1
|
Oluyemi K, Rechtman E, Invernizzi A, Gennings C, Renzetti S, Patrono A, Cagna G, Reichenberg A, Smith DR, Lucchini RG, Wright RO, Placidi D, Horton MK. Sex-specific associations between co-exposure to multiple metals and externalizing symptoms in adolescence and young adulthood. Environ Res 2024; 250:118443. [PMID: 38365053 DOI: 10.1016/j.envres.2024.118443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
Externalizing disorders, such as attention-deficit/hyperactivity disorder (ADHD), account for the majority of the child/adolescent referrals to mental health services and increase risk for later-life psychopathology. Although the expression of externalizing disorders is more common among males, few studies have addressed how sex modifies associations between metal exposure and adolescent externalizing symptoms. This study aimed to examine sex-specific associations between co-exposure to multiple metals and externalizing symptoms in adolescence and young adulthood. Among 150 adolescents and young adults (55% female, ages: 15-25 years) enrolled in the Public Health Impact of Metals Exposure (PHIME) study in Brescia, Italy, we measured five metals (manganese (Mn), lead (Pb), copper (Cu), chromium (Cr), nickel (Ni)) in four biological matrices (blood, urine, hair, and saliva). Externalizing symptoms were assessed using the Achenbach System of Empirically Based Assessment (ASEBA) Youth Self-Report (YSR) or Adult Self Report (ASR). Using generalized weighted quantile sum (WQS) regression, we investigated the moderating effect of sex (i.e., assigned at birth) on associations between the joint effect of exposure to the metal mixture and externalizing symptoms, adjusting for age and socioeconomic status. We observed that metal mixture exposure was differentially associated with aggressive behavior in males compared to females (β = -0.058, 95% CI [-0.126, -0.009]). In males, exposure was significantly associated with more externalizing problems, and aggressive and intrusive behaviors, driven by Pb, Cu and Cr. In females, exposure was not significantly associated with any externalizing symptoms. These findings suggest that the effect of metal exposure on externalizing symptoms differs in magnitude between the sexes, with males being more vulnerable to increased externalizing symptoms following metal exposure. Furthermore, our findings support the hypothesis that sex-specific vulnerabilities to mixed metal exposure during adolescence/young adulthood may play a role in sex disparities observed in mental health disorders, particularly those characterized by externalizing symptoms.
Collapse
Affiliation(s)
- Kristie Oluyemi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience Icahn School of Medicine at Mount Sinai, New York NY, USA; The Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alessandra Patrono
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, Robert Stempel School of Public Health, Florida International University, Miami, FL, USA; Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
2
|
Friedman A, Schildroth S, Bauer JA, Coull BA, Smith DR, Placidi D, Cagna G, Krengel MH, Tripodis Y, White RF, Lucchini RG, Wright RO, Horton M, Austin C, Arora M, Claus Henn B. Early-life manganese exposure during multiple developmental periods and adolescent verbal learning and memory. Neurotoxicol Teratol 2023; 100:107307. [PMID: 37832858 PMCID: PMC10834060 DOI: 10.1016/j.ntt.2023.107307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/08/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Manganese (Mn) is both an essential and toxic metal, and associations with neurodevelopment depend on exposure timing. Prospective data examining early life Mn with adolescent cognition are sparse. METHODS We enrolled 140 Italian adolescents (10-14 years old) from the Public Health Impact of Metals Exposure study. Mn in deciduous teeth was measured using laser ablation-mass spectrometry to represent prenatal, postnatal and early childhood exposure. The California Verbal Learning Test for Children (CVLT-C) was administered to assess adolescent verbal learning and memory. Multivariable regression models estimated changes in CVLT-C scores and the odds of making an error per doubling in dentine Mn in each exposure period. Multiple informant models tested for differences in associations across exposure periods. RESULTS A doubling in prenatal dentine Mn levels was associated with lower odds of making an intrusion error (OR = 0.23 [95% CI: 0.09, 0.61]). This beneficial association was not observed in other exposure periods. A doubling in childhood Mn was beneficially associated with short delay free recall: (ß = 0.47 [95% CI: -0.02, 0.97]), which was stronger in males (ß = 0.94 [95% CI: 0.05, 1.82]). Associations were null in the postnatal period. CONCLUSION Exposure timing is critical for understanding Mn-associated changes in cognitive function.
Collapse
Affiliation(s)
- Alexa Friedman
- Department of Environmental Health, Boston University School of Public Health, Boston, USA.
| | - Samantha Schildroth
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
| | - Julia A Bauer
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Darmouth, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H Chan School of Public Health, Boston, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maxine H Krengel
- Department of Neurology, Boston University School of Medicine, Boston, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, USA
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Boston, USA; Department of Neurology, Boston University School of Medicine, Boston, USA
| | - Roberto G Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy; Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
| |
Collapse
|
3
|
Invernizzi A, Renzetti S, van Thriel C, Rechtman E, Patrono A, Ambrosi C, Mascaro L, Cagna G, Gasparotti R, Reichenberg A, Tang CY, Lucchini RG, Wright RO, Placidi D, Horton MK. Covid-19 related cognitive, structural and functional brain changes among Italian adolescents and young adults: a multimodal longitudinal case-control study. medRxiv 2023:2023.07.19.23292909. [PMID: 37503251 PMCID: PMC10371098 DOI: 10.1101/2023.07.19.23292909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has been associated with brain functional, structural, and cognitive changes that persist months after infection. Most studies of the neurologic outcomes related to COVID-19 focus on severe infection and aging populations. Here, we investigated the neural activities underlying COVID-19 related outcomes in a case-control study of mildly infected youth enrolled in a longitudinal study in Lombardy, Italy, a global hotspot of COVID-19. All participants (13 cases, 27 controls, mean age 24 years) completed resting state functional (fMRI), structural MRI, cognitive assessments (CANTAB spatial working memory) at baseline (pre-COVID) and follow-up (post-COVID). Using graph theory eigenvector centrality (EC) and data-driven statistical methods, we examined differences in ECdelta (i.e., the difference in EC values pre- and post-COVID-19) and volumetricdelta (i.e., the difference in cortical volume of cortical and subcortical areas pre- and post-COVID) between COVID-19 cases and controls. We found that ECdeltasignificantly between COVID-19 and healthy participants in five brain regions; right intracalcarine cortex, right lingual gyrus, left hippocampus, left amygdala, left frontal orbital cortex. The left hippocampus showed a significant decrease in volumetricdelta between groups (p=0.041). The reduced ECdelta in the right amygdala associated with COVID-19 status mediated the association between COVID-19 and disrupted spatial working memory. Our results show persistent structural, functional and cognitive brain changes in key brain areas associated with olfaction and cognition. These results may guide treatment efforts to assess the longevity, reversibility and impact of the observed brain and cognitive changes following COVID-19.
Collapse
Affiliation(s)
- Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Patrono
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Claudia Ambrosi
- Department of Neuroscience, Neuroradiology Unit, ASST Cremona
| | | | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Cheuk Y Tang
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Roberto G Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
4
|
Rechtman E, Navarro E, de Water E, Tang CY, Curtin P, Papazaharias DM, Ambrosi C, Mascaro L, Cagna G, Gasparotti R, Invernizzi A, Reichenberg A, Austin C, Arora M, Smith DR, Lucchini RG, Wright RO, Placidi D, Horton MK. Early-Life Critical Windows of Susceptibility to Manganese Exposure and Sex-Specific Changes in Brain Connectivity in Late Adolescence. Biol Psychiatry Glob Open Sci 2023; 3:460-469. [PMID: 37519473 PMCID: PMC10382697 DOI: 10.1016/j.bpsgos.2022.03.016] [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] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background Early-life environmental exposures during critical windows (CWs) of development can impact life course health. Exposure to neuroactive metals such as manganese (Mn) during prenatal and early postnatal CWs may disrupt typical brain development, leading to persistent behavioral changes. Males and females may be differentially vulnerable to Mn, presenting distinctive CWs to Mn exposure. Methods We used magnetic resonance imaging to investigate sex-specific associations between early-life Mn uptake and intrinsic functional connectivity in adolescence. A total of 71 participants (15-23 years old; 53% female) from the Public Health Impact of Manganese Exposure study completed a resting-state functional magnetic resonance imaging scan. We estimated dentine Mn concentrations at prenatal, postnatal, and early childhood periods using laser ablation-inductively coupled plasma-mass spectrometry. We performed seed-based correlation analyses to investigate the moderating effect of sex on the associations between Mn and intrinsic functional connectivity adjusting for age and socioeconomic status. Results We identified significant sex-specific associations between dentine Mn at all time points and intrinsic functional connectivity in brain regions involved in cognitive and motor function: 1) prenatal: dorsal striatum, occipital/frontal lobes, and middle frontal gyrus; 2) postnatal: right putamen and cerebellum; and 3) early childhood: putamen and occipital, frontal, and temporal lobes. Network associations differed depending on exposure timing, suggesting that different brain networks may present distinctive CWs to Mn. Conclusions These findings suggest that the developing brain is vulnerable to Mn exposure, with effects lasting through late adolescence, and that females and males are not equally vulnerable to these effects. Future studies should investigate cognitive and motor outcomes related to these associations.
Collapse
Affiliation(s)
- Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Esmeralda Navarro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Erik de Water
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota
| | - Cheuk Y. Tang
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Demetrios M. Papazaharias
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Claudia Ambrosi
- ASST Spedali Civili Hospital, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Lorella Mascaro
- ASST Spedali Civili Hospital, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Abraham Reichenberg
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Donald R. Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, California
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Megan K. Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| |
Collapse
|
5
|
Schildroth S, Friedman A, White RF, Kordas K, Placidi D, Bauer JA, Webster TF, Coull BA, Cagna G, Wright RO, Smith D, Lucchini RG, Horton M, Claus Henn B. Associations of an industry-relevant metal mixture with verbal learning and memory in Italian adolescents: The modifying role of iron status. Environ Res 2023; 224:115457. [PMID: 36773645 PMCID: PMC10117691 DOI: 10.1016/j.envres.2023.115457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/30/2023] [Accepted: 02/08/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Biomarker concentrations of metals are associated with neurodevelopment, and these associations may be modified by nutritional status (e.g., iron deficiency). No prior study on associations of metal mixtures with neurodevelopment has assessed effect modification by iron status. OBJECTIVES We aimed to quantify associations of an industry-relevant metal mixture with verbal learning and memory among adolescents, and to investigate the modifying role of iron status on those associations. METHODS We used cross-sectional data from 383 Italian adolescents (10-14 years) living in proximity to ferroalloy industry. Verbal learning and memory was assessed using the California Verbal Learning Test for Children (CVLT-C), and metals were quantified in hair (manganese, copper, chromium) or blood (lead) using inductively coupled plasma mass spectrometry. Serum ferritin, a proxy for iron status, was measured using immunoassays. Covariate-adjusted associations of the metal mixture with CVLT subtests were estimated using Bayesian Kernel Machine Regression, and modification of the mixture associations by ferritin was examined. RESULTS Compared to the 50th percentile of the metal mixture, the 90th percentile was associated with a 0.12 standard deviation [SD] (95% CI = -0.27, 0.50), 0.16 SD (95% CI = -0.11, 0.44), and 0.11 SD (95% CI = -0.20, 0.43) increase in the number of words recalled for trial 5, long delay free, and long delay cued recall, respectively. For an increase from its 25th to 75th percentiles, copper was beneficially associated the recall trials when other metals were fixed at their 50th percentiles (for example, trial 5 recall: β = 0.31, 95% CI = 0.14, 0.48). The association between copper and trial 5 recall was stronger at the 75th percentile of ferritin, compared to the 25th or 50th percentiles. CONCLUSIONS In this metal mixture, copper was beneficially associated with neurodevelopment, which was more apparent at higher ferritin concentrations. These findings suggest that metal associations with neurodevelopment may depend on iron status, which has important public health implications.
Collapse
Affiliation(s)
- Samantha Schildroth
- Department of Environmental Health, Boston University School of Public Health, Boston MA, USA.
| | - Alexa Friedman
- Department of Environmental Health, Boston University School of Public Health, Boston MA, USA
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Boston MA, USA; Department of Neurology, Boston University, Boston MA, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Donatella Placidi
- Department of Occupational Health, University of Brescia, Brescia, Italy
| | - Julia A Bauer
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Thomas F Webster
- Department of Environmental Health, Boston University School of Public Health, Boston MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston MA, USA
| | - Giuseppa Cagna
- Department of Occupational Health, University of Brescia, Brescia, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Donald Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz CA, USA
| | - Roberto G Lucchini
- Department of Occupational Health, University of Brescia, Brescia, Italy; Department of Environmental Health Sciences, Florida International University, Miami FL, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston MA, USA
| |
Collapse
|
6
|
Invernizzi A, Rechtman E, Oluyemi K, Renzetti S, Curtin P, Colicino E, Ambrosi C, Mascaro L, Patrono A, Corbo D, Cagna G, Gasparotti R, Reichenberg A, Tang CY, Smith DR, Placidi D, Lucchini RG, Wright RO, Horton MK. Topological network properties of resting-state functional connectivity patterns are associated with metal mixture exposure in adolescents. Front Neurosci 2023; 17:1098441. [PMID: 36814793 PMCID: PMC9939635 DOI: 10.3389/fnins.2023.1098441] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Adolescent exposure to neurotoxic metals adversely impacts cognitive, motor, and behavioral development. Few studies have addressed the underlying brain mechanisms of these metal-associated developmental outcomes. Furthermore, metal exposure occurs as a mixture, yet previous studies most often consider impacts of each metal individually. In this cross-sectional study, we investigated the relationship between exposure to neurotoxic metals and topological brain metrics in adolescents. Methods In 193 participants (53% females, ages: 15-25 years) enrolled in the Public Health Impact of Metals Exposure (PHIME) study, we measured concentrations of four metals (manganese, lead, copper, and chromium) in multiple biological media (blood, urine, hair, and saliva) and acquired resting-state functional magnetic resonance imaging scans. Using graph theory metrics, we computed global and local efficiency (global:GE; local:LE) in 111 brain areas (Harvard Oxford Atlas). We used weighted quantile sum (WQS) regression models to examine association between metal mixtures and each graph metric (GE or LE), adjusted for sex and age. Results We observed significant negative associations between the metal mixture and GE and LE [βGE = -0.076, 95% CI (-0.122, -0.031); βLE= -0.051, 95% CI (-0.095, -0.006)]. Lead and chromium measured in blood contributed most to this association for GE, while chromium measured in hair contributed the most for LE. Discussion Our results suggest that exposure to this metal mixture during adolescence reduces the efficiency of integrating information in brain networks at both local and global levels, informing potential neural mechanisms underlying the developmental toxicity of metals. Results further suggest these associations are due to combined joint effects to different metals, rather than to a single metal.
Collapse
Affiliation(s)
- Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kristie Oluyemi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- The Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | | | - Alessandra Patrono
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Daniele Corbo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Cheuk Y. Tang
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Donald R. Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, CA, United States
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Roberto G. Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Health Sciences, Robert Stempel School of Public Health, Florida International University, Miami, FL, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Megan K. Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| |
Collapse
|
7
|
Patrono A, Invernizzi A, Placidi D, Cagna G, Calza S, Oppini M, Rechtman E, Papazaharias DM, Reichenberg A, Lucchini RG, Memo M, Ongaro E, Rota M, Wright RO, Renzetti S, Horton MK. Impact of COVID-19-Related Social Isolation on Behavioral Outcomes in Young Adults Residing in Northern Italy. Int J Environ Res Public Health 2022; 19:16496. [PMID: 36554375 PMCID: PMC9779507 DOI: 10.3390/ijerph192416496] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Social isolation affects our emotions, behavior and interactions. Worldwide, individuals experienced prolonged periods of isolation during the first wave of the COVID-19 pandemic when authorities-imposed restrictions to reduce the spread of the virus. In this study, we investigated the effects of social isolation on emotional and behavioral outcomes in young adults from Lombardy, Italy, a global hotspot of COVID-19. We leveraged baseline (pre-social isolation) and follow-up (mid- or post-isolation) data collected from young adults enrolled in the ongoing, longitudinal Public Health Impact of Metals Exposure (PHIME) study. At baseline, 167 participants completed the ASEBA questionnaires (ASR/YSR) by web link or in person; 65 completed the ASR 12-18 weeks after the onset of restrictions. Using the sign test and multiple linear regression models, we examined differences in ASR scores between baseline and follow-up adjusting for sex, age, pre-pandemic IQ and time with social restrictions (weeks). Further, we examined interactions between sex and time in social isolation. Participants completed the ASR after spending an average of 14 weeks in social isolation (range 12-18 weeks). Thought problems increased between baseline and follow-up (median difference 1.0; 1st, 3rd quartile: -1.0, 4.0; p = 0.049). Among males, a longer time in social isolation (≥14 weeks) was associated with increased rule-breaking behaviors of 2.8 points. These results suggest the social isolation related to COVID-19 adversely impacted mental health. In particular, males seem to externalize their condition. These findings might help future interventions and treatment to minimize the consequences of social isolation experience in young adults.
Collapse
Affiliation(s)
- Alessandra Patrono
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
| | - Manuela Oppini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Demetrios M. Papazaharias
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Roberto G. Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
| | - Maurizio Memo
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
| | - Elisa Ongaro
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Megan K. Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| |
Collapse
|
8
|
Renzetti S, Schito M, Borgese L, Cirelli P, Cagna G, Patrono A, Peli M, Ranzi R, Lucchini RG, Placidi D. Indoor metals pollution and metabolic outcomes among Italian children. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Through this study, we aimed to test the association between the exposure to metals measured in indoor dust and metabolic outcomes among children living in areas with environmental exposure to metals.
Methods
The project “Health impacts of environmental exposure to airborne pollutants in the sites of Brescia and Taranto, Italy: increase knowledge to address preventive intervention of local and global relevance” (ISEIA) enrolled 130 children aged 6 to 13 years (51.5% females) resident from pregnancy in highly industrialized areas of the Brescia province, Northern Italy. Metabolic outcomes including BMI, fasting blood glucose and blood creatinine were measured. The concentration of a mixture of 10 metals in indoor dust was determined through an X-ray fluorescence portable analyzer (p-XRF). Linear regressions and Weighted Quantile Sum (WQS) regression were applied to test for the association between metal exposure and metabolic outcomes. All models were adjusted for age, gender, socio-economic status and area of residence.
Results
A significant association was observed between Cd and blood creatinine (β = 0.01; 95%CI=0.001, 0.02; p-value=0.028) when considering each individual metal separately in the model. WQS regression showed a positive significant association between the mixture of metals and fasting glucose (β = 0.87; 95%CI 0.14, 1.61; p-value=0.023) identifying Mn, Cr and Cu as the elements with the higher weights, while a marginally significant association was found between the metal mixture and blood creatinine (β = 0.01; 95%CI=-0.001, 0.02; p-value=0.075) where Cd and Ti showed the highest weight.
Conclusions
We assessed the potential association between exposure to metals in indoor household dust and blood glucose and creatinine. Our results contribute to clarifying the role of metal exposure in the burden of non-communicable diseases although further studies are needed to better understand the relationship between metal exposure and metabolism.
Key messages
• The metal mixture in indoor household dust is associated with an increase in fasting glucose.
• Cd concentration in indoor household dust is associated with an increase in blood creatinine.
Collapse
Affiliation(s)
- S Renzetti
- Università degli Studi di Brescia , Brescia, Italy
| | - M Schito
- Università degli Studi di Brescia , Brescia, Italy
| | - L Borgese
- Università degli Studi di Brescia , Brescia, Italy
| | - P Cirelli
- Università degli Studi di Brescia , Brescia, Italy
| | - G Cagna
- Università degli Studi di Brescia , Brescia, Italy
| | - A Patrono
- Università degli Studi di Brescia , Brescia, Italy
| | - M Peli
- Università degli Studi di Brescia , Brescia, Italy
| | - R Ranzi
- Università degli Studi di Brescia , Brescia, Italy
| | - RG Lucchini
- Università degli Studi di Brescia , Brescia, Italy
- Florida International University , Miami, USA
| | - D Placidi
- Università degli Studi di Brescia , Brescia, Italy
| |
Collapse
|
9
|
Patrono A, Renzetti S, Manco A, Brunelli P, Moncada SM, Macgowan MJ, Placidi D, Calza S, Cagna G, Rota M, Memo M, Tira M, Lucchini RG. COVID-19 Aftermath: Exploring the Mental Health Emergency among Students at a Northern Italian University. IJERPH 2022; 19:ijerph19148587. [PMID: 35886439 PMCID: PMC9318913 DOI: 10.3390/ijerph19148587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 12/04/2022]
Abstract
In this study, we investigated the symptoms of physical and mental health associated with lifestyle changes due to a lockdown among the students of a university in Northern Italy, one of the most affected areas in Europe during the first wave of COVID-19. We examined the psychopathological variations in relation to mental health problems in a young population. The goal was to develop interventions to resolve these new psychosocial problems. From June to July 2020, students participated in an anonymous survey asking about habits and symptoms that emerged during the lockdown and the COVID-19 pandemic. Five health outcomes were assessed: digestive disorders; headaches; fear of COVID-19; panic and anxiety crises; and depression/sadness. The conditions and duration of the social isolation, lifestyle, SARS-CoV-2 infection in the household, financial situation, and productivity were considered in the analysis. A total of 3533 students completed the survey. The participants experienced headaches, depression and sadness, digestive disorders, a fear of COVID-19, and anxiety/panic crises. The duration of isolation was associated with an increased risk of digestive disorders, headaches, and COVID-19 fear. The female gender, medium–intense telephone usage, sleep quality, memory difficulties, and performance reduction were associated with an increased risk of the health outcomes. Future interventions should focus on promoting and implementing different habits with the support of health and university organizations.
Collapse
Affiliation(s)
- Alessandra Patrono
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (S.C.); (M.R.); (M.M.)
- Correspondence:
| | - Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
| | - Angela Manco
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
| | - Paola Brunelli
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
| | - Stefanny M. Moncada
- Departamento de Gobierno, Universidad del Desarrollo, Santiago 7590000, Chile;
| | - Mark J. Macgowan
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA;
| | - Donatella Placidi
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (S.C.); (M.R.); (M.M.)
| | - Giuseppa Cagna
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (S.C.); (M.R.); (M.M.)
| | - Maurizio Memo
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (S.C.); (M.R.); (M.M.)
| | - Maurizio Tira
- Department of Civil, Environmental, Architectural Engineering and Mathematics (DICATAM), University of Brescia, 25121 Brescia, Italy;
| | - Roberto G. Lucchini
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (S.R.); (A.M.); (P.B.); (D.P.); (G.C.); (R.G.L.)
- Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, FL 33199, USA
| |
Collapse
|
10
|
Patrono A, Placidi D, Calza S, Brunelli P, Cagna G, Manco A, Renzetti S, Rota M, Moncada S, Lucchini R. COVID-19, Mental health and intervention-priorities among Northern Italian University students. Eur J Public Health 2021. [PMCID: PMC8574842 DOI: 10.1093/eurpub/ckab165.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
During the first wave of COVID-19 pandemic, the most affected area in Italy was the southeast part of the Lombardy region. The University of Brescia is one of the largest in Northern Italy. The aim of this study is to investigate the psychological and somatic symptoms driven by lifestyle changes due to the lockdown among the students of the University of Brescia.15261 University students were enrolled through institutional email;14302 were Master's and Bachelor's Degreestudents,724 were Residents and 235 doctorates.3553 students (23.28% of total),aged on average 22 years, completed the survey. Physical health, dietary and sleep habits, physical activities, economic and social issues were investigated through an anonymous, online ad hoc form, available until July 2020 and approved by the local Ethic Committee. Five psychosomatic outcomes were assessed: digestive disorders, headache, panic-anxiety crises, depression-sadness, fear od COVID-19.Factor analysis was applied to reduce the number of variables while logistic and ordinal logistic regression models were used to test the association between the latent variables and each outcome. Female gender, medium-intensive use of telephone, worsening of sleep quality, mnemonic difficulties and performance reduction were associated with all the outcomes. Low physical activity, increased time spent watching television and the worsening of dietary habits represented a significant risk factor for at least three of the outcomes. Despite the relatively low compliance, the survey clearly identified few priorities of intervention to prevent psychological and somatic effects of pandemic in the next future: circadian rhythm, nutritional habits, physical activity, use of media, gender issues. The results of this study show the psychosomatic effects of social isolation and the pandemic on a population at risk of young adults and can promote interventions to minimize the occurrence of psychosomatic consequences on young adults. Key messages Analysis of the main risk and protection factors in a population of young adults in the development of psycho-physical symptoms during the period of isolation due to the covid-19 pandemic. Support the need to implement public health services also to reduce health costs with possible methods of intervention, in harmony with the findings.
Collapse
Affiliation(s)
- A Patrono
- Università degli Studi di Brescia, Brescia, Italy
| | - D Placidi
- Università degli Studi di Brescia, Brescia, Italy
| | - S Calza
- Università degli Studi di Brescia, Brescia, Italy
| | - P Brunelli
- Università degli Studi di Brescia, Brescia, Italy
| | - G Cagna
- Università degli Studi di Brescia, Brescia, Italy
| | - A Manco
- Università degli Studi di Brescia, Brescia, Italy
| | - S Renzetti
- Università degli Studi di Brescia, Brescia, Italy
| | - M Rota
- Università degli Studi di Brescia, Brescia, Italy
| | - S Moncada
- Universidad del Desarrollo, Concepción, Chile
| | - R Lucchini
- Università degli Studi di Brescia, Brescia, Italy
- Florida International Univeristy, Miami, USA
| |
Collapse
|
11
|
Renzetti S, Placidi D, Borgese L, Cagna G, Conversano M, Patrono A, Peli M, Ranzi R, van Thriel C, Lucchini RG. The relationship between soil and household dust metals and the impact on olfaction in children. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Through this study we aimed to test the association between the exposure to metals measured in soil, outdoor and indoor dust and olfactory function among children living close to ferromanganese alloy plants. Moreover, we investigated how metal concentrations vary with the distance from the plants and the relationships among the different environmental media.
Methods
A total of 130 children between 6 and 13 years old were enrolled in the province of Brescia in Italy. The olfactory performance was assessed through the Sniffin' Sticks test. The concentration of 20 metals in dust and soil samples was determined through an X-ray fluorescence portable analyzer (p-XRF). Weighted Quantile Sum (WQS) regression was applied to test for the association between the multi-media environmental markers (MMEM) and olfactory function while restricted cubic splines were used to evaluate the relationship between metal concentrations and distance from the closest plant and deviation from the main wind direction.
Results
WQS regression showed a negative significant association between the MMEM and the Sniffin' Sticks score (beta=-0.028; 95%CI -0.047, -0.009) identifying As, Fe, Rb, Pd, K and Pb as the elements with the higher weights. Except Rb, all elements together with Mn (one of the main elements released by the plants), showed a decreasing trend for soil and outdoor dust concentration at increasing distance from the source or at increasing deviation from the main wind direction. A positive association between outdoor and indoor dust and between soil and outdoor dust was also observed.
Conclusions
This work highlights the risk of the exposure to metal mixtures on child olfactory function which is known to be associated with neurodegenerative diseases in older age. Moreover, this analysis can contribute in terms of public health policies assessing the risk of being exposed as a function of the distance from the plants and the deviation from the main wind direction.
Key messages
Metal mixture concentration in dust is associated with decreased smell identification ability. Indoor metal concentrations can be affected by external source of exposure.
Collapse
Affiliation(s)
- S Renzetti
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
- Department of Medical-Surgical Specialties, Radiological Science, Università degli Studi di Brescia, Brescia, Italy
| | - D Placidi
- Department of Medical-Surgical Specialties, Radiological Science, Università degli Studi di Brescia, Brescia, Italy
| | - L Borgese
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - G Cagna
- Department of Medical-Surgical Specialties, Radiological Science, Università degli Studi di Brescia, Brescia, Italy
| | - M Conversano
- Department of Public Health, ASL, Taranto, Italy
| | - A Patrono
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
- Department of Medical-Surgical Specialties, Radiological Science, Università degli Studi di Brescia, Brescia, Italy
| | - M Peli
- Department of Civil, Environmental, Architectural Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - R Ranzi
- Department of Civil, Environmental, Architectural Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - C van Thriel
- Neurotoxicology and Chemosensation, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - RG Lucchini
- Department of Medical-Surgical Specialties, Radiological Science, Università degli Studi di Brescia, Brescia, Italy
- Florida International University, Miami, USA
| |
Collapse
|
12
|
Bauer JA, White RF, Coull BA, Austin C, Oppini M, Zoni S, Fedrighi C, Cagna G, Placidi D, Guazzetti S, Yang Q, Bellinger DC, Webster TF, Wright RO, Smith D, Horton M, Lucchini RG, Arora M, Claus Henn B. Critical windows of susceptibility in the association between manganese and neurocognition in Italian adolescents living near ferro-manganese industry. Neurotoxicology 2021; 87:51-61. [PMID: 34478771 DOI: 10.1016/j.neuro.2021.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/07/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Understanding the neurodevelopmental effects of manganese (Mn) is complicated due to its essentiality for growth and development. While evidence exists for the harmful effects of excess Mn, pediatric epidemiologic studies have observed inconsistent associations between Mn and child cognition. OBJECTIVE We sought to estimate prospective associations between Mn measured in three different early-life time windows with adolescent cognition using deciduous teeth biomarkers. METHODS Deciduous teeth were collected from 195 participants (ages 10-14 years) of the Public Health Impact of Manganese Exposure (PHIME) study in Brescia, Italy. Measurements of tooth Mn represented prenatal (∼14 weeks gestation - birth), early postnatal (birth - 1.5 years) and childhood (∼1.5 - 6 years) time windows. Neuropsychologists administered the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), to obtain composite IQ and subtest scores. Associations between tooth Mn at each time window and adolescent WISC-III scores were estimated using multivariable linear regression. We tested differences in associations between Mn and outcomes across time windows using multiple informant models. Sex-specific associations were explored in stratified models. RESULTS Adjusted associations between tooth Mn and composite IQ scores were positive in the prenatal period and negative in the childhood period. Associations were strongest for subtest scores that reflect working memory, problem solving, visuospatial ability and attention: prenatal Mn was positively associated with Digits backward [SD change in score per interquartile range increase in Mn: β = 0.20 (95 % CI: 0.02, 0.38)] and Block design [β = 0.21 (0.01, 0.41)] and early postnatal Mn was positively associated with Digits forward [β = 0.24 (0.09, 0.40)], while childhood Mn was negatively associated with Coding [β = -0.14 (-0.28, -0.001)]. Sex-stratified analyses suggested different Mn-cognition associations for boys and girls and was also dependent on the time window of exposure. CONCLUSION Our results suggest that exposure timing is critical when evaluating Mn associations between Mn and cognition. Higher prenatal Mn was beneficial for adolescent cognition; however, these beneficial associations shifted towards harmful effects in later time windows. Cognitive domains most sensitive to Mn across time windows included visuospatial ability, working memory, attention and problem-solving.
Collapse
Affiliation(s)
- Julia Anglen Bauer
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manuela Oppini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Silvia Zoni
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Chiara Fedrighi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | | | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Departments of Neurology and Psychiatry, Boston Children's Hospital, Boston, MA, USA; Departments of Neurology and Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Thomas F Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donald Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy; School of Public Health, Florida International University, Miami, FL, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
13
|
Rechtman E, Curtin P, Papazaharias DM, Renzetti S, Cagna G, Peli M, Levin-Schwartz Y, Placidi D, Smith DR, Lucchini RG, Wright RO, Horton MK. Sex-specific associations between co-exposure to multiple metals and visuospatial learning in early adolescence. Transl Psychiatry 2020; 10:358. [PMID: 33087698 PMCID: PMC7578810 DOI: 10.1038/s41398-020-01041-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/11/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
The predisposition, severity, and progression of many diseases differ between males and females. Sex-related differences in susceptibility to neurotoxicant exposures may provide insight into the cause of the observed discrepancy. Early adolescence, a period of substantial structural and functional brain changes, may present a critical window of vulnerability to environmental exposures. This study aimed to examine sex-specific associations between co-exposure to multiple metals and visuospatial memory in early adolescence. Manganese (Mn), lead (Pb), chromium (Cr), and copper (Cu) were measured in blood, urine, hair, nails, and saliva of 188 participants (88 girls; 10-14 years of age). Visuospatial memory skills were assessed using a computerized maze task, the virtual radial arm maze (VRAM). Using generalized weighted quantile sum regression, we investigated sex-specific associations between the combined effect of exposure to the metal mixture and visuospatial working memory and determined the contribution of each component to the outcome. The results suggest that sex moderates the association between the metal mixture and visuospatial learning for all outcomes measured. In girls, exposure was associated with slower visuospatial learning and driven by Mn and Cu. In boys, exposure was associated with faster visuospatial learning, and driven by Cr. These results suggest that (a) the effect of metal co-exposure on learning differs in magnitude, and in the direction between sexes, and (b) early adolescence may be a sensitive developmental period for metal exposure.
Collapse
Affiliation(s)
- Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Demetrios M Papazaharias
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Marco Peli
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Brescia, Italy
| | - Yuri Levin-Schwartz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Università degli Studi di Brescia, Brescia, Italy
- School of Public Health, Florida International University, Miami, FL, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
14
|
Bansal E, Renzetti S, Xhani N, Cagna G, Conversano M, Patrono A, Claudio L, Lucchini R, Placidi D. Family life stress, maternal depression and child behavioral health in industrialized Italian cities. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Although family life stress adversely impacts child health, few tools measure its relationship to child outcomes in the setting of maternal variables. This study validates the Italian version of Crisis in Family Systems-Revised (CRISYS-R) and characterizes relationships between family life stress, maternal depression and child behavior in two Italian cities.
This cross-sectional study was nested in current research on health impacts of neurotoxic environmental exposures in children. 101 mother-child pairs (child age=9.91±2.17yrs; 53% female) and children's teachers were enrolled in Taranto (south Italy) and Brescia (north Italy). Mothers performed the Italian CRISYS-R and PHQ9; teachers completed Child Behavior Checklist (CBCL/6-18). Spearman's rank correlation coefficients showed associations of family CRISYS-R, maternal PHQ9 and child CBCL/6-18. Wilcoxon Rank-Sum test compared groups of continuous variables.
Mothers with depressive symptoms (PHQ9≥5) reported higher ongoing stress and proportion of negative stressors on CRISYS-R than non-depressed mothers (p < 0.05). Children of depressed mothers performed worse in all CBCL/6-18 domains: Internalizing Problems, Externalizing Problems and Total Problems (p < 0.01). Specifically, children of depressed mothers scored higher on subscales of Anxious-Depressed (p < 0.05), Withdrawn-Depressed (p < 0.01), Rule-Breaking (p < 0.01) and Aggressive Behavior (p < 0.05). Maternal depressive symptoms correlated with ongoing stress (rs = 0.27; p < 0.01), child Internalizing Problems (rs = 0.34; p < 0.001), Externalizing Problems (rs = 0.28; p < 0.01) and Total Problems (rs = 0.35; p < 0.001).
This study describes links among maternal depression, family life stress, and child behavioral health. It is first to validate Italian CRISYS-R and to explore these factors conjointly in Italian contexts with known neurotoxic exposures. Findings support considering maternal depression and family life stress in child behavioral and environmental health research and policy.
Key messages
Family life stress, maternal depressive symptoms, and preadolescent behavioral health were highly interrelated in two industrialized Italian cities. The Italian version of CRISYS-R is a useful instrument for assessing and understanding family life stress, a crucial yet under-explored contributor to child behavioral health outcomes.
Collapse
Affiliation(s)
- E Bansal
- Department of Medical & Surgical Specialties & Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - S Renzetti
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - N Xhani
- Department of Medical & Surgical Specialties & Public Health, University of Brescia, Brescia, Italy
| | - G Cagna
- Department of Medical & Surgical Specialties & Public Health, University of Brescia, Brescia, Italy
| | - M Conversano
- Department of Prevention, Local Health Authority of Taranto, Taranto, Italy
| | - A Patrono
- Department of Prevention, Local Health Authority of Taranto, Taranto, Italy
| | - L Claudio
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - R Lucchini
- Department of Medical & Surgical Specialties & Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - D Placidi
- Department of Medical & Surgical Specialties & Public Health, University of Brescia, Brescia, Italy
| |
Collapse
|
15
|
Bauer JA, Devick KL, Bobb JF, Coull BA, Bellinger D, Benedetti C, Cagna G, Fedrighi C, Guazzetti S, Oppini M, Placidi D, Webster TF, White RF, Yang Q, Zoni S, Wright RO, Smith DR, Lucchini RG, Claus Henn B. Associations of a Metal Mixture Measured in Multiple Biomarkers with IQ: Evidence from Italian Adolescents Living near Ferroalloy Industry. Environ Health Perspect 2020; 128:97002. [PMID: 32897104 PMCID: PMC7478128 DOI: 10.1289/ehp6803] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 08/04/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Research on the health effects of chemical mixtures has focused mainly on early life rather than adolescence, a potentially important developmental life stage. OBJECTIVES We examined associations of a metal mixture with general cognition in a cross-sectional study of adolescents residing near ferromanganese industry, a source of airborne metals emissions. METHODS We measured manganese (Mn), lead (Pb), copper (Cu), and chromium (Cr) in hair, blood, urine, nails, and saliva from 635 Italian adolescents 10-14 years of age. Full-scale, verbal, and performance intelligence quotient (FSIQ, VIQ, PIQ) scores were assessed using the Wechsler Intelligence Scale for Children-III. Multivariable linear regression and Bayesian kernel machine regression (BKMR) were used to estimate associations of the metal mixture with IQ. In secondary analyses, we used BKMR's hierarchical variable selection option to inform biomarker selection for Mn, Cu, and Cr. RESULTS Median metal concentrations were as follows: hair Mn, 0.08 μ g / g ; hair Cu, 9.6 μ g / g ; hair Cr, 0.05 μ g / g ; and blood Pb, 1.3 μ g / dL . Adjusted models revealed an inverted U-shaped association between hair Cu and VIQ, consistent with Cu as an essential nutrient that is neurotoxic in excess. At low levels of hair Cu (10th percentile, 5.4 μ g / g ), higher concentrations (90th percentiles) of the mixture of Mn, Pb, and Cr (0.3 μ g / g , 2.6 μ g / dL , and 0.1 μ g / g , respectively) were associated with a 2.9 (95% CI: - 5.2 , - 0.5 )-point decrease in VIQ score, compared with median concentrations of the mixture. There was suggestive evidence of interaction between Mn and Cu. In secondary analyses, saliva Mn, hair Cu, and saliva Cr were selected as the biomarkers most strongly associated with VIQ score. DISCUSSION Higher adolescent levels of Mn, Pb, and Cr were associated with lower IQ scores, especially at low Cu levels. Findings also support further investigation into Cu as both beneficial and toxic for neurobehavioral outcomes. https://doi.org/10.1289/EHP6803.
Collapse
Affiliation(s)
- Julia A. Bauer
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Katrina L. Devick
- Division of Biomedical Statistics and Informatics, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Jennifer F. Bobb
- Biostatistics Unit, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David Bellinger
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Departments of Neurology and Psychiatry, Boston Children’s Hospital, Boston, Massachusetts, USA
- Departments of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Chiara Benedetti
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Chiara Fedrighi
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | | | - Manuela Oppini
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Donatella Placidi
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Thomas F. Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Roberta F. White
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Neurology, Boston University Medical School, Boston, Massachusetts, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Silvia Zoni
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Donald R. Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, California, USA
| | - Roberto G. Lucchini
- Department of Medical-Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
16
|
Broberg K, Taj T, Guazzetti S, Peli M, Cagna G, Pineda D, Placidi D, Wright RO, Smith DR, Lucchini RG, Wahlberg K. Manganese transporter genetics and sex modify the association between environmental manganese exposure and neurobehavioral outcomes in children. Environ Int 2019; 130:104908. [PMID: 31233999 PMCID: PMC6682429 DOI: 10.1016/j.envint.2019.104908] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 05/05/2023]
Abstract
There is increasing evidence that environmental manganese (Mn) exposure early in life can have negative effects on children's neurodevelopment and increase the risk of behavioral problems, including attention deficit hyperactivity disorder (ADHD). Factors that may contribute to differences in sensitivity to Mn exposure are sex and genetic variation of proteins involved in the regulation of Mn concentrations. Here we investigate if sex and polymorphisms in Mn transporter genes SLC30A10 and SLC39A8 influence the association between Mn exposure and ADHD-related behavioral problems in children. The SNPs rs1776029 and rs12064812 in SLC30A10, and rs13107325 in SLC39A8 were genotyped by TaqMan PCR or pyrosequencing in a population of Italian children (aged 11-14 years; n = 645) with a wide range of environmental Mn exposure. Mn in surface soil was measured in situ using XRF technology or modeled by geospatial analysis. Linear regression models or generalized additive models (GAM) were used for analyzing associations between soil Mn and neurobehavioral problems assessed by the Conners' behavior rating scales (self-, and parent-reported). Gene-environment interactions (Mn transporter genotype x soil Mn) were evaluated using a genetic score in which genotypes for the three SNPs were combined based on their association with blood Mn, as an indication of their influence on Mn regulation. We observed differences in associations between soil Mn and neurobehavior between sexes. For several self-reported Conners' scales, girls showed U-shaped relationships with higher (worse) Conners' scoring at higher soil Mn levels, and several parent-reported scales showed positive linear relationships between increasing soil Mn and higher Conner's scores. For boys, we observed a positive linear relationship with soil Mn for one Conner's outcome only (hyperactivity, parent-reported). We also observed some interactions between soil Mn and the genetic score on Conner's scales in girls and girls with genotypes linked to high blood Mn showed particularly strong positive associations between soil Mn and parent-reported Conners' scales. Our results indicate that sex and polymorphisms in Mn transporter genes contribute to differences in sensitivity to Mn exposure from the environment and that girls that are genetically less efficient at regulating Mn, may be a particularly vulnerable group.
Collapse
Affiliation(s)
- Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, Klinikgatan 21, 221 85 Lund, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 65 Solna, Sweden
| | - Tahir Taj
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Marco Peli
- Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa, 11, 25123 Brescia, BS, Italy
| | - Giuseppa Cagna
- Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa, 11, 25123 Brescia, BS, Italy
| | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Lund University, Klinikgatan 21, 221 85 Lund, Sweden
| | - Donatella Placidi
- Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa, 11, 25123 Brescia, BS, Italy
| | - Robert O Wright
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Donald R Smith
- Microbiology and Environmental Toxicology, University of California, 1156 High Street, Santa Cruz, CA 95064, USA
| | - Roberto G Lucchini
- Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa, 11, 25123 Brescia, BS, Italy; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Karin Wahlberg
- Division of Occupational and Environmental Medicine, Lund University, Klinikgatan 21, 221 85 Lund, Sweden.
| |
Collapse
|
17
|
Lucchini RG, Guazzetti S, Renzetti S, Conversano M, Cagna G, Fedrighi C, Giorgino A, Peli M, Placidi D, Zoni S, Forte G, Majorani C, Pino A, Senofonte O, Petrucci F, Alimonti A. Neurocognitive impact of metal exposure and social stressors among schoolchildren in Taranto, Italy. Environ Health 2019; 18:67. [PMID: 31324194 PMCID: PMC6642538 DOI: 10.1186/s12940-019-0505-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/10/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Metal exposure is a public health hazard due to neurocognitive effects starting in early life. Poor socio-economic status, adverse home and family environment can enhance the neurodevelopmental toxicity due to chemical exposure. Disadvantaged socio-economic conditions are generally higher in environmentally impacted areas although the combined effect of these two factors has not been sufficiently studied. METHODS The effect of co-exposure to neurotoxic metals including arsenic, cadmium, manganese, mercury, lead, selenium, and to socio-economic stressors was assessed in a group of 299 children aged 6-12 years, residing at incremental distance from industrial emissions in Taranto, Italy. Exposure was assessed with biological monitoring and the distance between the home address and the exposure point source. Children's cognitive functions were examined using the Wechsler Intelligence Scale for Children (WISC) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Linear mixed models were chosen to assess the association between metal exposure, socio-economic status and neurocognitive outcomes. RESULTS Urinary arsenic, cadmium and hair manganese resulted inversely related to the distance from the industrial emission source (β - 0.04; 95% CI -0.06, - 0.01; β - 0.02; 95% CI -0.05, - 0.001; β - 0.02 95% CI -0.05, - 0.003) while the WISC intellectual quotient and its sub-scores (except processing speed index) showed a positive association with distance. Blood lead and urinary cadmium were negatively associated with the IQ total score and all sub-scores, although not reaching the significance level. Hair manganese and blood lead was positively associated with the CANTAB between errors of spatial working memory (β 2.2; 95% CI 0.3, 3.9) and the reaction time of stop signal task (β 0.05; 95% CI 0.02, 0.1) respectively. All the other CANTAB neurocognitive tests did not show to be significantly influenced by metal exposure. The highest socio-economic status showed about five points intellectual quotient more than the lowest level on average (β 4.8; 95% CI 0.3, 9.6); the interaction term between blood lead and the socio-economic status showed a significant negative impact of lead on working memory at the lowest socio-economic status level (β - 4.0; 95% CI -6.9, - 1.1). CONCLUSIONS Metal exposure and the distance from industrial emission was associated with negative cognitive impacts in these children. Lead exposure had neurocognitive effect even at very low levels of blood lead concentration when socio-economic status is low, and this should further address the importance and prioritize preventive and regulatory interventions.
Collapse
Affiliation(s)
- Roberto G Lucchini
- Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Stefano Guazzetti
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
- Department of Public Health, Azienda USL - IRCCS, Reggio Emilia, Italy
| | - Stefano Renzetti
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | | | - Giuseppa Cagna
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Chiara Fedrighi
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | | | - Marco Peli
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Donatella Placidi
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Silvia Zoni
- Department of Occupational Health, University of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Giovanni Forte
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Costanza Majorani
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Anna Pino
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Oreste Senofonte
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Francesco Petrucci
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Alessandro Alimonti
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| |
Collapse
|
18
|
Bansal E, Placidi D, Carver S, Renzetti S, Giorgino A, Cagna G, Zoni S, Fedrighi C, Montemurro M, Oppini M, Conversano M, Guazzetti S, Wright RO, Smith D, Claudio L, Lucchini RG. Metabolic Outcomes in Southern Italian Preadolescents Residing Near an Industrial Complex: The Role of Residential Location and Socioeconomic Status. Int J Environ Res Public Health 2019; 16:E2036. [PMID: 31181712 PMCID: PMC6603983 DOI: 10.3390/ijerph16112036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/02/2019] [Accepted: 06/06/2019] [Indexed: 11/25/2022]
Abstract
Evidence suggests that environmental exposures and socioeconomic factors may interact to produce metabolic changes in children. We assessed the influence of residential location and socioeconomic status (SES) on pediatric body mass index (BMI) Z-score and fasting blood glucose (FBG) concentration. Participants included 214 children aged 6-11 years who live near a large industrial complex in Taranto, Italy. Participants were grouped into residential zones based on the distance between their home address and the complex periphery (Zone 1: 0.000-4.999 km, Zone 2: 5.000-9.999 km, Zone 3: 10.000-15.000 km). BMI Z-scores were calculated via World Health Organization (WHO) pediatric reference curves. FBG was obtained via venous blood sampling. Closer residential location to the industrial complex on the order of 5.000 km was significantly associated with worsened metabolic outcomes, particularly in female children. Zone 1 participants had higher BMI-adjusted FBG than Zone 2 and 3 participants (p < 0.05 versus Zone 2; p < 0.01 versus Zone 3). SES did not significantly influence BMI-adjusted FBG. Moreover, BMI Z-scores indicated high rates of overweight (22.0%) and obesity (22.9%) in the cohort. BMI Z-score was not significantly associated with SES or residential zone but was negatively associated with maternal education level (p < 0.05). These results offer new evidence that residing near industrial activity may predict adverse effects on child metabolic health.
Collapse
Affiliation(s)
- Esha Bansal
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Shaye Carver
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
- Department of Biology, Morrissey College of Arts and Sciences, Boston College, Chestnut Hill, PA 02467, USA.
| | - Stefano Renzetti
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
| | - Augusto Giorgino
- Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy.
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Silvia Zoni
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Chiara Fedrighi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Miriana Montemurro
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
- Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy.
| | - Manuela Oppini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Michele Conversano
- Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy.
| | - Stefano Guazzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
- Local Health Authority of Reggio Emilia, 42122 Reggio Emilia, Italy.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Donald Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA 95064, USA.
| | - Luz Claudio
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Roberto G Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| |
Collapse
|
19
|
Wahlberg KE, Guazzetti S, Pineda D, Larsson SC, Fedrighi C, Cagna G, Zoni S, Placidi D, Wright RO, Smith DR, Lucchini RG, Broberg K. Polymorphisms in Manganese Transporters SLC30A10 and SLC39A8 Are Associated With Children's Neurodevelopment by Influencing Manganese Homeostasis. Front Genet 2018; 9:664. [PMID: 30619481 PMCID: PMC6307466 DOI: 10.3389/fgene.2018.00664] [Citation(s) in RCA: 23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022] Open
Abstract
Background: Manganese (Mn) is an essential element but at excessive levels, it is neurotoxic. Even a moderate increase in Mn has been suggested to interfere with neurodevelopment in children. Genetics influencing Mn concentrations and toxicity is unclear. Objective: We assessed, in a cross-sectional study, whether common single-nucleotide polymorphisms in the Mn transporters SLC39A8 (influx) and SLC30A10 (efflux) are associated with neurodevelopment in children. Design: We genotyped SLC39A8 (rs13107325 C/T) and SLC30A10 (rs1776029 G/A and rs12064812 T/C) in Italian children (n = 686, ages 11–14). We then used linear regression models to analyze associations between genotype, blood Mn concentrations, and neurodevelopmental outcomes including intelligence, behavior, motor function, and sway. Inferred causal relationships were evaluated using instrumental variables (IV) analysis. Results: For SLC30A10 rs1776029, the minor allele (A) was associated with increased average blood Mn of 41% (p < 0.001), whereas minor alleles for rs12064812 (C) and rs13107325 (T) were associated with reduced blood Mn of 7% (p = 0.002) and 15% (p < 0.001), respectively. For children carrying genotypes associated with high blood Mn, we observed lower performance for certain IQ subtests, increased sway, and increased scores for behavioral problems. High Mn genotypes showed odds ratios of 2–4 (p ≤ 0.01) for high scores in tests assessing ADHD-related behavior. IV analyses suggested that several of the associations were mediated by blood Mn. Conclusions: Our results suggest that common polymorphisms in SLC39A8 and SLC30A10 influence neurodevelopmental outcomes in children via differences in Mn homeostasis.
Collapse
Affiliation(s)
- Karin E Wahlberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | | | - Daniela Pineda
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Susanna C Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Chiara Fedrighi
- Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Silvia Zoni
- Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Donatella Placidi
- Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Robert O Wright
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Donald R Smith
- Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, CA, United States
| | - Roberto G Lucchini
- Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| |
Collapse
|
20
|
Chiu YHM, Claus Henn B, Hsu HHL, Pendo MP, Coull BA, Austin C, Cagna G, Fedrighi C, Placidi D, Smith DR, Wright RO, Lucchini RG, Arora M. Sex differences in sensitivity to prenatal and early childhood manganese exposure on neuromotor function in adolescents. Environ Res 2017; 159:458-465. [PMID: 28858760 PMCID: PMC5623637 DOI: 10.1016/j.envres.2017.08.035] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/25/2017] [Accepted: 08/18/2017] [Indexed: 05/06/2023]
Abstract
INTRODUCTION While studies have suggested that exposure to manganese (Mn) may be associated with neurodevelopment in school-age children, there is limited information on prenatal and postnatal Mn exposures and tremor or motor function in children. METHODS We measured Mn levels in dentine of shed teeth, representing prenatal, early postnatal, and cumulative childhood exposure windows, from 195 children (predominantly right-handed, 92%) in Italy. Pursuit Aiming, Luria Nebraska Motor Battery, as well as Tremor and Sway system from Computerized Adaptive Testing System (CATSYS) were administered at 11-14 years old. We examined the relationships of tooth Mn (ln-transformed) with motor function using multivariable linear regressions and generalized additive models, adjusting for age, sex, and socioeconomic status index. Effect modification by sex was also examined. RESULTS We found that higher prenatal Mn was associated with better body stability in boys in a number of sway tests (including mean sway, transversal sway, sagittal sway, sway area, and sway intensity), while Mn was associated with poorer performance in girls on all of these metrics (all p for Mn × sex interaction < 0.05). Higher prenatal Mn was also modestly associated with better hand/finger and eye-hand coordination in boys compared to girls in sex-stratified analyses, although interaction models did not reach statistical significance. For tremor, on the other hand, higher early postnatal Mn was associated with increased right-hand center frequency in girls (p for interaction < 0.01), but increased Mn level at the later postnatal period was associated with increased center frequency in boys (p for interaction = 0.01). CONCLUSIONS This study, which used a direct measure of prenatal and childhood Mn exposure, suggested sex-specific critical windows of early life Mn exposure in relation to neuromotor function in adolescents. The sex-specific associations might be strongest with measures of whole body stability, for which the critical exposure window was during the prenatal period.
Collapse
Affiliation(s)
- Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mathew P Pendo
- Center for Medicine, Health and Society, Vanderbilt University College of Arts and Science, Nashville, TN, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Occupational Medicine, University of Brescia, Brescia, Italy
| | - Chiara Fedrighi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Occupational Medicine, University of Brescia, Brescia, Italy
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Occupational Medicine, University of Brescia, Brescia, Italy
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Occupational Medicine, University of Brescia, Brescia, Italy
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
21
|
Bauer JA, Claus Henn B, Austin C, Zoni S, Fedrighi C, Cagna G, Placidi D, White RF, Yang Q, Coull BA, Smith D, Lucchini RG, Wright RO, Arora M. Manganese in teeth and neurobehavior: Sex-specific windows of susceptibility. Environ Int 2017; 108:299-308. [PMID: 28941415 PMCID: PMC5679133 DOI: 10.1016/j.envint.2017.08.013] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/14/2017] [Accepted: 08/22/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Manganese (Mn) is an essential element required for growth and development, but higher body burdens have been associated with neurobehavioral decrements in children. OBJECTIVES We examined whether prenatal or postnatal Mn measured in deciduous teeth was associated with scores on a test of visuospatial learning and memory. METHODS Deciduous teeth were collected from 142 participants (ages 10-14years) residing near varied ferro‑manganese industry in Italy. Mn concentrations were measured in prenatal and postnatal tooth regions by laser ablation inductively coupled plasma mass spectrometry (ICP-MS). The Virtual Radial Arm Maze (VRAM), an animal-human analogue task, was used to assess visuospatial learning and memory. We used generalized additive, linear and zero-inflated Poisson mixed regression models to estimate associations between prenatal or postnatal Mn concentrations and repeated measures of all four VRAM outcomes: time, distance, working and reference memory errors. Effect measure modification by sex was examined in stratified models. RESULTS U-shaped associations between prenatal Mn and VRAM outcomes were observed among girls only (pGAMM=0.001 to 0.02 in stratified models). Compared to the mid-tertile of prenatal Mn, girls in the highest tertile took 7.7s [95% CI: -6.1, 21.5] longer to complete the task, traveled 2.3 maze units [0.1, 4.4] farther, and committed more working and reference memory errors (β for count ratio=1.33 [1.01, 1.83]; 1.10 [0.98, 1.24], respectively). This association was not observed among boys. In contrast, for postnatal Mn, no significant associations were found, and patterns were similar for boys and girls. CONCLUSIONS The prenatal period may be a critical window for the impact of environmental Mn on visuospatial ability and executive function, especially for females.
Collapse
Affiliation(s)
- Julia Anglen Bauer
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Silvia Zoni
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Chiara Fedrighi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Donald Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
22
|
Sepe V, Ottone S, Patrucco G, Cecere P, Colombo P, Cagna G, Costantini L, Piccini G, Filiberti O, Peona C. [Effectiveness of oral supplements of folates, vitamins B12 and B6 in hemodialysed patients. Preliminary results after 5 months of follow-up]. MINERVA UROL NEFROL 2001; 53:57-9. [PMID: 11455311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Elevated serum levels of homocysteine have increasingly been associated as a risk factor of cardiovascular disease. Recent reports demonstrated that supplements of folates, vitamin B12 (B12) and vitamin B6 (B6) are effective in correcting serum Hcy levels in hemodialysed patients. AIM to assess the effectiveness of oral supplements of folates, B12 and B6, in order to reduce serum Hcy levels in our cohort of hemodialysed patients. METHODS Sixty-one hemodialysed patients have been enrolled in the study (age 68+/-13 years; hemodialysis 62+/-42 months). Oral supplements of calcium folinate (30 mg 3 times a week), B12 (500 mg 3 times a week) and B6 (200 mg 3 times a week) were administered at the end of each hemodialysis session. Serum levels of Hcy, folic acid and B12 were tested at the beginning of the study and at 2 month intervals. RESULTS After 5 months of follow-up, serum levels of Hcy were normalised in 19% of our patients and in total 70% of them showed a reduction >8% when compared with the basal Hcy levels. No side effects related to folates, B12 or B6 supplementation were observed. CONCLUSIONS Oral supplements of folates, B12 and B6 are a safe and effective treatment of hyperhomocysteinemia in hemodialysed patients.
Collapse
Affiliation(s)
- V Sepe
- Servizio di Nefrologia e Dialisi, Ospedale S. Andrea, Vercelli, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Ottone S, Cecere P, Colombo P, Porcu M, Filiberti O, Costantini L, Guazzotti GC, Cagna G, Peona C. [Infections from extemporaneous catheters for hemodialysis. Experience in a center]. MINERVA UROL NEFROL 1998; 50:179-83. [PMID: 9842219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND AIMS This study reports a retrospective evaluation of the predominance of infection in 67 dual lumen central venous catheters (CVC), 35 of which were positioned in the femoral vein by the nephrological team and 32 in the subclavian vein by anesthetists. METHODS The microorganisms responsible for infection, the prevalence of clinically symptomatic infections, the relationship between CVC-correlated infection and the time the catheter remained inserted were evaluated, together with a comparison between the two different insertion sites. RESULTS Culture tests, performed using Maki's semiquantitative technique, gave positive results in 16/67 (23.8%) cases. The main pathogenic agents found were Staphylococcus epidermidis (37.5%) and Staphylococcus aureus (31.2%). In 3/16 cases (18.78%) infections were clinically symptomatic. The mean permanence of CVC with positive cultures was not statistically different to the mean permanence of CVC with negative cultures (22.44 +/- 13.48 vs 18.38 +/- 17.76). The microorganisms isolated on femoral and subclavian catheters showed a comparable distribution and the prevalence of infection was not statistically different in the two insertion sites. CONCLUSIONS In conclusion, in the absence of infection, the authors tend to keep working catheters in the site, thus avoiding repeated invasive manoeuvres for replacement and/or repositioning, whereas in the presence of suspected systemic infection they feel it is more prudent to remove the CVC without waiting for the results of the hemoculture, starting first empiric and then specific antibiotic treatment on the basis of the antibiogram.
Collapse
Affiliation(s)
- S Ottone
- Servizio di Nefrologia e Dialisi, Ospedale Sant'Andrea, Vercelli
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Peona C, Fortina A, Colombo P, Filiberti O, Cagna G, Costantini L, Porcu M. [Levels of tumor necrosis factor and interleukin 1 in uremia and in hemodialysis]. MINERVA UROL NEFROL 1991; 43:175-9. [PMID: 1726274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The present study aimed to assess the serum levels of tumor necrosis factor (TNFalpha) and Interleukin-1 (IL-1) in uremic patients and those patients undergoing extracorporeal replacement therapy in relation to the duration of dialysis and the type of membrane. Serum cytokine values were assayed using an immunoradiometric technique (monoclonal antibodies) in 28 uremic patients and 7 healthy controls. TNFalpha levels were normal in control subjects but increased in uremic patients. Patients undergoing hemodialytic treatment showed increases which were statistically significant in comparison to basal levels, with a trend which was directly correlated to the duration of dialysis. No significant variations were induced by the different types of dialysis membranes used. In virtually all patients IL-1 values could not be assayed using this method.
Collapse
Affiliation(s)
- C Peona
- Servizio di Nefrologia e Dialisi, Ospedale Sant'Andrea, Vercelli
| | | | | | | | | | | | | |
Collapse
|
25
|
Cagna G, Bodo G, Ventura M. [Review of the literature and personal experience in the use of calcitonin in the dialysed patient]. MINERVA UROL NEFROL 1986; 38:223-6. [PMID: 3750165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
26
|
Cagna G, Bossola M, Genesi D, Ventura M. [Effects of the administration of exogenous calcitonin in dialysis patients. Preliminary study]. Clin Ter 1985; 113:467-71. [PMID: 4028652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
27
|
Cagna G, Bossola M, Castri M. [A case of renal tubular acidosis]. Minerva Urol 1982; 34:127-30. [PMID: 7110095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
28
|
Ventura M, Acanfora F, Cagna G, Genesi D, Zolfanelli R, Guarda F. [Experimental study: inosine and renal ischemia]. J Urol Nephrol (Paris) 1979; 85:762-5. [PMID: 537151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
29
|
Ventura M, Zolfanelli R, Conti PG, Barasolo E, Cagna G, Acanfora F, Bossola M. [Bladder distention in the treatment of inoperable bladder neoplasms]. J Urol Nephrol (Paris) 1979; 85:68-75. [PMID: 439200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
30
|
Ventura M, Zolfanelli R, Conti PG, Barasolo E, Cagna G, Acanfora F, Bossola M. [Cases of coralliform calculosis operated on under renal perfrigeration]. Minerva Urol 1978; 30:147-56. [PMID: 732794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
31
|
Ventura M, Zolfanelli R, Conti PG, Barasolo E, Cagna G, Acanfora F, Bossola M. [Surgery of coralliform calculus using kidney hypothermia]. J Urol Nephrol (Paris) 1978; 84:626-30. [PMID: 745288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
32
|
Ventura M, Cagna G, Acanfora F. [Importance of hemodialysis in the treatment of uremigenic obstructive uropathy]. Minerva Urol 1977; 29:149-60. [PMID: 76985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
33
|
Zolfanelli R, Conti P, Acanfora F, Barasolo E, Cagna G, Bollero E, Biroli E. [Cytohistological examination of the urine in diagnosis of neoplasms of the bladder. Considerations on 5 years of experience]. Minerva Urol 1976; 28:161-6. [PMID: 798121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
34
|
Ventura M, Barasolo E, Conti PG, Cagna G, Zanini E. [Critical considerations on a case of renal tuberculosis]. Minerva Urol 1974; 26:126-32. [PMID: 4424656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
35
|
Ventura M, Cagna G. [Bladder papilloma. Diagnostic considerations]. Minerva Urol 1974; 26:71-6. [PMID: 4845155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
36
|
Ventura M, Bavagnoli A, Cagna G. [Model of a cannula for periodic peritoneal dialysis]. Minerva Urol 1974; 26:7-11. [PMID: 4278612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
37
|
Ventura M, Cagna G, Morano E, Bollero E. [Use of differential interference contrast microscopy (DIC) in ex-tempore screening of bladder neoplasms]. Minerva Urol 1974; 26:1-6. [PMID: 4607421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|