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Uldbjerg CS, Lim YH, Renault CH, Hansen D, Juul A, Bräuner EV, Jensen RB. Girls with idiopathic central precocious puberty did not display substatial changes in body mass index after treatment with gonadotropin-releasing hormone analogues. Acta Paediatr 2024. [PMID: 38506052 DOI: 10.1111/apa.17185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/21/2024]
Abstract
AIM To evaluate changes in body mass index (BMI) in girls during and after treatment for idiopathic central precocious puberty (iCPP). METHODS We studied 123 girls receiving gonadotropin-releasing hormone analogue (GnRHa)treatment for iCPP from 2009 to 2019. Pubertal and anthropometric measurements were monitored at routine clinical visits. BMI standard deviation scores (SDS) were estimated at baseline and followed in two stages from baseline to end of treatment (median 18.9 months) and from end of treatment to end of follow-up (median 18.2 months). The influence of baseline BMI SDS and the frequency and dose of treatment was evaluated using BMI trajectories and latent class mixed models. RESULTS The median age at treatment initiation was 8.5 years. The median BMI SDS at baseline was 0.7, corresponding to a median BMI of 17.4 kg/m2 . Overall, no changes in BMI SDS were observed during treatment. According to baseline BMI subgroups, an increasing trend in BMI trajectories during treatment was observed for girls in the lowest BMI group. After treatment, most girls maintained stable BMI levels. CONCLUSION Our retrospective study did not provide evidence that GnRHa treatment for iCPP had a significant impact on BMI trajectories in girls.
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Affiliation(s)
- Cecilie Skaarup 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, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Youn-Hee Lim
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Copenhagen, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Christoffer Højrup Renault
- 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, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Dorte Hansen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - 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, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elvira Vaclavik 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, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rikke Beck Jensen
- 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, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital - Herlev and Gentofte Hospital, Herlev, Denmark
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2
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Cole-Hunter T, So R, Amini H, Backalarz C, Brandt J, Bräuner EV, Hertel O, Jensen SS, Jørgensen JT, Ketzel M, Laursen JE, Lim YH, Loft S, Mehta A, Mortensen LH, Simonsen MK, Sisgaard T, Westendorp R, Andersen ZJ. Long-term exposure to road traffic noise and all-cause and cause-specific mortality: a Danish Nurse Cohort study. Sci Total Environ 2022; 820:153057. [PMID: 35031374 DOI: 10.1016/j.scitotenv.2022.153057] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 11/10/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Long-term road traffic noise exposure is linked to cardio-metabolic disease morbidity, whereas evidence on mortality remains limited. OBJECTIVES We investigated association of long-term exposure to road traffic noise with all-cause and cause-specific mortality. METHODS We linked 22,858 females from the Danish Nurse Cohort (DNC), recruited into the Danish Register of Causes of Death up to 2014. Road traffic noise levels since 1970 were modelled by Nord2000 as the annual mean of a weighted 24 h average (Lden). Cox regression models examined the associations between Lden (5-year and 23-year means) and all-cause and cause-specific mortalities, adjusting for lifestyle and exposure to PM2.5 (particulate matter with diameter < 2.5 μm) and NO2 (nitrogen dioxide). RESULTS During follow-up (mean 17.4 years), 3902 nurses died: 1622 from cancer, 922 from CVDs (289 from stroke), 338 from respiratory diseases (186 from chronic obstructive pulmonary disease, 114 from lower respiratory tract infections [ALRIs]), 234 from dementia, 95 from psychiatric disorders, and 79 from diabetes. Hazard ratios (95% confidence intervals) for all-cause mortality from fully-adjusted models were 1.06 (1.01, 1.11) and 1.09 (1.03, 1.15) per 10 dB of 5-year and 23-year mean Lden, respectively, which attenuated slightly in our main model (fully-adjusted plus PM2.5: 1.04 [1.00, 1.10]; 1.08 [1.02, 1.13]). Main model estimates suggested the strongest associations between 5-year mean Lden and diabetes (1.14: 0.81, 1.61), ALRIs (1.13: 0.84, 1.54), dementia (1.12: 0.90, 1.38), and stroke (1.10: 0.91, 1.31), whereas associations with 23-year mean Lden were suggested for respiratory diseases (1.15: 0.95, 1.39), psychiatric disorders (1.11: 0.78, 1.59), and all cancers (1.08: 0.99, 1.17). DISCUSSION Among the female nurses from the DNC, we observed that long-term exposure to road traffic noise led to premature mortality, independently of air pollution, and its adverse effects may extend well beyond those on the cardio-metabolic system to include respiratory diseases, cancer, neurodegenerative and psychiatric disorders.
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Affiliation(s)
- Tom Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Elvira Vaclavik Bräuner
- Juliane Marie Center, Department of Growth and Reproduction, Capital Region of Denmark, Rigshospitalet, Copenhagen, Denmark
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Denmark
| | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Mette Kildevæld Simonsen
- Diakonissestiftelsen, Peter Bangsvej 1, 2000 Frederiksberg, Denmark; Research Unit for Dietary Studies, The Parker Institute Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Torben Sisgaard
- Section of Environment, Occupation & Health Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Rudi Westendorp
- Section of Epidemiology and Center for Healthy Ageing, Department of Public Health, University of Copenhagen
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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3
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Madvig F, Pedersen MK, Urhoj SK, Bräuner EV, Jørgensen N, Priskorn L. Anogenital distance, male factor infertility and time to pregnancy. Andrology 2022; 10:686-693. [PMID: 35178873 PMCID: PMC9306635 DOI: 10.1111/andr.13161] [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: 12/15/2021] [Revised: 02/01/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anogenital distance (AGD), the distance between the anus and genitals, is in rodents a well-established marker of early androgen action and has been suggested to be so in humans as well. Thus, a link between human AGD and semen quality and potentially fecundity may exist. OBJECTIVE The aim of this study was to assess the association between AGD and male factor infertility and among proven fertile men also time to pregnancy (TTP). MATERIAL AND METHODS All included men were recruited from and examined at Copenhagen University Hospital, Denmark (N=388). Men with impaired semen quality were included from infertile couples (N=128), and men with naturally conceived pregnant partners were invited to participate when their partners had their routine second trimester examination (N=260). All men underwent a physical examination, completed a questionnaire (including TTP for the fertile men), delivered a semen sample and had a blood sample drawn. The primary exposure was AGDAS measured from the centre of the anus to the posterior base of the scrotum. Associations between AGD and fertility status as well as between AGD and TTP among the fertile men were calculated using multiple logistic regression adjusted for covariates. RESULTS AGD did not show a statistically significant association with fertility status. In adjusted logistic regression models, the odds of infertility per 1 cm increase in AGDAS was 1.02 (95% CI: 0.88; 1.19). Amongst fertile men, a 1 cm increase in AGDAS was associated with an 8% non-statistically significantly reduced odds of having a longer (>3months) TTP (adjusted OR= 0.92, 95%CI: 0.76-1.11). CONCLUSION Our study showed that the clinical application of AGD as a predictor of fertility and fecundity seems to be limited as no associations were observed between AGD and fertility status, nor was the decreased risk of experiencing a longer TTP with longer AGDAS statistically significant. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- F Madvig
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - M K Pedersen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - S K Urhoj
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - E V Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - N Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - L Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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Uldbjerg CS, Koch T, Lim YH, Gregersen LS, Olesen CS, Andersson AM, Frederiksen H, Coull BA, Hauser R, Juul A, Bräuner EV. OUP accepted manuscript. Hum Reprod Update 2022; 28:687-716. [PMID: 35466359 PMCID: PMC9434240 DOI: 10.1093/humupd/dmac013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 08/26/2021] [Revised: 01/25/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Globally, the ages at pubertal onset for girls and boys have been decreasing during recent decades, partly attributed to excess body fat accumulation. However, a growing body of literature has recognized that endocrine disrupting chemicals (EDCs) may play an important role in this global trend, but the association has not yet been fully established. OBJECTIVE AND RATIONALE EDCs can interfere with normal hormone function and metabolism and play a role in pubertal onset. We aimed to systematically identify and evaluate the current evidence on the timing of pubertal onset in girls and boys following prenatal or postnatal exposures to xenobiotic EDCs. SEARCH METHODS Following PRISMA guidelines, we performed a systematic literature search of original peer-reviewed publications in the PubMed database through a block search approach using a combination of index MeSH and free text search terms. Publications were considered if they covered biomarkers of prenatal or postnatal exposures to xenobiotic EDCs (European Commission's list of category 1 EDCs) measured in maternal or child biospecimen and pubertal onset defined by the progression of the following milestones (and assessed in terms of the following measures): menarche (age), thelarche (Tanner staging) and pubarche (Tanner staging), in girls, and genital stage (Tanner staging), testicular volume (ml) and pubarche (Tanner staging), in boys. OUTCOMES The literature search resulted in 703 references, of which we identified 52 publications fulfilling the eligibility criteria for the qualitative trend synthesis and 23 publications for the meta-analysis. The qualitative trend synthesis provided data on 103 combinations of associations between prenatal or postnatal exposure to EDC compounds groups and puberty outcomes and the meta-analysis enabled 18 summary risk estimates of meta-associations. WIDER IMPLICATIONS Statistically significant associations in the qualitative trend synthesis suggested that postnatal exposure to phthalates may be associated with earlier thelarche and later pubarche. However, we did not find consistent evidence in the meta-analysis for associations between timing of pubertal onset in girls and boys and exposures to any of the studied xenobiotic EDCs. We were not able to identify specific pre- or postnatal windows of exposure as particularly critical and susceptible for effects of EDCs. Current evidence is subject to several methodological challenges and inconsistencies and evidence on specific exposure-outcome associations remains too scarce to firmly confirm EDC exposure as a risk factor for changes in age of pubertal onset in the general child population. To create a more uniform foundation for future comparison of evidence and to strengthen pooled studies, we recommend the use of more standardized approaches in the choice of statistical analyses, with exposure transformations, and in the definitions and assessments of puberty outcomes. The impact of mixtures of EDC exposures on the association also remains unestablished and would be valuable to elucidate for prenatal and postnatal windows of exposure. Future large, longitudinal epidemiological studies are needed to clarify the overall association.
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Affiliation(s)
| | | | - Y -H Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - L S Gregersen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - C S Olesen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A -M Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - H Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B A Coull
- Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - R Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - A Juul
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
| | - E V Bräuner
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
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5
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Priskorn L, Tøttenborg SS, Almstrup K, Andersson AM, Axelsson J, Bräuner EV, Elenkov A, Freiesleben NLC, Giwercman YL, Grøndahl ML, Hansen AH, Hansen LS, Henic E, Kitlinski ML, Landersoe SK, Lindh C, Løkkegaard EL, Malm J, Olsen KW, Petersen KU, Schmidt L, Stormlund S, Svendsen PF, Vassard D, Wang NF, Zedeler A, Bhasin S, Chavarro J, Eisenberg ML, Hauser R, Huhtaniemi I, Krawetz SA, Marko-Varga G, Salonia A, Toppari J, Juul A, Jørgensen N, Nielsen HS, Pinborg A, Rylander L, Giwercman A. RUBIC (ReproUnion Biobank and Infertility Cohort): A binational clinical foundation to study risk factors, life course, and treatment of infertility and infertility-related morbidity. Andrology 2021; 9:1828-1842. [PMID: 34114375 PMCID: PMC10015988 DOI: 10.1111/andr.13063] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Infertility affects 15%-25% of all couples during their reproductive life span. It is a significant societal and public health problem with potential psychological, social, and economic consequences. Furthermore, infertility has been linked to adverse long-term health outcomes. Despite the advanced diagnostic and therapeutic techniques available, approximately 30% of infertile couples do not obtain a live birth after fertility treatment. For these couples, there are no further options to increase their chances of a successful pregnancy and live birth. OBJECTIVES Three overall questions will be studied: (1) What are the risk factors and natural life courses of infertility, early embryonic loss, and adverse pregnancy outcomes? (2) Can we develop new diagnostic and prognostic biomarkers for fecundity and treatment success? And (3) what are the health characteristics of women and men in infertile couples at the time of fertility treatment and during long-term follow-up? MATERIAL AND METHODS ReproUnion Biobank and Infertility Cohort (RUBIC) is established as an add-on to the routine fertility management at Copenhagen University Hospital Departments in the Capital Region of Denmark and Reproductive Medicine Centre at Skåne University Hospital in Sweden. The aim is to include a total of 5000 couples equally distributed between Denmark and Sweden. The first patients were enrolled in June 2020. All eligible infertile couples are prospectively asked to participate in the project. Participants complete an extensive questionnaire and undergo a physical examination and collection of biospecimens (blood, urine, hair, saliva, rectal swabs, feces, semen, endometrial biopsies, and vaginal swabs). After the cohort is established, the couples will be linked to the Danish and Swedish national registers to obtain information on parental, perinatal, childhood, and adult life histories, including disease and medication history. This will enable us to understand the causes of infertility and identify novel therapeutic options for this important societal problem.
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Affiliation(s)
- Laerke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kristian Almstrup
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jonatan Axelsson
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Angel Elenkov
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Nina la Cour Freiesleben
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Marie Louise Grøndahl
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ann Holm Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Laura Smidt Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Emir Henic
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | | | - Selma Kloeve Landersoe
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Ellen Leth Løkkegaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - North Zealand, Copenhagen, Denmark
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Kajsa Uglevig Petersen
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sacha Stormlund
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Pernille Fog Svendsen
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nathalie Friis Wang
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anne Zedeler
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jorge Chavarro
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael L Eisenberg
- Department of Urology and Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Russ Hauser
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ilpo Huhtaniemi
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Andrea Salonia
- Graduate School of Urology, University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrated Physiology and Pharmacology, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden.,Department of Translational Medicine, Lund University, Malmö, Sweden
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Bräuner EV, Koch T, Juul A, Doherty DA, Hart R, Hickey M. Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study. Hum Reprod 2021; 36:1959-1969. [PMID: 33744952 DOI: 10.1093/humrep/deab039] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 12/21/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is there an association between prenatal exposure to stressful life events and age at menarche, and does childhood BMI mediate this association? SUMMARY ANSWER Girls exposed to prenatal stress had a slightly earlier age at menarche, but this association did not show a dose-response effect and was not mediated by childhood offspring BMI. WHAT IS ALREADY KNOWN Prenatal stress may impact on reproductive function in females including age at menarche, but human data are very limited. High childhood BMI is known to be associated with earlier age at menarche. Only one small study has measured the association between maternal stress and age at menarche and reported that childhood BMI mediated the association between maternal stress and earlier age at menarche. However, neither maternal stress nor age at menarche was prospectively recorded and the study was limited to 31 mother-daughter pairs. STUDY DESIGN, SIZE, DURATION The Raine Study is a large prospective population-based pregnancy cohort study (n = 1414 mother-daughter pairs) continuously followed from prenatal life through to adolescence. In the present study, we examined the association between exposure to maternal stressful life events during early, late and total gestation and age at menarche in offspring using 753 mother-daughter pairs with complete case information. PARTICIPANTS/MATERIALS, SETTING, METHODS Mothers prospectively reported stressful life events during pregnancy at 18 and 34 weeks using a standardized 10-point questionnaire. Exact date of menarche was assessed using a purpose-designed questionnaire at 8, 10, 14 and 17 years of age. Complete information on exposure, outcome and confounding variables was obtained from 753 mothers-daughter pairs. Multivariate linear regression complete case analysis was used to examine associations between maternal stressful life event exposure and age at menarche. Potential selection bias was evaluated using multiple imputations (50 datasets). The mediating effects of offspring childhood BMI (ages 5, 8, or 10 years) on these associations were measured in separate sub-analyses. MAIN RESULTS AND ROLE OF CHANCE Most (580/753, 77%) daughters were exposed to at least one prenatal stressful life event. Exposure to maternal stressful life events during the entire pregnancy was associated with a non-linear earlier age at menarche. Exposure to one event and two or more psychological stressful events was associated with a 3.5 and 1.7-month earlier onset of puberty, respectively when compared to the reference group with no exposure maternal stressful life events. The estimates from multiple imputation with 50 datasets were comparable with complete case analysis confirming the existence of an underlying effect. No separate significant effects were observed for exposure during early or late gestation. The association between prenatal stressful events and age at menarche was not mediated by childhood BMI in the offspring. LIMITATIONS, REASONS FOR CAUTION Stressful life events may have affected pregnant women in different ways and self-perceived maternal stress severity may have provided a more precise estimate of gestational psychological stress. The observed non-linear U-shape of the association between maternal psychological stress and age at menarche did not reflect a dose-response. This suggests that the first exposure to prenatal stress exerts a greater effect on fetal reproductive development. A potential mechanism is via dramatic initial activation of the hypothalamic-pituitary-adrenal (HPA) axis following the first stressful life event which is greater than that observed following subsequent exposure to two or more maternal stressful life events. Whilst we adjusted for a priori chosen confounders, we cannot exclude residual confounding or confounding by factors we did not include. Maternal age at menarche was not available so the effects of familial history/genetics could not be assessed. There was a large loss due to the number of girls with no information on date of menarche and missing confounder information implying risk of selection bias and multiple imputation analyses did not fully exclude this risk (similar direction but slightly weaker estimate magnitude). WIDER IMPLICATIONS OF THE FINDINGS Menarche is a sentinel reproductive event and earlier age at menarche carries implications for psychological, social and reproductive health and for long-term risk of common non-communicable diseases. Understanding the factors regulating age at menarche has extensive health implications. This is the first population-based cohort study in humans to demonstrate that prenatal psychological stress might directly modify age at menarche. STUDY FUNDING/COMPETING INTEREST(S) Dr. Bräuner and Trine Koch's salaries were supported by Doctor Sofus Carl Emil Friis and spouse Olga Doris Friis foundation, The Danish Cancer Society (Kræftens Bekæmpelse, RP15468, R204-A12636, Denmark) and The Danish Health Foundation (Helsefonden, F-22181-23, Denmark). Martha Hickey was funded by NHMRC Practitioner Fellowships. The funding bodies played no role in the design, collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Dr. Hart has received personal fees in his function as the Medical Director of Fertility Specialists of Western Australia and received educational sponsorship grants from MSD, Merck-Serono and from Ferring Pharmaceuticals. Dr Hart has also received personal fees from Shareholders in Western IVF outside the submitted work. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- E V Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - T Koch
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - D A Doherty
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - R Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia.,Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
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Koch T, Doherty DA, Dickinson JE, Juul A, Hart R, Bräuner EV, Hickey M. In utero exposure to maternal stressful life events and risk of polycystic ovary syndrome in the offspring: The Raine Study. Psychoneuroendocrinology 2021; 125:105104. [PMID: 33352473 DOI: 10.1016/j.psyneuen.2020.105104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/03/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND PCOS is the most common endocrine disorder in reproductive age women. The origins of PCOS are unknown but experimental and limited human evidence suggests that greater prenatal exposure to androgens may predispose to PCOS. Experimental evidence suggests that maternal stressors may affect reproductive function in the offspring via changes in prenatal androgen exposure. In this present study, we aim to investigate whether maternal stressful life events during pregnancy are associated with polycystic ovary morphology (PCOM) or polycystic ovary syndrome (PCOS) in adolescent offspring. METHOD In a large population-based pregnancy cohort study (The Raine Study) continuously followed from prenatal life through to adolescence we examined the association between maternal stressful life events during pregnancy in both early and late gestation, and subsequent circulating concentrations of ovarian and adrenal androgens, PCOM and PCOS in the normal menstrual cycle of offspring age 14-16 years. Maternal stressful life events were prospectively recorded during pregnancy at 18 and 34 weeks using a 10-point questionnaire. Female offspring (n = 223) completed a questionnaire about their menstrual cycles, underwent a clinical examination for hirsutism (Ferriman-Gallwey score) and transabdominal pelvic ultrasound examination to determine ovarian morphology according to standardized criteria for classification of PCOM. Plasma samples were obtained at day 2-6 of the normal menstrual cycle for measurement of androgens. PCOM was defined according to the international consensus definition, 2003 and the evidence-based guideline for the assessment and management of PCOS, 2018. PCOS was diagnosed according to Rotterdam criteria and National Institute of Health (NIH) criteria. Multivariate linear and logistic regression analyses were used to examine the associations between maternal stressful life event exposure and ovarian morphology (PCOM), circulating ovarian and adrenal androgens (clinical and biochemical hyperandrogenism (hirsutism)) and presence of PCOS. RESULTS Of 223 recruited adolescent girls, 78 (35.9%) and 68 (31.3%) had PCOM by the 2003 and 2018 criteria respectively, while 66 (29.6%) and 37 (16.6%) had PCOS, using Rotterdam and NIH criteria, respectively. Most girls (141/223, 63.2%) were exposed to at least one stressful life event in early gestation and around half (121/223, 54.3%) were exposed to at least one stressful life event in late gestation. Maternal stressful life events in early gestation were associated with a statistically significant lower prevalence of PCOM when applying the 2003 criteria [adjusted odds ratio [aOR] and 95% confidence intervals (CI): 0.74 (95% CI: 0.55; 0.99)], and a similar association was detected when applying the 2018 PCOM criteria (aOR, 0.69, 95% CI: 0.50; 0.95)]. Maternal stressful life events in early gestation were also associated with lower circulating concentrations of testosterone (β = -0.05, 95% CI: -0.09; -0.004) and androstenedione (β = -0.05, 95% CI: -0.10; -0.002) in the offspring. No similar effects for PCOM or circulating androgens were detected in late gestation. No statistically significant associations between maternal stressful life events in early or late gestation with PCOS (neither Rotterdam nor NIH criteria) in adolescence were detected. The prospective collection of maternal stressful life events during both early and late gestation and direct measurement of PCOM, PCOS and circulating androgens in adolescence and key co-variates implies minimal possibility of recall, information bias and selection bias. CONCLUSION Maternal exposure to stressful life events in early gestation is associated with significantly reduced circulating ovarian and adrenal androgen concentrations in adolescence (testosterone and androstenedione), and an indication of fewer cases of polycystic ovary morphology (PCOM) defined by the 2003 international consensus definition and by the 2018 international evidence-based guideline, but has no effect on polycystic ovary syndrome (PCOS), diagnosed using either Rotterdam or NIH criteria.
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Affiliation(s)
- T Koch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - D A Doherty
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - J E Dickinson
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - A Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - R Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia; Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
| | - E V Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.
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8
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So R, Jørgensen JT, Lim YH, Mehta AJ, Amini H, Mortensen LH, Westendorp R, Ketzel M, Hertel O, Brandt J, Christensen JH, Geels C, Frohn LM, Sisgaard T, Bräuner EV, Jensen SS, Backalarz C, Simonsen MK, Loft S, Cole-Hunter T, Andersen ZJ. Long-term exposure to low levels of air pollution and mortality adjusting for road traffic noise: A Danish Nurse Cohort study. Environ Int 2020; 143:105983. [PMID: 32736159 DOI: 10.1016/j.envint.2020.105983] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The association between air pollution and mortality is well established, yet some uncertainties remain: there are few studies that account for road traffic noise exposure or that consider in detail the shape of the exposure-response function for cause-specific mortality outcomes, especially at low-levels of exposure. OBJECTIVES We examined the association between long-term exposure to particulate matter [(PM) with a diameter of <2.5 µm (PM2.5), <10 µm (PM10)], and nitrogen dioxide (NO2) and total and cause-specific mortality, accounting for road traffic noise. METHODS We used data on 24,541 females (age > 44 years) from the Danish Nurse Cohort, who were recruited in 1993 or 1999, and linked to the Danish Causes of Death Register for follow-up on date of death and its cause, until the end of 2013. Annual mean concentrations of PM2.5, PM10, and NO2 at the participants' residences since 1990 were estimated using the Danish DEHM/UBM/AirGIS dispersion model, and annual mean road traffic noise levels (Lden) were estimated using the Nord2000 model. We examined associations between the three-year running mean of PM2.5, PM10, and NO2 with total and cause-specific mortality by using time-varying Cox Regression models, adjusting for individual characteristics and residential road traffic noise. RESULTS During the study period, 3,708 nurses died: 843 from cardiovascular disease (CVD), 310 from respiratory disease (RD), and 64 from diabetes. In the fully adjusted models, including road traffic noise, we detected associations of three-year running mean of PM2.5 with total (hazard ratio; 95% confidence interval: 1.06; 1.01-1.11), CVD (1.14; 1.03-1.26), and diabetes mortality (1.41; 1.05-1.90), per interquartile range of 4.39 μg/m3. In a subset of the cohort exposed to PM2.5 < 20 µg/m3, we found even stronger association with total (1.19; 1.11-1.27), CVD (1.27; 1.01-1.46), RD (1.27; 1.00-1.60), and diabetes mortality (1.44; 0.83-2.48). We found similar associations with PM10 and none with NO2. All associations were robust to adjustment for road traffic noise. DISCUSSION Long-term exposure to low-levels of PM2.5 and PM10 is associated with total mortality, and mortality from CVD, RD, and diabetes. Associations were even stronger at the PM2.5 levels below EU limit values and were independent of road traffic noise.
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Affiliation(s)
- Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Centre for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark
| | | | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amar J Mehta
- Denmark Statistics, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Laust H Mortensen
- Denmark Statistics, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rudi Westendorp
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, United Kingdom
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Torben Sisgaard
- Institute of Environmental and Occupational Medicine, Department of Public Health, Aarhus University, Denmark
| | | | | | | | - Mette Kildevæld Simonsen
- Diakonissestiftelsen, Frederiksberg, Denmark; Research Unit for Dietary Studies, The Parker Institute Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tom Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Centre for Air Pollution, Energy and Health Research (CAR), University of Sydney, Sydney, Australia
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Centre for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark.
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Glazer CH, Eisenberg ML, Tøttenborg SS, Giwercman A, Flachs EM, Bräuner EV, Vassard D, Pinborg A, Schmidt L, Bonde JP. Male factor infertility and risk of death: a nationwide record-linkage study. Hum Reprod 2020; 34:2266-2273. [PMID: 31725880 DOI: 10.1093/humrep/dez189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 05/13/2019] [Revised: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION What is the risk of death among men with oligospermia, unspecified male factor and azoospermia in the years following fertility treatment? SUMMARY ANSWER No significantly elevated risk was observed among men with oligospermia and unspecified male factor, while an increased risk was found among men with azoospermia. WHAT IS KNOWN ALREADY Previous studies have shown associations between male factor infertility and risk of death, but these studies have relied on internal reference groups and the risk of death according to type of male infertility is not well characterized. STUDY DESIGN, SIZE, DURATION In this prospective record-linkage cohort study, we identified men who had undergone medically assisted reproduction (MAR) between 1994 and 2015. Data was linked to the Danish causes of death register and sociodemographic registers through personal identification numbers assigned to all Danish citizens at birth. PARTICIPANTS/MATERIALS, SETTING, METHODS Men that had undergone MAR in Denmark (MAR Cohort; n = 64 563) were identified from the Danish IVF register, which includes data on whether infertility was due to male factor. For each man in the MAR cohort, five age-matched men who became fathers without fertility treatment were selected from the general population (non-MAR fathers; n = 322 108). Men that could not adequately be tracked in the Danish CPR register (n = 1259) and those that were censored prior to study entry (n = 993) were excluded, leaving a final population of 384 419 men. Risk of death was calculated by Cox regression analysis with age as an underlying timeline and adjustments for educational attainment, civil status and year of study entry. The risk of death was compared among men with and without male factor infertility identified from the IVF register (internal comparisons) as well as to the non-MAR fathers (external comparison). MAIN RESULTS AND THE ROLE OF CHANCE The risk of death between the MAR cohort (all men, regardless of infertility) and the non-MAR fathers was comparable [hazard ratio (HR), 1.07; 95% CI, 0.98-1.15]. When the MAR cohort was limited to infertile men, these men were at increased risk of death [HR, 1.27; 95% CI, 1.12-1.44]. However, when stratified by type of male factor infertility, men with azoospermia had the highest risk of death, which persisted when in both the internal [HR, 2.30; 95% CI, 1.54-3.41] and external comparison [HR, 3.32; 95% CI, 2.02-5.40]. No significantly elevated risk of death was observed among men with oligospermia [HR, 1.14; 95% CI, 0.87-1.50] and unspecified male factor [HR, 1.10; 95% CI, 0.75-1.61] compared with the non-MAR fathers. The same trends were observed for the internal comparison. LIMITATIONS, REASONS FOR CAUTION Duration of the follow-up was limited and there is limited generalizability to infertile men who do not seek fertility treatment. WIDER IMPLICATIONS OF THE FINDINGS Using national health registers, we found an increased risk of death among azoospermic men while no increased risk was found among men with other types of infertility. For the azoospermic men, further insight into causal pathways is needed to identify options for monitoring and prevention. STUDY FUNDING/COMPETING INTEREST(S) This study is part of the ReproUnion collaborative study, co-financed by the European Union, Interreg V ÖKS. C.G.'s research stay at Stanford was funded by grants from the University of Copenhagen, Kong Christian den Tiendes Fond, Torben og Alice Frimodt Fond and Julie Von Müllen Fond. M.E. is an advisor for Sandstone and Dadi. All other authors declare no conflict of interests. TRIAL REGISTRATION NUMBER Not relevant.
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Affiliation(s)
- Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.,Department of Urology, Stanford University, Palo Alto, CA, USA
| | | | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Vassard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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Liu S, Jørgensen JT, Lim YH, Amini H, Mehta AJ, Mortensen LH, Westendorp RG, Pedersen M, Loft S, Bräuner EV, Ketzel M, Hertel O, Brandt J, Jensen SS, Sigsgaard T, Backalarz C, Simonsen MK, Andersen ZJ. Long-term exposure to air pollution, road traffic noise and asthma incidence: the Danish Nurse Cohort. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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Bräuner EV, Hansen ÅM, Doherty DA, Dickinson JE, Handelsman DJ, Hickey M, Skakkebæk NE, Juul A, Hart R. The association between in-utero exposure to stressful life events during pregnancy and male reproductive function in a cohort of 20-year-old offspring: The Raine Study. Hum Reprod 2020; 34:1345-1355. [PMID: 31143949 DOI: 10.1093/humrep/dez070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is exposure to gestational stress in the critical time window for the normal differentiation and growth of male reproductive tissue associated with male reproductive function in offspring in later life? SUMMARY ANSWER Exposure to stressful life events (SLEs) in early, but not late gestation, are associated with reduced adult male reproductive function, consistent with the hypothesis that events during early prenatal life programme adult male reproductive function. WHAT IS ALREADY KNOWN Animal studies suggest that gestational stress may impact on the reproductive function of male offspring, but human evidence is sparse. STUDY DESIGN, SIZE, DURATION Using a prospective longitudinal cohort, we examined the association between number and type of maternal stressors during pregnancy in both early and late gestation and reproductive function in 643 male Generation 2 (offspring) at age 20 years. Mothers and their male Generation 2 (offspring) from The Raine Study participated. Mothers prospectively reported SLEs during pregnancy recorded at gestational weeks 18 and 34 using a standardized 10-point questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS The 643 male Generation 2 (offspring) underwent testicular ultrasound examination and semen analysis and provided serum for reproductive hormone analysis. Multivariate linear regression analysis was used to examine associations. MAIN RESULTS AND ROLE OF CHANCE Of 643 recruited males, 407 (63%) were exposed to at least one SLE in early gestation. Fewer SLEs were reported in late gestation (n = 343, 53%). Maternal SLE exposure in early gestation was negatively associated with total sperm count (β = -0.31, 95% CI -0.58; -0.03), number of progressive motile sperm (β = -0.15, 95% CI -0.31; 0.00) and morning serum testosterone concentration (β = -0.04, 95% CI -0.09; -0.00). No similar effects of maternal SLE exposure in late pregnancy were detected. The large sample size and an objective detailed direct assessment of adult male reproductive function with strict external quality control for sperm quality, as well as detailed prospectively collected information on prenatal SLEs in two distinct time windows of pregnancy reported by the women in early and late gestation along with other risk factors, imply minimal possibility of recall, information bias and selection bias. When assessing our results, we adjusted for a priori chosen confounders, but residual confounding or confounding by factors unbeknown to us cannot be ruled out. LIMITATIONS, REASONS FOR CAUTION It is not possible to measure how SLEs impacted differently on the mother's experience or perception of stress. Resilience (coping) gradients may alter cortisol levels and thus modify the associations we observed and the mothers' own perception of stress severity may have provided a more precise estimate of her exposure. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that exposure to SLEs in early, but not late gestation, are associated with reduced adult male reproductive function. Improved support for women with exposure to SLEs during pregnancy, particularly during the first trimester, may improve the reproductive health of their male offspring in later life. Intervention studies of improved pregnancy support could provide more insight into this association and more information is needed about the potential specific epigenetic mechanisms underlying this association. STUDY FUNDING/COMPETING INTEREST(S) The male fertility sub-study was funded by NHMRC Grant 634 457. The core management of the Raine Study is funded by University of Western Australia, Curtin University, Telethon Kids Institute, Women and Infants Research Foundation, Edith Cowan University, Murdoch University, The University of Notre Dame Australia and Raine Medical Research foundation. Dr Bräuner's salary was supported by Læge Sofus Carl Emil Friis og Hustru Olga Doris Friis foundation in Denmark. All authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- E V Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Å M Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Copenhagen Denmark
| | - D A Doherty
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - J E Dickinson
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - D J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney NSW Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - N E Skakkebæk
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - R Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia.,Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
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Jørgensen JT, Bräuner EV, Backalarz C, Laursen JE, Pedersen TH, Jensen SS, Ketzel M, Hertel O, Lophaven SN, Simonsen MK, Andersen ZJ. Long-Term Exposure to Road Traffic Noise and Incidence of Diabetes in the Danish Nurse Cohort. Environ Health Perspect 2019; 127:57006. [PMID: 31084449 PMCID: PMC6791549 DOI: 10.1289/ehp4389] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Evidence on the association between road traffic noise and diabetes risk is sparse and inconsistent with respect to how confounding by air pollution was treated. OBJECTIVES In this study, we aimed to examine whether long-term exposure to road traffic noise over 25 years is associated with incidence of diabetes, independent of air pollution. METHODS A total of 28,731 female nurses from the Danish Nurse cohort ([Formula: see text] at recruitment in 1993 or 1999) were linked to the Danish National Diabetes Register with information on incidence of diabetes from 1995 until 2013. The annual mean weighted levels of 24-h average road traffic noise ([Formula: see text]) at nurses' residences from 1970 until 2013 were estimated with the Nord2000 method and annual mean levels of particulate matter (PM) with diameter [Formula: see text] and [Formula: see text] ([Formula: see text] and [Formula: see text]), nitrogen dioxide ([Formula: see text]), and nitrogen oxide ([Formula: see text]) with the Danish AirGIS modeling system. Cox proportional hazards regression models were used to examine the association between residential [Formula: see text] in four different exposure windows (1-, 5-, 10-, and 25-years) and the incidence of diabetes, adjusted for lifestyle factors and air pollutants. RESULTS Of 23,762 nurses free of diabetes at the cohort baseline, 1,158 developed diabetes during a mean follow-up of 15.2 years. We found weak positive associations between 5-y mean exposure to [Formula: see text] (per [Formula: see text] increase) and diabetes incidence in a crude model [hazard ratio (HR): 1.07; 95% confidence interval (CI): 0.99, 1.12], which attenuated in a model adjusted for lifestyle factors (HR:1.04; 95% CI: 0.97, 1.12), and reached unity after additional adjustment for [Formula: see text] (HR: 0.99; 0.91, 1.08). In analyses by level of urbanization, we found a positive association between noise and diabetes in urban areas (HR:1.27; 95% CI: 0.98, 1.63) that was unchanged after adjusting for [Formula: see text] (HR: 1.25; 95% CI: 0.97, 1.62), but we found no apparent association in provincial (HR: 1.02; 95% CI: 0.88, 1.18) or rural areas (HR: 0.97; 95% CI: 0.87, 1.08). CONCLUSION In the nationwide cohort of Danish nurses 44 years of age and older, we found no association between long-term exposure to road traffic noise and diabetes incidence after adjustment for [Formula: see text] but found suggestive evidence of an association limited to urban areas. https://doi.org/10.1289/EHP4389.
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Affiliation(s)
| | - Elvira Vaclavik Bräuner
- Juliane Marie Center, Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Søren Nyman Lophaven
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kildevæld Simonsen
- Diakonissestiftelsen, Frederiksberg, Denmark
- Research Unit for Dietary Studies, The Parker Institute Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Nykøbing F Hospital, Centre for Epidemiological Research, Nykøbing F, Denmark
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Cramer J, Therming Jørgensen J, Sørensen M, Backalarz C, Laursen JE, Ketzel M, Hertel O, Jensen SS, Simonsen MK, Bräuner EV, Andersen ZJ. Road traffic noise and markers of adiposity in the Danish Nurse Cohort: A cross-sectional study. Environ Res 2019; 172:502-510. [PMID: 30852453 DOI: 10.1016/j.envres.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Studies have suggested that traffic noise is associated with markers of obesity. We investigated the association of exposure to road traffic noise with body mass index (BMI) and waist circumference in the Danish Nurse Cohort. METHODS We used data on 15,501 female nurses (aged >44 years) from the nationwide Danish Nurse Cohort who, in 1999, reported information on self-measured height, weight, and waist circumference, together with information on socioeconomic status, lifestyle, work and health. Road traffic noise at the most exposed façade of the residence was estimated using Nord2000 as the annual mean of a weighted 24-h average (Lden). We used multiple linear regression models to examine associations of road traffic noise levels in 1999 (1-year mean) with BMI and waist circumference, adjusting for potential confounders, and evaluated effect modification by degree of urbanization, air pollution levels, night shift work, job strain, sedative use, sleep aid use, and family history of obesity. RESULTS We did not observe associations between road traffic noise (per 10 dB increase in the 1-year mean Lden) and BMI (kg/m2) (β: 0.00; 95% confidence interval (CI): -0.07, 0.07) or waist circumference (cm) (β: -0.09; 95% CI: -0.31, 0.31) in the fully adjusted model. We found significant effect modification of job strain and degree of urbanization on the associations between Lden and both BMI and waist circumference. Job strained nurses were associated with a 0.41 BMI-point increase, (95% CI: 0.06, 0.76) and a 1.00 cm increase in waist circumference (95% CI: 0.00, 2.00). Nurses living in urban areas had a statistically significant positive association of Lden with BMI (β: 0.26; 95% CI: 0.11, 0.42), whilst no association was found for nurses living in suburban and rural areas. CONCLUSION Our results suggest that road traffic noise exposure in nurses with particular susceptibilities, such as those with job strain, or living in urban areas, may lead to increased BMI, a marker of adiposity.
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Affiliation(s)
- Johannah Cramer
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Jeanette Therming Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Mette Sørensen
- Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark.
| | | | - Mette Kildevæld Simonsen
- Diakonissestiftelsen and Parker Institute, Frederiksberg Hospital, Peter Bangsvej 1, 2000 Frederiksberg, Denmark.
| | - Elvira Vaclavik Bräuner
- Juliane Marie Center, Department of Growth and Reproduction, Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; Centre for Epidemiological Research, Nykøbing F Hospital, Ejegodvej 63, 4800 Nykøbing F, Denmark.
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14
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Andersen ZJ, Pedersen M, Weinmayr G, Stafoggia M, Galassi C, Jørgensen JT, Sommar JN, Forsberg B, Olsson D, Oftedal B, Aasvang GM, Schwarze P, Pyko A, Pershagen G, Korek M, Faire UD, Östenson CG, Fratiglioni L, Eriksen KT, Poulsen AH, Tjønneland A, Bräuner EV, Peeters PH, Bueno-de-Mesquita B, Jaensch A, Nagel G, Lang A, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Migliore E, Vermeulen R, Sokhi R, Keuken M, de Hoogh K, Beelen R, Vineis P, Cesaroni G, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-term exposure to ambient air pollution and incidence of brain tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE). Neuro Oncol 2019; 20:420-432. [PMID: 29016987 PMCID: PMC5817954 DOI: 10.1093/neuonc/nox163] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [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] [Indexed: 12/17/2022] Open
Abstract
Background Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
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Affiliation(s)
- Zorana J Andersen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy.,Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jeanette T Jørgensen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johan N Sommar
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Per Schwarze
- Norwegian Institute of Public Health, Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
| | - Kirsten T Eriksen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Aslak H Poulsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg Hospital, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Biomarkers and Clinical Resreach in Eating Disorders, Ballerup Center for Mental Health Services, Capitol Region of Denmark, Rigshospitalt- Ballerup, Denmark
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.,Vorarlberg Cancer Registry, Bregenz, Austria
| | - Alois Lang
- Vorarlberg Cancer Registry, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ming-Yi Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.,Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.,Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, UK
| | - Menno Keuken
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.,National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy
| | - Bert Brunekreef
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
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15
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Glazer CH, Bonde JP, Giwercman A, Vassard D, Pinborg A, Schmidt L, Vaclavik Bräuner E. Risk of diabetes according to male factor infertility: a register-based cohort study. Hum Reprod 2018; 32:1474-1481. [PMID: 28486688 PMCID: PMC5850522 DOI: 10.1093/humrep/dex097] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [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: 01/23/2017] [Accepted: 04/24/2017] [Indexed: 01/23/2023] Open
Abstract
STUDY QUESTION Is male factor infertility associated with an increased risk of developing diabetes? SUMMARY ANSWER The study provides evidence that male factor infertility may predict later occurrence of diabetes mellitus with the risk being related to the severity of the underlying fertility problem. WHAT IS KNOWN ALREADY Previous cross-sectional studies have shown an increased prevalence of comorbidities among infertile men when compared to controls. STUDY DESIGN, SIZE, DURATION In this prospective cohort study, 39 516 men who had since 1994 undergone fertility treatment with their female partner were identified from the Danish national IVF register, which includes data on assumed cause of couple infertility (male/female factor, mixed and unexplained infertility) and type of fertility treatment. With a median follow-up time of 5.6 years, each man was followed for diabetes occurrence from enrollment until 31 December 2012 using the National Diabetes Register (NDR). Men with a history of diabetes prior to their fertility diagnosis were excluded. Hazard ratios (HR) were estimated by Cox proportional hazard models with age as the underlying time scale. In addition to analyzing the data for the entire IVF registration period (1994–2012), separate analyses were performed for men identified from the first (1994–2005) and second (2006–2012) IVF registration period owing to heterogeneity in the reporting of male factor infertility in these two time periods, because the reason for male factor infertility was not available from the first register. PARTICIPANTS/MATERIALS, SETTING, METHODS Male factor infertility was identified from the variable ‘yes’ or ‘no’ from the first IVF register and through a diagnosis code (e.g. oligospermia, azoospermia) from the second IVF register. The reference group was men with male factor infertility (=‘no’) and those with normal semen quality or sterilized men. Of the included men, 18 499 (46.8%) had male factor infertility and 21 017 (53.2%) made up the reference group. MAIN RESULTS AND THE ROLE OF CHANCE A total of 651 (1.6%) diabetes cases were identified during the follow-up period. The adjusted HR's for diabetes risk among men with male factor infertility when compared to the reference group were HR = 1.08 (95% CI: 0.89, 1.31) and HR = 1.45 (95% CI: 1.06, 1.97) for the first and second IVF registration period, respectively. When assessing the effects of individual causes of male factor infertility, the adjusted HR's for men with oligospermia, azoospermia and aspermia were HR = 1.44 (95% CI: 1.01, 2.06), HR = 2.10 (95% 1.25, 3.56) and HR = 3.20 (95% CI 1.00, 10.31), respectively. LIMITATIONS, REASONS FOR CAUTION We found no increased risk among men identified from the first IVF register, which may be related to exposure misclassification as the reason for male factor infertility was not available from this time period. The NDR does not distinguish between type 1 and type 2 diabetes. WIDER IMPLICATIONS OF THE FINDINGS These findings support previous studies that a man's reproductive and somatic health are closely intertwined and highlight the importance for further monitoring of these men. Further, implementation of diabetes screening may be especially relevant among aspermic and azoospermic men. STUDY FUNDING/COMPETING INTERESTS This article is part of the ReproUnion collaborative study, co-financed by the European Union, Intereg V Öresund-Kattegat-Skagerrak. None of the authors declare any conflict of interest. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Sweden
| | - Ditte Vassard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, DK-1014 Copenhagen K, Denmark
| | - Anja Pinborg
- Department of Obstetrics/Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, DK-2650 Hvidovre, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, DK-1014 Copenhagen K, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.,Research Center for Prevention and Health (RCPH), University of Copenhagen, DK-2600 Glostrup, Denmark
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16
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Roswall N, Sørensen M, Bräuner EV, Tjønneland A, Raaschou-Nielsen O. No Association between Organochlorine Concentrations in Adipose Tissue and Survival after Non-Hodgkin Lymphoma. Cancer Epidemiol Biomarkers Prev 2017; 27:224-226. [DOI: 10.1158/1055-9965.epi-17-0937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/16/2022] Open
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17
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Glazer CH, Tøttenborg SS, Giwercman A, Bräuner EV, Eisenberg ML, Vassard D, Magyari M, Pinborg A, Schmidt L, Bonde JP. Male factor infertility and risk of multiple sclerosis: A register-based cohort study. Mult Scler 2017; 24:1835-1842. [DOI: 10.1177/1352458517734069] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Gender, possibly due to the influence of gonadal hormones, is presumed to play a role in the pathogenesis of multiple sclerosis (MS), but no studies have evaluated whether male infertility is associated with MS. Objective: To study the association between male factor infertility and prevalent as well as incident MS. Method: Our cohort was established by linkage of the Danish National in vitro fertilization (IVF) registry to The Danish Multiple Sclerosis Registry and consisted of 51,063 men whose partners had undergone fertility treatment in all public and private fertility clinics in Denmark between 1994 and 2015. Results: With a median age of 34 years at baseline, 24,011 men were diagnosed with male factor infertility and 27,052 did not have male factor infertility and made up the reference group. Men diagnosed with male factor infertility had a higher risk of prevalent (odds ratio (OR) = 1.61, 95% confidence interval (95% CI) 1.04–2.51) and incident MS (hazard ratio (HR) = 1.28, 95% CI 0.76–2.17) when compared to the reference group. Conclusion: This nationwide cohort study has shown, for the first time, an association between male infertility and MS which may be due to underlying common etiologies such as hypogonadism, shared genetics, or a joint autoimmune component.
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Affiliation(s)
- Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Elvira Vaclavik Bräuner
- Mental Health Center Ballerup, Capital Region of Denmark, Center for Eating Disorders, Research Unit, Ballerup, Denmark
| | - Michael L Eisenberg
- Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ditte Vassard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Melinda Magyari
- Department of Neurology, The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Obstetrics/Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
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18
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Glazer CH, Bonde JP, Eisenberg ML, Giwercman A, Hærvig KK, Rimborg S, Vassard D, Pinborg A, Schmidt L, Bräuner EV. Male Infertility and Risk of Nonmalignant Chronic Diseases: A Systematic Review of the Epidemiological Evidence. Semin Reprod Med 2017; 35:282-290. [PMID: 28658712 DOI: 10.1055/s-0037-1603568] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractThe association between male infertility and increased risk of certain cancers is well studied. Less is known about the long-term risk of nonmalignant diseases in men with decreased fertility. A systemic literature review was performed on the epidemiologic evidence of male infertility as a precursor for increased risk of diabetes, cardiovascular diseases, and all-cause mortality. PubMed and Embase were searched from January 1, 1980, to September 1, 2016, to identify epidemiological studies reporting associations between male infertility and the outcomes of interest. Animal studies, case reports, reviews, studies not providing an accurate reference group, and studies including infertility due to vasectomy or malignancy were excluded. The literature search resulted in 2,485 references among which we identified seven articles fulfilling the eligibility criteria. Of these, four articles were prospective (three on risk of mortality, one on risk of chronic diseases) and three were cross-sectional relating male infertility to the Charlson Comorbidity Index. The current epidemiological evidence is compatible with an association between male infertility and risk of chronic disease and mortality, but the small number of prospective studies and insufficient adjustment of confounders preclude strong statements about male infertility as precursor of these outcomes.
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Affiliation(s)
- Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark
| | - Michael L Eisenberg
- Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, California
| | - Aleksander Giwercman
- Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Lund, Sweden
| | - Katia Keglberg Hærvig
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark
| | - Susie Rimborg
- Faculty Library of Natural and Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Obstetrics/Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark.,Mental Health Center Ballerup, Ballerup, Denmark
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19
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Andersen ZJ, Ravnskjær L, Andersen KK, Loft S, Brandt J, Becker T, Ketzel M, Hertel O, Lynge E, Bräuner EV. Long-term Exposure to Fine Particulate Matter and Breast Cancer Incidence in the Danish Nurse Cohort Study. Cancer Epidemiol Biomarkers Prev 2016; 26:428-430. [DOI: 10.1158/1055-9965.epi-16-0578] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/24/2016] [Accepted: 11/14/2016] [Indexed: 11/16/2022] Open
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20
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Bonde JP, Flachs EM, Rimborg S, Glazer CH, Giwercman A, Ramlau-Hansen CH, Hougaard KS, Høyer BB, Hærvig KK, Petersen SB, Rylander L, Specht IO, Toft G, Bräuner EV. The epidemiologic evidence linking prenatal and postnatal exposure to endocrine disrupting chemicals with male reproductive disorders: a systematic review and meta-analysis. Hum Reprod Update 2016; 23:104-125. [PMID: 27655588 PMCID: PMC5155570 DOI: 10.1093/humupd/dmw036] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [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: 05/27/2016] [Revised: 08/22/2016] [Accepted: 08/31/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND More than 20 years ago, it was hypothesized that exposure to prenatal and early
postnatal environmental xenobiotics with the potential to disrupt endogenous
hormone signaling might be on the causal path to cryptorchidism, hypospadias, low
sperm count and testicular cancer. Several consensus statements and narrative
reviews in recent years have divided the scientific community and have elicited a
call for systematic transparent reviews. We aimed to fill this gap in knowledge in
the field of male reproductive disorders. OBJECTIVE AND RATIONALE The aim of this study was to systematically synthesize published data on the risk
of cryptorchidism, hypospadias, low sperm counts and testicular cancer following
in utero or infant exposure to chemicals that have been
included on the European Commission's list of Category 1 endocrine
disrupting chemicals defined as having documented adverse effects due to endocrine
disruption in at least one intact organism. SEARCH METHODS A systematic literature search for original peer reviewed papers was performed in
the databases PubMed and Embase to identify epidemiological studies reporting
associations between the outcomes of interest and exposures documented by
biochemical analyses of biospecimens including maternal blood or urine, placenta
or fat tissue as well as amnion fluid, cord blood or breast milk; this was
followed by meta-analysis of quantitative data. OUTCOMES The literature search resulted in 1314 references among which we identified 33
papers(28 study populations) fulfilling the eligibility criteria. These provided
85 risk estimates of links between persistent organic pollutants and rapidly
metabolized compounds (phthalates and Bisphenol A) and male reproductive
disorders. The overall odds ratio (OR) across all exposures and outcomes was 1.11
(95% CI 0.91–1.35). When assessing four specific chemical subgroups
with sufficient data for meta-analysis for all outcomes, we found that exposure to
one of the four compounds, p,p′-DDE, was related to an elevated risk: OR
1.35 (95% CI 1.04–1.74). The data did not indicate that this
increased risk was driven by any specific disorder. WIDER IMPLICATIONS The current epidemiological evidence is compatible with a small increased risk of
male reproductive disorders following prenatal and postnatal exposure to some
persistent environmental chemicals classified as endocrine disruptors but the
evidence is limited. Future epidemiological studies may change the weight of the
evidence in either direction. No evidence of distortion due to publication bias
was found, but exposure–response relationships are not evident. There are
insufficient data on rapidly metabolized endocrine disruptors and on specific
exposure–outcome relations. A particular data gap is evident with respect
to delayed effects on semen quality and testicular cancer. Although high quality
epidemiological studies are still sparse, future systematic and transparent
reviews may provide pieces of evidence contributing to the narrative and weight of
the evidence assessments in the field.
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Affiliation(s)
- Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark .,Institute of Public Health, University of Copenhagen, DK-1016 Copenhagen K, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Susie Rimborg
- The Royal Library/ University of Copenhagen Library, DK-2200 Copenhagen N, Denmark
| | - Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
| | | | - Karin Sørig Hougaard
- National Research Centre for the Working Environment, DK-2100 Copenhagen Ø, Denmark
| | - Birgit Bjerre Høyer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Katia Keglberg Hærvig
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Sesilje Bondo Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Lars Rylander
- Department of Occupational and Environmental Medicine, University of Lund, SE-221 85 Lund, Sweden
| | - Ina Olmer Specht
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.,Research Center for Prevention and Health (RCPH), University of Copenhagen, DK-2600 Glostrup, Denmark
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Jørgensen JT, Johansen MS, Ravnskjær L, Andersen KK, Bräuner EV, Loft S, Ketzel M, Becker T, Brandt J, Hertel O, Andersen ZJ. Long-term exposure to ambient air pollution and incidence of brain tumours: The Danish Nurse Cohort. Neurotoxicology 2016; 55:122-130. [DOI: 10.1016/j.neuro.2016.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 01/18/2023]
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22
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Hansen AB, Ravnskjær L, Loft S, Andersen KK, Bräuner EV, Baastrup R, Yao C, Ketzel M, Becker T, Brandt J, Hertel O, Andersen ZJ. Long-term exposure to fine particulate matter and incidence of diabetes in the Danish Nurse Cohort. Environ Int 2016; 91:243-50. [PMID: 26989812 DOI: 10.1016/j.envint.2016.02.036] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [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: 11/19/2015] [Revised: 02/05/2016] [Accepted: 02/29/2016] [Indexed: 05/10/2023]
Abstract
AIMS/HYPOTHESIS It has been suggested that air pollution may increase the risk of type 2 diabetes but data on particulate matter with diameter <2.5μm (PM2.5) are inconsistent. We examined the association between long-term exposure to PM2.5 and diabetes incidence. METHODS We used the Danish Nurse Cohort with 28,731 female nurses who at recruitment in 1993 or 1999 reported information on diabetes prevalence and risk factors, and obtained data on incidence of diabetes from National Diabetes Register until 2013. We estimated annual mean concentrations of PM2.5, particulate matter with diameter <10μm (PM10), nitrogen oxides (NOx) and nitrogen dioxide (NO2) at their residence since 1990 using a dispersion model and examined the association between the 5-year running mean of pollutants and diabetes incidence using a time-varying Cox regression. RESULTS Of 24,174 nurses 1137 (4.7%) developed diabetes. We detected a significant positive association between PM2.5 and diabetes incidence (hazard ratio; 95% confidence interval: 1.11; 1.02-1.22 per interquartile range of 3.1μg/m(3)), and weaker associations for PM10 (1.06; 0.98-1.14 per 2.8μg/m(3)), NO2 (1.05; 0.99-1.12 per 7.5μg/m(3)), and NOx (1.01; 0.98-1.05 per 10.2μg/m(3)) in fully adjusted models. Associations with PM2.5 persisted in two-pollutant models. Associations with PM2.5 were significantly enhanced in never smokers (1.24; 1.09-1.42), and augmented in obese (1.25; 1.06-1.47) and subjects with myocardial infarction (1.32; 0.86-2.02), but without significant interaction. CONCLUSIONS/INTERPRETATION Fine particulate matter may the most relevant pollutant for diabetes development among women, and non-smokers, obese women, and heart disease patients may be most susceptible.
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Affiliation(s)
- Anne Busch Hansen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Line Ravnskjær
- Danish Cancer Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Steffen Loft
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Elvira Vaclavik Bräuner
- Research Center for Prevention and Health, Capitol Region of Denmark, Rigshospitalet - Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Baastrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Claire Yao
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Thomas Becker
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Zorana Jovanovic Andersen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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23
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Bräuner EV, Andersen ZJ, Frederiksen M, Specht IO, Hougaard KS, Ebbehøj N, Bailey J, Giwercman A, Steenland K, Longnecker MP, Bonde JP. Health Effects of PCBs in Residences and Schools (HESPERUS): PCB - health Cohort Profile. Sci Rep 2016; 6:24571. [PMID: 27090775 PMCID: PMC4835792 DOI: 10.1038/srep24571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 10/11/2015] [Accepted: 03/31/2016] [Indexed: 11/23/2022] Open
Abstract
Polychlorinated-biphenyls (PCBs) were introduced in the late 1920s and used until the 1970s when they were banned in most countries due to evidence of environmental build-up and possible adverse health effects. However they still persist in the environment, indoors and in humans. Indoor air in contaminated buildings may confer airborne exposure markedly above background regional PCB levels. To date, no epidemiological studies have assessed the health effects from exposure to semi-volatile PCBs in the indoor environment. Indoor air PCBs are generally less chlorinated than PCBs that are absorbed via the diet, or via past occupational exposure; therefore their health effects require separate risk assessment. Two separate cohorts of individuals who have either attended schools (n = 66,769; 26% exposed) or lived in apartment buildings (n = 37,185; 19% exposed), where indoor air PCB concentrations have been measured were created. An individual estimate of long-term airborne PCB exposure was assigned based on measurements. The cohorts will be linked to eight different national data sources on mortality, school records, residential history, socioeconomic status, and chronic disease and reproductive outcomes. The linking of indoor air exposures with health outcomes provides a dataset unprecedented worldwide. We describe a project, called HESPERUS (Health Effects of PCBs in Residences and Schools), which will be the first study of the long term health effects of the lower-chlorinated, semi-volatile PCBs in the indoor environment.
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Affiliation(s)
- Elvira Vaclavik Bräuner
- Research Center of Prevention and Health, Center of Health, Capital region of Denmark, Rigshospital - Glostrup, Copenhagen University, Denmark.,Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Department of Public Health, Center for Epidemiology and Screening, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Marie Frederiksen
- Department of Energy, Environment and Indoor Climate, Danish Building Research Institute, Aalborg University, Denmark
| | - Ina Olmer Specht
- Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Niels Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Janice Bailey
- Department of Animal Sciences, Centre de Recherche en Biologie de la Reproduction, Université Laval, Canada
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Sweden
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Matthew Paul Longnecker
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, NC, USA
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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Egsmose EL, Bräuner EV, Frederiksen M, Mørck TA, Siersma VD, Hansen PW, Nielsen F, Grandjean P, Knudsen LE. Associations between plasma concentrations of PCB 28 and possible indoor exposure sources in Danish school children and mothers. Environ Int 2016; 87:13-19. [PMID: 26638015 DOI: 10.1016/j.envint.2015.11.005] [Citation(s) in RCA: 12] [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: 08/21/2015] [Revised: 11/07/2015] [Accepted: 11/08/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) are ubiquitously present in the environment and are suspected of carcinogenic, neurotoxic and immunotoxic effects. Significantly higher plasma concentrations of the congener PCB 28 occur in children compared to adults. Exposure in schools may contribute to this difference. OBJECTIVE To determine whether increased blood plasma concentrations of PCB 28 in Danish school children and mothers are associated with living in homes or attending schools constructed in the PCB period (1959-1977). METHODS PCB 28 was analyzed in plasma samples from 116 children aged 6-11years and 143 mothers living in an urban and a rural area in Denmark and participating in the European pilot project DEMOCOPHES (Demonstration of a study to COordinate and Perform Human Biomonitoring on a European Scale). In Denmark, PCBs were used in construction in the period 1950-1977, and year of construction or renovation of the homes and schools was used as a proxy for indoor PCB exposure. Linear regression models were used to assess the association between potential PCB exposure from building materials and lipid adjusted concentrations of PCB 28 in plasma, with and without adjustment for potential confounders. RESULTS Among the 116 children and 143 mothers, we were able to specify home construction period in all but 4 children and 5 mothers leaving 111 children and 138 mothers for our analyses. The median lipid adjusted plasma PCB 28 concentration was 3 (range: 1-28) ng/g lipid in the children and 2 (range: 1-8) ng/g lipid in the mothers. Children living in homes built in the PCB period had significantly higher lipid adjusted plasma PCB 28 concentrations compared to children living in homes built before or after the PCB period. Following adjustment for covariates, PCB 28 concentrations in children were 40 (95% CI: 13; 68) percent higher than concentrations of children living in homes constructed at other times. Furthermore, children attending schools built or substantially refurbished in the PCB period also had significantly higher (46%, 95% CI: 22; 70) PCB 28 concentrations compared to children attending schools constructed before or after the PCB period, while their mothers had similar concentrations. Adjustment for the most prevalent congener, PCB 153, did not change this effect of home or school construction. When both home and school construction year were included in the models, the increase in lipid adjusted plasma PCB 28 for children living in or attending schools from the PCB period was no longer statistically significant. The individual effect of home and school construction periods could not be evaluated further with the available data. CONCLUSION Our results suggest that PCB exposure in the indoor environment in schools and homes constructed during the PCB period may contribute significantly to children's plasma PCB 28 concentration. Efforts to minimize PCB exposure in indoor environments should be considered.
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Affiliation(s)
- Emilie Lund Egsmose
- Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Construction and Health, Danish Building Research Institute, Aalborg University, Denmark
| | - Marie Frederiksen
- Department of Construction and Health, Danish Building Research Institute, Aalborg University, Denmark
| | - Thit Aarøe Mørck
- Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Volkert Dirk Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Winton Hansen
- Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Flemming Nielsen
- Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Philippe Grandjean
- Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lisbeth E Knudsen
- Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Denmark.
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25
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Bräuner EV, Loft S, Sørensen M, Jensen A, Andersen CE, Ulbak K, Hertel O, Pedersen C, Tjønneland A, Krüger Kjær S, Raaschou-Nielsen O. Residential Radon Exposure and Skin Cancer Incidence in a Prospective Danish Cohort. PLoS One 2015; 10:e0135642. [PMID: 26274607 PMCID: PMC4537191 DOI: 10.1371/journal.pone.0135642] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/23/2015] [Indexed: 12/02/2022] Open
Abstract
Background Although exposure to UV radiation is the major risk factor for skin cancer, theoretical models suggest that radon exposure can contribute to risk, and this is supported by ecological studies. We sought to confirm or refute an association between long-term exposure to residential radon and the risk for malignant melanoma (MM) and non-melanoma skin cancer (NMSC) using a prospective cohort design and long-term residential radon exposure. Methods During 1993–1997, we recruited 57,053 Danish persons and collected baseline information. We traced and geocoded all residential addresses of the cohort members and calculated radon concentrations at each address lived in from 1 January 1971 until censor date. Cox proportional hazards models were used to estimate incidence rate-ratios (IRR) and confidence intervals (CI) for the risk associated with radon exposure for NMSC and MM, and effect modification was assessed. Results Over a mean follow-up of 13.6 years of 51,445 subjects, there were 3,243 cases of basal cell carcinoma (BCC), 317 cases of squamous cell carcinoma (SCC) and 329 cases of MM. The adjusted IRRs per 100 Bq/m3 increase in residential radon levels for BCC, SCC and MM were 1.14 (95% CI: 1.03, 1.27), 0.90 (95% CI: 0.70, 1.37) and 1.08 (95% CI: 0.77, 1.50), respectively. The association between radon exposure and BCC was stronger among those with higher socio-economic status and those living in apartments at enrollment. Conclusion and Impact Long-term residential radon exposure may contribute to development of basal cell carcinoma of the skin. We cannot exclude confounding from sunlight and cannot conclude on causality, as the relationship was stronger amongst persons living in apartments and non-existent amongst those living in single detached homes.
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Affiliation(s)
- Elvira Vaclavik Bräuner
- Research Center of Prevention and Heath, Center of Health, Capital region of Denmark, Glostrup Hospital, Glostrup, Denmark
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
- * E-mail:
| | - Steffen Loft
- Department Public Health, Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Claus Erik Andersen
- Center for Nuclear Technologies, Technical University of Denmark, Roskilde, Denmark
| | - Kaare Ulbak
- National Institute of Radiation Protection, Herlev, Denmark
| | - Ole Hertel
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Pedersen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Susanne Krüger Kjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
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Bräuner EV, Nordsborg RB, Andersen ZJ, Tjønneland A, Loft S, Raaschou-Nielsen O. Long-term exposure to low-level arsenic in drinking water and diabetes incidence: a prospective study of the diet, cancer and health cohort. Environ Health Perspect 2014; 122:1059-65. [PMID: 24927198 PMCID: PMC4181933 DOI: 10.1289/ehp.1408198] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/11/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Established causes of diabetes do not fully explain the present epidemic. High-level arsenic exposure has been implicated in diabetes risk, but the effect of low-level arsenic exposure in drinking water remains unclear. OBJECTIVE We sought to determine whether long-term exposure to low-level arsenic in drinking water in Denmark is associated with an increased risk of diabetes using a large prospective cohort. METHODS During 1993-1997, we recruited 57,053 persons. We followed each cohort member for diabetes occurrence from enrollment until 31 December 2006. We traced and geocoded residential addresses of the cohort members and used a geographic information system to link addresses with water-supply areas. We estimated individual exposure to arsenic using all addresses from 1 January 1971 until the censoring date. Cox proportional hazards models were used to model the association between arsenic exposure and diabetes incidence, separately for two definitions of diabetes: all cases and a more strict definition in which cases of diabetes based solely on blood glucose results were excluded. RESULTS Over a mean follow-up period of 9.7 years for 52,931 eligible participants, there were a total of 4,304 (8.1%) diabetes cases, and 3,035 (5.8%) cases of diabetes based on the more strict definition. The adjusted incidence rate ratios (IRRs) per 1-μg/L increment in arsenic levels in drinking water were as follows: IRR = 1.03 (95% CI: 1.01, 1.06) and IRR = 1.02 (95% CI: 0.99, 1.05) for all and strict diabetes cases, respectively. CONCLUSIONS Long-term exposure to low-level arsenic in drinking water may contribute to the development of diabetes.
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Bräuner EV, Rasmussen TV, Gunnarsen L. Variation in residential radon levels in new Danish homes. Indoor Air 2013; 23:311-317. [PMID: 23210617 DOI: 10.1111/ina.12021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 08/27/2012] [Accepted: 11/23/2012] [Indexed: 06/01/2023]
Abstract
Radon-222 gas arises from the radioactive decay of radium-226 and has a half-life of 3.8 days. This gas percolates up through soil into buildings, and if it is not evacuated, there can be much higher exposure levels indoors than outdoors, which is where human exposure occurs. Radon exposure is classified as a human carcinogen, and new Danish homes must be constructed to ensure indoor radon levels below 100 Bq/m(3). Our purpose was to assess how well 200 newly constructed single detached homes perform according to building regulations pertaining to radon and identify the association between indoor radon in these homes and municipality, home age, floor area, floor level, basement, and outer wall and roof construction. Median (5-95 percentile) indoor radon levels were 36.8 (9.0-118) Bq/m(3) , but indoor radon exceeded 100 Bq/m(3) in 14 of these new homes. The investigated variables explained nine percent of the variation in indoor radon levels, and although associations were positive, none of these were statistically significant. In this study, radon levels were generally low, but we found that 14 (7%) of the 200 new homes had indoor radon levels over 100 Bq/m(3). More work is needed to determine the determinants of indoor radon.
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Affiliation(s)
- E V Bräuner
- Danish Building Research Institute, Aalborg University, Copenhagen, Denmark.
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28
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Bräuner EV, Sørensen M, Gaudreau E, LeBlanc A, Eriksen KT, Tjønneland A, Overvad K, Raaschou-Nielsen O. A prospective study of organochlorines in adipose tissue and risk of non‑Hodgkin lymphoma. Environ Health Perspect 2012; 120:105-11. [PMID: 22328999 PMCID: PMC3261942 DOI: 10.1289/ehp.1103573] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [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: 02/14/2011] [Accepted: 08/26/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND Exposure to organochlorines has been examined as a potential risk factor for non-Hodgkin lymphoma (NHL), with inconsistent results that may be related to limited statistical power or to imprecise exposure measurements. OBJECTIVE Our purpose was to examine associations between organochlorine concentrations in prediagnostic adipose tissue samples and the risk of NHL. METHODS We conducted a case–cohort study using a prospective Danish cohort of 57,053 persons enrolled between 1993 and 1997. Within the cohort we identified 256 persons diagnosed with NHL in the population-based nationwide Danish Cancer Registry and randomly selected 256 subcohort persons. We measured concentrations of 8 pesticides and 10 polychlorinated biphenyl (PCB) congeners in adipose tissue collected upon enrollment. Associations between the 18 organochlorines and NHL were analyzed in Cox regression models, adjusting for body mass index. RESULTS Incidence rate ratios and confidence intervals (CIs) for interquartile range increases in concentrations of dichlorodiphenyltrichlorethane (DDT), cis-nonachlor, and oxychlordane were 1.35 (95% CI: 1.10, 1.66), 1.13 (95% CI: 0.94, 1.36), and 1.11 (95% CI: 0.89, 1.38), respectively, with monotonic dose–response trends for DDT and cis-nonachlor based on categorical models. The relative risk estimates were higher for men than for women. In contrast, no clear association was found between NHL and PCBs. CONCLUSION We found a higher risk of NHL in association with higher adipose tissue levels of DDT, cis-nonachlor, and oxychlordane, but no association with PCBs. This is the first study of organochlorines and NHL using prediagnostic adipose tissue samples in the exposure assessment and provides new environmental health evidence that these organochlorines contribute to NHL risk.
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Löndahl J, Massling A, Swietlicki E, Bräuner EV, Ketzel M, Pagels J, Loft S. Experimentally determined human respiratory tract deposition of airborne particles at a busy street. Environ Sci Technol 2009; 43:4659-4664. [PMID: 19673248 DOI: 10.1021/es803029b] [Citation(s) in RCA: 37] [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] [Indexed: 05/26/2023]
Abstract
Traffic is one of the major sources of harmful airborne particles worldwide. To relate exposure to adverse health effects it is important to determine the deposition probability of the inhaled particles in the human respiratory tract. The size-dependent deposition of 12-580 nm particles was measured with a novel setup in 9 healthy subjects breathing by mouth on the windward side of a busy street in Copenhagen, Denmark. The aerosol was characterized both at the curbside and, to obtain the background concentration, at rooftop level. Particle hygroscopicity, a key parameter affecting respiratory tract deposition, was also measured at the same time of exposure. The total deposition fraction of the curbside particles in the range 12-580 nm was 0.60 by number, 0.29 by surface area, and 0.23 by mass. The deposition fractions of the "traffic exhaust" contribution, calculated as the hydrophobic fraction of the curbside particles, was 0.68, 0.35, and 0.28 by number, surface area, and mass, respectively. The deposited amount of traffic exhaust particles was 16 times higher by number and 3 times higher by surface area compared to the deposition of residential biofuel combustion particles investigated previously (equal inhaled mass concentrations). This was because the traffic exhaust particles had both a higher deposition probability and a higher number and surface area concentration per unit mass. To validate the results, the respiratory tract deposition was estimated by using the well-established ICRP model. Predictions were in agreement with experimental results when the effects of particle hygroscopicity were considered in the model.
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Affiliation(s)
- Jakob Löndahl
- Division of Nuclear Physics, Department of Physics, Lund University, PO Box 118, SE-221 00 Lund, Sweden.
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Bräuner EV, Mortensen J, Møller P, Bernard A, Vinzents P, Wåhlin P, Glasius M, Loft S. Effects of Ambient Air Particulate Exposure on Blood–Gas Barrier Permeability and Lung Function. Inhal Toxicol 2009; 21:38-47. [DOI: 10.1080/08958370802304735] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Danielsen PH, Bräuner EV, Barregard L, Sällsten G, Wallin M, Olinski R, Rozalski R, Møller P, Loft S. Oxidatively damaged DNA and its repair after experimental exposure to wood smoke in healthy humans. Mutat Res 2008; 642:37-42. [PMID: 18495177 DOI: 10.1016/j.mrfmmm.2008.04.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [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: 10/16/2007] [Revised: 03/28/2008] [Accepted: 04/04/2008] [Indexed: 05/22/2023]
Abstract
Particulate matter from wood smoke may cause health effects through generation of oxidative stress with resulting damage to DNA. We investigated oxidatively damaged DNA and related repair capacity in peripheral blood mononuclear cells (PBMC) and measured the urinary excretion of repair products after controlled short-term exposure of human volunteers to wood smoke. Thirteen healthy adults were exposed first to clean air and then to wood smoke in a chamber during 4h sessions, 1 week apart. Blood samples were taken 3h after exposure and on the following morning, and urine was collected after exposure, from bedtime until the next morning. We measured the levels of DNA strand breaks (SB), oxidized purines as formamidopyrimidine-DNA-glycosylase (FPG) sites and activity of oxoguanine glycosylase 1 (hOGG1) in PBMC by the comet assay, whereas mRNA levels of hOGG1, nucleoside diphosphate linked moiety X-type motif 1 (hNUDT1) and heme oxygenase 1 (hHO1) were determined by real-time RT-PCR. The excretion of 8-oxo-7,8-dihydro-oxoguanine (8-oxoGua) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) in urine was measured by high performance liquid chromatography purification followed by gas chromatography with mass spectrometry. The morning following exposure to wood smoke the PBMC levels of SB were significantly decreased and the mRNA levels of hOGG1 significantly increased. FPG sites, hOGG1 activity, expression of hNUDT1 and hHO1, urinary excretion of 8-oxodG and 8-oxoGua did not change significantly. Our findings support that exposure to wood smoke causes systemic effects, although we could not demonstrate genotoxic effects, possibly explained by enhanced repair and timing of sampling.
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Møller P, Folkmann JK, Forchhammer L, Bräuner EV, Danielsen PH, Risom L, Loft S. Air pollution, oxidative damage to DNA, and carcinogenesis. Cancer Lett 2008; 266:84-97. [PMID: 18367322 DOI: 10.1016/j.canlet.2008.02.030] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 01/31/2008] [Accepted: 02/11/2008] [Indexed: 11/26/2022]
Abstract
There is growing concern that air pollution exposure increases the risk of lung cancer. The mechanism of action is related to particle-induced oxidative stress and oxidation of DNA. Humans exposed to urban air with vehicle emissions have elevated levels of oxidized guanine bases in blood cells and urine. Animal experimental studies show that pulmonary and gastrointestinal exposure is associated with elevated levels of oxidized guanines in the lung and other organs. Collectively, there is evidence indicating that exposure to traffic-related air pollution particles is associated with oxidative damage to DNA and this might be associated with increased risk of cancer.
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Affiliation(s)
- Peter Møller
- Institute of Public Health, Department of Occupational and Environmental Health, University of Copenhagen, Oster Farimagsgade 5, Build 5, 2nd Floor, P.O. 2099, DK-1014 Copenhagen K, Denmark.
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Bräuner EV, Forchhammer L, Møller P, Barregard L, Gunnarsen L, Afshari A, Wåhlin P, Glasius M, Dragsted LO, Basu S, Raaschou-Nielsen O, Loft S. Indoor particles affect vascular function in the aged: an air filtration-based intervention study. Am J Respir Crit Care Med 2007; 177:419-25. [PMID: 17932377 DOI: 10.1164/rccm.200704-632oc] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Exposure to particulate matter is associated with risk of cardiovascular events, possibly through endothelial dysfunction, and indoor air may be most important. OBJECTIVES We investigated effects of controlled exposure to indoor air particles on microvascular function (MVF) as the primary endpoint and biomarkers of inflammation and oxidative stress as secondary endpoints in a healthy elderly population. METHODS A total of 21 nonsmoking couples participated in a randomized, double-blind, crossover study with two consecutive 48-hour exposures to either particle-filtered or nonfiltered air (2,533-4,058 and 7,718-12,988 particles/cm(3), respectively) in their homes. MEASUREMENTS AND MAIN RESULTS MVF was assessed noninvasively by measuring digital peripheral artery tone after arm ischemia. Secondary endpoints included hemoglobin, red blood cells, platelet count, coagulation factors, P-selectin, plasma amyloid A, C-reactive protein, fibrinogen, IL-6, tumor necrosis factor-alpha, protein oxidation measured as 2-aminoadipic semialdehyde in plasma, urinary 8-iso-prostaglandin F(2alpha), and blood pressure. Indoor air filtration significantly improved MVF by 8.1% (95% confidence interval, 0.4-16.3%), and the particulate matter (diameter < 2.5 mum) mass of the indoor particles was more important than the total number concentration (10-700 nm) for these effects. MVF was significantly associated with personal exposure to iron, potassium, copper, zinc, arsenic, and lead in the fine fraction. After Bonferroni correction, none of the secondary biomarkers changed significantly. CONCLUSIONS Reduction of particle exposure by filtration of recirculated indoor air for only 48 hours improved MVF in healthy elderly citizens, suggesting that this may be a feasible way of reducing the risk of cardiovascular disease.
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Affiliation(s)
- Elvira Vaclavik Bräuner
- D. Institute of Public Health, Department of Environmental and Occupational Health, Øster Farimagsgade 5A, DK-1014 Copenhagen K, Denmark
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Bräuner EV, Forchhammer L, Møller P, Simonsen J, Glasius M, Wåhlin P, Raaschou-Nielsen O, Loft S. Exposure to ultrafine particles from ambient air and oxidative stress-induced DNA damage. Environ Health Perspect 2007; 115:1177-82. [PMID: 17687444 PMCID: PMC1940068 DOI: 10.1289/ehp.9984] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [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: 12/13/2006] [Accepted: 04/27/2007] [Indexed: 05/04/2023]
Abstract
BACKGROUND Particulate matter, especially ultrafine particles (UFPs), may cause health effects through generation of oxidative stress, with resulting damage to DNA and other macromolecules. OBJECTIVE We investigated oxidative damage to DNA and related repair capacity in peripheral blood mononuclear cells (PBMCs) during controlled exposure to urban air particles with assignment of number concentration (NC) to four size modes with average diameters of 12, 23, 57, and 212 nm. DESIGN Twenty-nine healthy adults participated in a randomized, two-factor cross-over study with or without biking exercise for 180 min and with exposure to particles (NC 6169-15362/cm(3)) or filtered air (NC 91-542/cm(3)) for 24 hr. METHODS The levels of DNA strand breaks (SBs), oxidized purines as formamidopyrimidine DNA glycolase (FPG) sites, and activity of 7,8-dihydro-8-oxoguanine-DNA glycosylase (OGG1) in PBMCs were measured by the Comet assay. mRNA levels of OGG1, nucleoside diphosphate linked moiety X-type motif 1 (NUDT1), and heme oxygenase-1 (HO1) were determined by real-time reverse transcriptase-polymerase chain reaction. RESULTS Exposure to UFPs for 6 and 24 hr significantly increased the levels of SBs and FPG sites, with a further insignificant increase after physical exercise. The OGG1 activity and expression of OGG1, NUDT1, and HO1 were unaltered. There was a significant dose-response relationship between NC and DNA damage, with the 57-nm mode as the major contributor to effects. Concomitant exposure to ozone, nitrogen oxides, and carbon monoxide had no influence. CONCLUSION Our results indicate that UFPs, especially the 57-nm soot fraction from vehicle emissions, causes systemic oxidative stress with damage to DNA and no apparent compensatory up-regulation of DNA repair within 24 hr.
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Affiliation(s)
- Elvira Vaclavik Bräuner
- Institute of Public Health, Department of Environmental and Occupational Health, University of Copenhagen, Copenhagen, Denmark
| | - Lykke Forchhammer
- Institute of Public Health, Department of Environmental and Occupational Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Møller
- Institute of Public Health, Department of Environmental and Occupational Health, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Simonsen
- Institute of Public Health, Department of Environmental and Occupational Health, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Glasius
- Department of Atmospheric Environment, National Environmental Research Institute, Roskilde, Denmark
| | - Peter Wåhlin
- Department of Atmospheric Environment, National Environmental Research Institute, Roskilde, Denmark
| | | | - Steffen Loft
- Institute of Public Health, Department of Environmental and Occupational Health, University of Copenhagen, Copenhagen, Denmark
- Address correspondence to S. Loft, Department of Environmental and Occupational Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Telephone: 45 3532 7649. Fax: 45 3525 7686. E-mail:
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