occup Environ Med 2020; 77:488-495. [PMID: 32385190 PMCID: PMC7306866 DOI: 10.1136/oemed-2020-106413] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 01/03/2023]
Abstract
Objectives Exposure to high-molecular-weight polycyclic aromatic hydrocarbons (PAHs) may cause cancer in chimney sweeps and creosote-exposed workers, however, knowledge about exposure to low-molecular-weight PAHs in relation to cancer risk is limited. In this study, we aimed to investigate occupational exposure to the low-molecular-weight PAHs phenanthrene and fluorene in relation to different cancer biomarkers. Methods We recruited 151 chimney sweeps, 19 creosote-exposed workers and 152 unexposed workers (controls), all men. We measured monohydroxylated metabolites of phenanthrene and fluorene in urine using liquid chromatography coupled to tandem mass spectrometry. We measured, in peripheral blood, the cancer biomarkers telomere length and mitochondrial DNA copy number using quantitative PCR; and DNA methylation of F2RL3 and AHRR using pyrosequencing. Results Median PAH metabolite concentrations were higher among chimney sweeps (up to 3 times) and creosote-exposed workers (up to 353 times), compared with controls (p<0.001; adjusted for age and smoking). ∑OH-fluorene (sum of 2-hydroxyfluorene and 3-hydroxyfluorene) showed inverse associations with percentage DNA methylation of F2RL3 and AHRR in chimney sweeps (B (95% CI)=–2.7 (–3.9 to –1.5) for F2RL3_cg03636183, and –7.1 (–9.6 to –4.7) for AHRR_cg05575921: adjusted for age and smoking), but not in creosote-exposed workers. In addition, ∑OH-fluorene showed a 42% mediation effect on the inverse association between being a chimney sweep and DNA methylation of AHRR CpG2. Conclusions Chimney sweeps and creosote-exposed workers were occupationally exposed to low-molecular-weight PAHs. Increasing fluorene exposure, among chimney sweeps, was associated with lower DNA methylation of F2RL3 and AHRR, markers for increased lung cancer risk. These findings warrant further investigation of fluorene exposure and toxicity.
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Affiliation(s)
- Ayman Alhamdow
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yona J Essig
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Annette M Krais
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Region Stockholm, Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Håkan Tinnerberg
- School of Public Health and Community Medicine, Section of Occupational and Environmental Medicine, University of Gothenburg Sahlgrenska Academy, Göteborg, Sweden
| | - Christian H Lindh
- Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Jessika Hagberg
- MTM Research Centre, Örebro universitet Akademin för Naturvetenskap och Teknik, Orebro, Sweden.,Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Pål Graff
- Department of Chemical and Biological Work Environment, STAMI, Oslo, Norway
| | - Maria Albin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Region Stockholm, Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .,Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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Li Y, Barregard L, Xu Y, Scott K, Pineda D, Lindh CH, Jakobsson K, Fletcher T. Associations between perfluoroalkyl substances and serum lipids in a Swedish adult population with contaminated drinking water. Environ Health 2020; 19:33. [PMID: 32169067 PMCID: PMC7071576 DOI: 10.1186/s12940-020-00588-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/04/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Exposures to perfluoroalkyl substances (PFAS) have shown positive associations with serum lipids in previous studies. While many studies on lipids investigated associations with perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), there are only a few studies regarding other PFAS, such as perfluorohexane sulfonic acid (PFHxS). The purpose of the current study is to investigate if associations with serum lipids were present, not only for serum PFOS and PFOA, but also for PFHxS, and if the associations with PFAS remained also in a comparison based only on residency in areas with contrasting exposure to PFAS. METHODS 1945 adults aged 20-60 were included from Ronneby, Sweden, a municipality where one out of two waterworks had been heavily contaminated from aqueous fire-fighting foams, and from a nearby control area. The exposure was categorized based on either been living in areas with contrasting PFAS exposure or based on the actual serum PFAS measurements. Regression analyses of serum lipids were fitted against serum PFAS levels, percentile groups, smooth splines and between exposed and reference areas, adjusting for age, sex and BMI. RESULTS Drinking water contamination caused high serum levels of PFOS (median 157 ng/ml) and PFHxS (median 136 ng/ml) and PFOA (median 8.6 ng/ml). These serum PFAS levels in the exposed groups were 5 to 100-fold higher than in the controls. In this population with mixed PFAS exposure, predominantly PFOS and PFHxS, PFAS exposure were positively associated with serum lipids. This was observed both when quantifying exposure as contrast between exposed and controls, and in terms of serum PFAS. Due to high correlations between each PFAS, we cannot separate them. CONCLUSIONS In conclusion, the present study provides further evidence of a causal association between PFAS and serum lipids, especially for PFHxS.
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Affiliation(s)
- Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, SE, 405 30, Gothenburg, Sweden.
| | - Lars Barregard
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, SE, 405 30, Gothenburg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, SE, 405 30, Gothenburg, Sweden
| | - Kristin Scott
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, SE, 405 30, Gothenburg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
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Xu Y, Jurkovic-Mlakar S, Li Y, Wahlberg K, Scott K, Pineda D, Lindh CH, Jakobsson K, Engström K. Association between serum concentrations of perfluoroalkyl substances (PFAS) and expression of serum microRNAs in a cohort highly exposed to PFAS from drinking water. Environ Int 2020; 136:105446. [PMID: 31926437 DOI: 10.1016/j.envint.2019.105446] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 11/07/2019] [Revised: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are widespread synthetic substances with various adverse health effects. Not much is known about the modes of action of PFAS toxicity, but one likely mechanism is alteration of microRNA expression. OBJECTIVES To investigate whether PFAS exposure is associated with altered microRNA expression in serum. METHODS We selected women from the Ronneby cohort, with high exposure to perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS), emanating from drinking water contaminated by firefighting foam, and a control group of women from a neighbouring municipality without drinking water contamination. Serum levels of PFAS were analysed using LC/MS/MS. High coverage microRNA expression was analysed by next generation sequencing (NGS) in 53 individuals to screen for microRNAs associated with PFAS exposure. After verification by qPCR, associations between PFAS exposure and expression of 18 selected microRNAs were validated by qPCR in 232 individuals. In silico functional analyses were performed using Ingenuity pathway analysis (IPA). RESULTS Three microRNAs were consistently associated with PFAS exposure in the different steps of the study: miR-101-3p, miR-144-3p and miR-19a-3p (all downregulated with increasing exposure). In silico functional analyses suggested that these PFAS-associated microRNAs were annotated to e.g. cardiovascular function and disease, Alzheimer's disease, growth of cancer cell lines and cancer. Seven predicted target genes for the downregulated microRNAs were annotated to PFAS in IPA knowledge database: DNA methyltransferase 3 alpha (DNMT3a), epidermal growth factor receptor (EGFR), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), nuclear receptor subfamily 1, group H, member 3 (NR1H3), peroxisome proliferator-activated receptor alpha (PPARα), prostaglandin-endoperoxide synthase 2 (PTGS2), and tumour growth factor alpha (TGFα). DISCUSSION PFAS exposure was associated with downregulation of specific microRNAs. Further, in silico functional analyses suggest potential links between the specific PFAS-associated microRNAs, specific microRNA target genes and possibly also health effects.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Simona Jurkovic-Mlakar
- CANSEARCH Research Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Karin Wahlberg
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kristin Scott
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Daniela Pineda
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Engström
- EPI@LUND, Department of Laboratory Medicine, Lund University, Lund, Sweden.
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Mora AM, Hoppin JA, Córdoba L, Cano JC, Soto-Martínez M, Eskenazi B, Lindh CH, van Wendel de Joode B. Prenatal pesticide exposure and respiratory health outcomes in the first year of life: Results from the infants' Environmental Health (ISA) study. Int J Hyg Environ Health 2020; 225:113474. [PMID: 32066110 DOI: 10.1016/j.ijheh.2020.113474] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/15/2019] [Revised: 01/18/2020] [Accepted: 01/29/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Growing evidence suggests that pesticide exposure may influence respiratory health, but data in young children are very limited. We examined the association of prenatal pesticide exposure with lower respiratory tract infections (LRTIs) and wheeze at one year of age in children from the Infants' Environmental Health (ISA) study in Costa Rica. METHODS We measured seven pesticide metabolites, including ethylenethiourea (ETU, metabolite of mancozeb), in maternal urine samples collected repeatedly during pregnancy. For each woman, we averaged pesticide concentrations during each half of pregnancy (≤20 and >20 weeks of gestation) and across repeated samples collected over the course of pregnancy. We collected information about LRTIs (n = 355) and wheezing (n = 272) during the first year of life from mothers when their children were 11-19 months old. We fit multivariable logistic regression models using high (quartile 4) vs. low (quartiles 1-3) urinary pesticide concentrations as exposures and adjusted models for maternal age, education, parity, gestational age at birth, and child sex. RESULTS Ten percent of the children had at least one LRTI and 39% had at least one episode of wheezing during their first year of life. Median (25-75th percentile) specific gravity-corrected urinary ETU concentrations during the first half, second half, and over the course of pregnancy were 3.4 (2.1-5.0), 3.3 (2.2-4.7), and 3.4 (2.4-5.0) ng/mL, respectively. We observed that high urinary ETU concentrations during the first half of pregnancy were associated with increased odds of LRTI (OR = 2.45; 95% CI: 0.96, 6.26), whereas high urinary ETU concentrations during the second half of pregnancy were associated with decreased odds of wheezing (OR = 0.50; 95% CI: 0.26, 0.96). We found that the association between high urinary ETU concentrations during the first half of pregnancy and LRTIs persisted among mother-child pairs with either high or low ETU concentrations during the second half. In contrast, the association of high urinary ETU concentrations during the second half of pregnancy with wheezing was attenuated when we simultaneously adjusted for urinary ETU concentrations during the first half. We observed null associations between other pesticide metabolites measured during pregnancy and respiratory outcomes. CONCLUSIONS Our data indicate that exposure to mancozeb/ETU during the first half of pregnancy may be associated with respiratory outcomes in the first year of life.
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Affiliation(s)
- Ana M Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica; Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, United States.
| | - Jane A Hoppin
- Department of Biological Sciences and Center for Human Health and the Environment, North Carolina State University, United States
| | - Leonel Córdoba
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Juan C Cano
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Manuel Soto-Martínez
- Respiratory Department, Hospital Nacional de Niños, Caja Costarricense del Seguro Social, Costa Rica
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Berna van Wendel de Joode
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
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Xu Y, Li Y, Scott K, Lindh CH, Jakobsson K, Fletcher T, Ohlsson B, Andersson EM. Inflammatory bowel disease and biomarkers of gut inflammation and permeability in a community with high exposure to perfluoroalkyl substances through drinking water. Environ Res 2020; 181:108923. [PMID: 31759646 DOI: 10.1016/j.envres.2019.108923] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 04/12/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
Perfluoroalkyl substances (PFAS) can act as surfactants and have been suggested to be capable of affecting gut mucosa integrity, a possible factor in the pathogenesis of inflammatory bowel disease (IBD). So far, only PFOA has been shown to have a positive association with ulcerative colitis. The present study aimed to investigate the association of PFAS and clinically diagnosed IBD in the Ronneby cohort, a population with high PFAS exposure (especially high PFOS and PFHxS) from Aqueous Film-Forming Foam through drinking water, using registry data. Additionally, to explore associations of PFAS with fecal zonulin and calprotectin, subclinical biomarkers of gut inflammation and permeability, in a sub-set of participants from Ronneby and Karlshamn (a nearby control municipality). The registry study included all people that ever resided in Ronneby municipality at least one year between 1980 and 2013. Yearly exposure to contaminated drinking water was assessed based on residential addresses and waterworks supply data, and the population classified by early, mid and late periods in ascending level of contamination. Diagnosed IBD cases were retrieved from the Swedish National Patient register and cause-of-death register. The Cox proportional hazards model was used to derive the hazard ratios (HRs) for diagnosed IBD. The biomarker study included 189 individuals who provided fecal samples. Serum PFAS were measured using LC-MS/MS. Fecal zonulin and calprotectin were measured using ELISA. Linear regression was used to assess the associations between measured PFAS and biomarker levels. In the registry study, no raised HRs for diagnosed IBD were found for cohort subjects with mid (1995-2004) or late period (2005-2013) exposure compared to never exposure. Early period exposure only (1985-1994) showed raised HRs for Crohn's disease (HR = 1.58, p = 0.048) and other non-specified IBD (HR = 1.38, p = 0.037). In the biomarker study, Karlshamn showed higher fecal calprotectin levels (median = 99.6 mg/kg in Karlshamn vs. 66.8 mg/kg in Ronneby, p = 0.04). A trend of decreased calprotectin with increased serum PFAS indicated higher PFAS was associated with lower degree of gut inflammation (p = 0.002). No association between serum PFAS and fecal zonulin was found. In conclusion, the present study found no consistent evidence to support PFAS exposure as a risk factor for IBD.
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Affiliation(s)
- Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristin Scott
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Eva M Andersson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Wikström S, Lin PI, Lindh CH, Shu H, Bornehag CG. Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight. Pediatr Res 2020; 87:1093-1099. [PMID: 31835271 PMCID: PMC7196936 DOI: 10.1038/s41390-019-0720-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/16/2019] [Accepted: 09/19/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are widespread, bioaccumulating, and persistent and show placental transfer. Emerging research indicates associations between prenatal exposure and low birth weight. The aim of this study was to assess the associations between first trimester exposure to PFASs and birth weight (BW) in the Swedish Environmental, Longitudinal, Mother and child, Asthma and allergy (SELMA) study and examine whether associations differ between girls and boys. METHODS Eight PFASs were analyzed in maternal serum (median: 10 weeks of pregnancy). Associations between prenatal PFAS exposure and birth outcomes with BW, BW for gestational age, and birth small for gestational age (SGA) were assessed in 1533 infants, adjusted for potential confounders and stratified by sex. RESULTS Increased maternal perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA) were associated with lower BW, lower BW for gestational age, and SGA birth. Associations were significant only in girls, where prenatal exposure in the upper quartile was associated with a 93-142-g lower BW when compared with that of the lowest quartile exposure. The associations were not mediated by effects on gestational age. CONCLUSIONS We found associations between prenatal exposure for five different PFASs and birth weight, with more pronounced associations in girls than in boys.
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Affiliation(s)
- Sverre Wikström
- School of Medical Sciences, Örebro University, Örebro, Sweden. .,Department of Health Sciences, Karlstad University, Karlstad, Sweden.
| | - Ping-I Lin
- 0000 0001 0721 1351grid.20258.3dDepartment of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Christian H. Lindh
- 0000 0001 0930 2361grid.4514.4Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Huan Shu
- 0000 0001 0721 1351grid.20258.3dDepartment of Health Sciences, Karlstad University, Karlstad, Sweden ,0000 0004 1936 9377grid.10548.38Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden
| | - Carl-Gustaf Bornehag
- 0000 0001 0721 1351grid.20258.3dDepartment of Health Sciences, Karlstad University, Karlstad, Sweden ,0000 0001 0670 2351grid.59734.3cDepartment of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY USA
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Derakhshan A, Shu H, Peeters RP, Kortenkamp A, Lindh CH, Demeneix B, Bornehag CG, Korevaar TIM. Association of urinary bisphenols and triclosan with thyroid function during early pregnancy. Environ Int 2019; 133:105123. [PMID: 31521814 DOI: 10.1016/j.envint.2019.105123] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 06/07/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Bisphenols and triclosan are considered as potential thyroid disruptors. While mild alterations in maternal thyroid function can result in adverse pregnancy and child developmental outcomes, there is still uncertainty whether bisphenols or triclosan can interfere with thyroid function during pregnancy. OBJECTIVES We aimed to investigate the association of urinary bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF) and triclosan with early pregnancy thyroid function. METHODS This study was embedded in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (SELMA), a population-based prospective pregnancy cohort. In total, 1996 participants were included in the current study. Maternal urinary concentrations of three bisphenols and triclosan, collected at median (95% range) 10 (6-14) weeks of pregnancy as well as serum concentrations of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were measured. RESULTS Higher BPA levels were associated with lower TT4 concentrations (non-monotonic, P = 0.03), a lower FT4/FT3 ratio (β [SE] -0.02 [0.01], P = 0.03) and a lower TT4/TT3 ratio (β [SE] -0.73 [0.27], P = 0.008). Higher BPF levels were associated with a higher FT3 (β [SE] 0.01 [0.007], P = 0.04). There were no associations between other bisphenols or triclosan and absolute TSH, (F)T4 or (F)T3 concentrations. The association of BPA with thyroid function differed with gestational age. The negative association of BPA with FT4/FT3 and TT4/TT3 ratios was only apparent in early but not late gestation (P for interaction: 0.003, 0.008, respectively). CONCLUSION These human data during pregnancy substantiate experimental findings suggesting that BPA could potentially affect thyroid function and deiodinase activities in early gestation.
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Affiliation(s)
- Arash Derakhshan
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Huan Shu
- Department of Environmental Science and Analytical Chemistry, Stockholm University, Sweden
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands
| | - Andreas Kortenkamp
- Institute of Environment, Health and Societies, Brunel University, London, Uxbridge, UK
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, 22363 Lund, Sweden
| | - Barbara Demeneix
- Laboratoire d'Evolution des Régulations Endocriniennes, Muséum National d'Histoire Naturelle, 57 Rue Cuvier, 75005 Paris, France
| | - Carl-Gustaf Bornehag
- Division of Public Health Sciences, Karlstad University, Karlstad, Sweden; Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 15, 3051 GE Rotterdam, the Netherlands.
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Faniband M, Ekman E, Littorin M, Maxe M, Larsson E, Lindh CH. Biomarkers of Exposure to Pyrimethanil After Controlled Human Experiments. J Anal Toxicol 2019; 43:277-283. [PMID: 30462228 PMCID: PMC6460343 DOI: 10.1093/jat/bky091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 11/17/2022] Open
Abstract
Pyrimethanil (PYM) is a fungicide used pre- and post-harvest on many crops. It has a low acute toxicity but is of toxicological concern because of its antiandrogenic properties. The aim of the current work was to investigate some metabolism and estimate elimination kinetics of PYM in humans after experimental oral and dermal exposure. A liquid chromatography triple quadrupole mass spectrometry (LC–MS-MS) method was developed and validated for the analysis of PYM and its metabolite 4-hydroxypyrimethanil (OH–PYM) in human urine. The method was applied to analyze urine obtained from two volunteers experimentally exposed to PYM. The elimination of OH–PYM seemed to follow first-order kinetics and a two-phase excretion. After the oral exposure, the elimination half-life of OH–PYM in the rapid phase was 5 and 3 h for the female and male volunteer, respectively. In the slower phase, it was 15 h in both volunteers. After the dermal exposure, the half-life in the rapid phase was 8 h in both volunteers. In the slower phase, it was 30 and 20 h, respectively. About 80% of the oral dose was recovered as urinary OH–PYM in both volunteers. The dermal dose recovered as urinary OH–PYM was 9.4% and 19%, in the female and male volunteer, respectively. OH–PYM was mainly found as a conjugate of sulfonate and glucuronic acid. No free PYM was found. The analytical method showed good within-run, between-run and between-batch precision with a coefficient of variation between 6% and 12%. A limit of detection of 0.1 ng/mL and a limit of quantification of 0.4 ng/mL were achieved for both the analytes. The method was applied to biomonitor PYM exposure in populations in Sweden. OH–PYM was detected in nearly 50% and 96% of samples from the environmentally and occupationally exposed populations, respectively.
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Affiliation(s)
- Moosa Faniband
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Eva Ekman
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Margareta Maxe
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Estelle Larsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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48
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Berge TLL, Lygre GB, Lie SA, Lindh CH, Björkman L. Bisphenol A in human saliva and urine before and after treatment with dental polymer-based restorative materials. Eur J Oral Sci 2019; 127:435-444. [PMID: 31392814 PMCID: PMC6790658 DOI: 10.1111/eos.12647] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 12/24/2022]
Abstract
The aim of this study was to quantify bisphenol A (BPA) concentrations in saliva and urine before and after treatment with dental polymer-based restorative materials to assess if placement of this material is associated with increased BPA levels in saliva and urine. Twenty individuals in need of at least one dental restoration with polymer-based restorative material were included in this study. The participants were instructed to abstain from eating, drinking, and brushing their teeth for at least 10 h prior to sampling. Saliva and urine were collected before and 10 min (saliva only), 1 h, 24 h, and 1 wk after treatment. Samples were stored at -80°C before analyses. BPA in saliva and urine was determined with liquid chromatography/mass spectrometry. Linear mixed effects regression models were used for statistical analyses. There was a statistically significant increase of salivary BPA concentration directly after placement of the dental polymer-based restorations. Following placement, the concentration of BPA decreased exponentially with time. One week after treatment the BPA level in saliva was only marginally higher than before treatment. In urine, no statistically significant change of the BPA concentration was detected after treatment.
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Affiliation(s)
- Trine L. L. Berge
- Dental Biomaterials Adverse Reaction UnitNORCE Norwegian Research Centre ASBergenNorway
- Oral Health Centre of Expertise in Western Norway, HordalandBergenNorway
| | - Gunvor B. Lygre
- Dental Biomaterials Adverse Reaction UnitNORCE Norwegian Research Centre ASBergenNorway
| | - Stein A. Lie
- Department of Clinical DentistryFaculty of MedicineUniversity of BergenBergenNorway
| | - Christian H. Lindh
- Division of Occupational and Environmental MedicineLund UniversityLundSweden
| | - Lars Björkman
- Dental Biomaterials Adverse Reaction UnitNORCE Norwegian Research Centre ASBergenNorway
- Department of Clinical DentistryFaculty of MedicineUniversity of BergenBergenNorway
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49
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Smpokou ET, González-Quiroz M, Martins C, Alvito P, Le Blond J, Glaser J, Aragón A, Wesseling C, Nitsch D, Pearce N, Norman J, Lindh CH, Morton J, Caplin B. Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican nephropathy. Occup Environ Med 2019; 76:920-926. [PMID: 31562235 DOI: 10.1136/oemed-2019-105772] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 02/18/2019] [Revised: 06/28/2019] [Accepted: 09/01/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVES There is an epidemic of Mesoamerican nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months and decline in kidney function over 2 years. METHODS Urine samples collected at baseline (pre-sugarcane harvest) and the first 6 month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (aluminium, total arsenic, cadmium, chromium, cobalt, copper, lead, manganese, mercury, selenium, silicon and strontium) were analysed by inductively coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-dichlorophenoxyacetic acid, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzoic acid, chloro-3,3,3-trifluoro-1-propen-1-yl-2,2-dimethylcyclopropanecarboxylic acid, cis/trans 3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid, ethylenethiourea, glyphosate, 4-chloro-2-methylphenoxy acetic acid, 3-hydroxy-pyrimetanil, 5-hydroxytiabendazole, hydroxy-tebuconazole and 3,5,6-trichloro-2-pyridinol) and two mycotoxins (ochratoxin A (OTA) and citrinin (CIT)) were analysed by liquid chromatography coupled-mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable vs declining kidney function) were examined. RESULTS Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. CONCLUSIONS The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.
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Affiliation(s)
| | - Marvin González-Quiroz
- Department of Renal Medicine, University College London, London, UK.,Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua
| | - Carla Martins
- Department of Food and Nutrition, National Institute of Health Dr Ricardo Jorge (INSA), Lisboa, Portugal.,Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - Paula Alvito
- Department of Food and Nutrition, National Institute of Health Dr Ricardo Jorge (INSA), Lisboa, Portugal.,Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | | | - Jason Glaser
- Executive, La Isla Network, Ada, Michigan, USA.,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Aurora Aragón
- Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua
| | - Catharina Wesseling
- Executive, La Isla Network, Ada, Michigan, USA.,Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Neil Pearce
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Medical Statistics, Faculty of Epidemiology and Population Health, Centre for Global NCDs, London School of Hygiene and Tropical Medicine, London, UK
| | - Jill Norman
- Department of Renal Medicine, University College London, London, UK
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Jackie Morton
- HSE Science and Research Centre, Health and Safety Executive, Buxton, UK
| | - Ben Caplin
- Department of Renal Medicine, University College London, London, UK
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50
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Wikström S, Lindh CH, Shu H, Bornehag CG. Early pregnancy serum levels of perfluoroalkyl substances and risk of preeclampsia in Swedish women. Sci Rep 2019; 9:9179. [PMID: 31235847 PMCID: PMC6591359 DOI: 10.1038/s41598-019-45483-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/31/2019] [Indexed: 01/09/2023] Open
Abstract
Preeclampsia is a major cause of maternal and fetal morbidity. Emerging research shows an association with environmental exposures. The present aim was to investigate associations between early pregnancy serum levels of perfluoroalkyl substances (PFAS) and preeclampsia. Within the Swedish SELMA study, eight PFAS were measured at median 10 gestational weeks and cases of preeclampsia were postnatally identified from registers. Associations between individual PFAS and preeclampsia were assessed, adjusting for parity, age, weight and smoking. Out of 1,773 women in the study group, 64 (3.6%), developed preeclampsia. A doubling of PFOS and PFNA exposure, corresponding to an inter-quartile increase, was associated with an increased risk for preeclampsia of about 38–53% respectively. Serum PFOS within the highest quartile was associated with an odds ratio of 2.68 (CI 95%: 1.17–6.12), equal to the increased risk associated with nulliparity, when compared to exposure in the first quartile. The same associations were identified, although with higher risk estimates, in analyses restricted to nulliparous women. For other PFAS, there were no associations. In conclusion and consistent with limited previous research only on PFOS, increasing serum levels of PFOS and PFNA during early pregnancy were associated with a clinically relevant risk of preeclampsia, adjusting for established confounders.
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Affiliation(s)
- Sverre Wikström
- School of Medical Sciences, Örebro University, Örebro, Sweden. .,Department of Health Sciences, Karlstad University, Karlstad, Sweden.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Huan Shu
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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