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van den Brekel L, Lenters V, Mackenbach JD, Hoek G, Wagtendonk A, Lakerveld J, Grobbee DE, Vaartjes I. Ethnic and socioeconomic inequalities in air pollution exposure: a cross-sectional analysis of nationwide individual-level data from the Netherlands. Lancet Planet Health 2024; 8:e18-e29. [PMID: 38199717 DOI: 10.1016/s2542-5196(23)00258-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/19/2023] [Accepted: 11/15/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Air pollution contributes to a large disease burden and some populations are disproportionately exposed. We aimed to evaluate ethnic and socioeconomic differences in exposure to air pollution in the Netherlands. METHODS We did a nationwide, cross-sectional analysis of all residents of the Netherlands on Jan 1, 2019. Sociodemographic information was centralised by Statistics Netherlands and mainly originated from the National Population Register, the tax register, and education registers. Concentrations of NO2, PM2·5, PM10, and elemental carbon, modelled by the National Institute for Public Health and the Environment, were linked to the individual-level demographic data. We assessed differences in air pollution exposures across the 40 largest minority ethnic groups. Evaluation of how ethnicity intersected with socioeconomic position in relation to exposures was done for the ten largest ethnic groups, plus Chinese and Indian groups, in both urban and rural areas using multivariable linear regression analyses. FINDINGS The total study population consisted of 17 251 511 individuals. Minority ethnic groups were consistently exposed to higher levels of air pollution than the ethnic Dutch population. The magnitude of inequalities varied between the minority ethnic groups, with 3-44% higher exposures to NO2 and 1-9% higher exposures to PM2·5 compared with the ethnic Dutch group. Average exposures were highest for the lowest socioeconomic group. Ethnic inequalities in exposure remained after adjustment for socioeconomic position and were of similar magnitude in urban and rural areas. INTERPRETATION The variability in air pollution exposure across ethnic and socioeconomic subgroups in the Netherlands indicates environmental injustice at the intersection of social characteristics. The health consequences of the observed inequalities and the underlying processes driving them warrant further investigation. FUNDING The Gravitation programme of the Dutch Ministry of Education, Culture, and Science, the Netherlands Organization for Scientific Research, the Netherlands Organisation for Health Research and Development, and Amsterdam University Medical Center.
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Affiliation(s)
- Lieke van den Brekel
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Virissa Lenters
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht University, Utrecht, Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Alfred Wagtendonk
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jeroen Lakerveld
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Upstream Team, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht University, Utrecht, Netherlands.
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2
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Cai A, Remy S, Lenters V, Cox B, Schoeters G, Covaci A, Vermeulen R, Portengen L. Exposure to a Mixture of Endocrine-Disrupting Chemicals and Metabolic Outcomes in Belgian Adolescents. Environ Sci Technol 2023; 57:19871-19880. [PMID: 37944124 PMCID: PMC10702523 DOI: 10.1021/acs.est.3c07607] [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: 09/14/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Childhood exposure to endocrine-disrupting chemicals (EDCs), either alone or in mixtures, may affect metabolic outcomes, yet existing evidence remains inconclusive. In our study of 372 adolescents from the Flemish Environment and Health Study (FLEHS IV, 2017-2018), we measured 40 known and suspected EDCs and assessed metabolic outcomes, including body mass index z-score (zBMI), abdominal obesity (AO), total cholesterol (TC), and triglycerides (TG). We applied Bayesian kernel machine regression (BKMR) and Bayesian penalized horseshoe regression for variable selection and then built multivariate generalized propensity score (mvGPS) models to provide an overview of the effects of selected EDCs on metabolic outcomes. As a result, BKMR and horseshoe together identified five EDCs associated with zBMI, three with AO, three with TC, and five with TG. Through mvGPS analysis, monoiso-butyl phthalate (MIBP), polychlorinated biphenyl (PCB-170), and hexachlorobenzene (HCB) each showed an inverse association with zBMI, as did PCB-170 with AO. Copper (Cu) was associated with higher TC and TG, except in boys where it was linked to lower TG. Additionally, monoethyl phthalate (MEP) and monobenzyl phthalate (MBzP) were associated with higher TG. To conclude, our findings support the association between certain chemicals (Cu, MEP, and MBzP) and elevated lipid levels, aligning with prior studies. Further investigation is needed for sex-specific effects.
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Affiliation(s)
- Anran Cai
- Institute
for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht 3584 CM, The Netherlands
- VITO
Health, Flemish Institute for Technological
Research (VITO), Mol 2400, Belgium
| | - Sylvie Remy
- VITO
Health, Flemish Institute for Technological
Research (VITO), Mol 2400, Belgium
| | - Virissa Lenters
- Institute
for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht 3584 CM, The Netherlands
- Amsterdam
Institute for Life and Environment, Department of Environment and
Health, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Bianca Cox
- VITO
Health, Flemish Institute for Technological
Research (VITO), Mol 2400, Belgium
| | - Greet Schoeters
- Department
of Biomedical Sciences, University of Antwerp, Antwerp 2000, Belgium
| | - Adrian Covaci
- Toxicological
Centre, University of Antwerp, Wilrijk 2610, Belgium
| | - Roel Vermeulen
- Institute
for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht 3584 CM, The Netherlands
- Julius Center
for Health Sciences and Primary Care, University
Medical Center Utrecht, Utrecht 3584 CG, The Netherlands
| | - Lützen Portengen
- Institute
for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht 3584 CM, The Netherlands
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Desalegn AA, van der Ent W, Lenters V, Iszatt N, Stigum H, Lyche JL, Berg V, Kirstein-Smardzewska KJ, Esguerra CV, Eggesbø M. Perinatal exposure to potential endocrine disrupting chemicals and autism spectrum disorder: From Norwegian birth cohort to zebrafish studies. Environ Int 2023; 181:108271. [PMID: 37879205 DOI: 10.1016/j.envint.2023.108271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The etiology of autism spectrum disorder (ASD) is multifactorial, involving genetic and environmental contributors such as endocrine-disrupting chemicals (EDCs). OBJECTIVE To evaluate the association between perinatal exposure to 27 potential EDCs and ASD among Norwegian children, and to further examine the neurodevelopmental toxicity of associated chemicals using zebrafish embryos and larvae. METHOD 1,199 mothers enrolled in the prospective birth-cohort (HUMIS, 2002-2009) study. Breastmilk levels of 27 chemicals were measured: polychlorinated biphenyls, organochlorine pesticides, polybrominated diphenyl ethers, and perfluoroalkyl substances as a proxy for perinatal exposure. We employed multivariable logistic regression to determine association, utilized elastic net logistic regression as variable selection method, and conducted an in vivo study with zebrafish larvae to confirm the neurodevelopmental effect. RESULTS A total of 20 children had specialist confirmed diagnosis of autism among 1,199 mother-child pairs in this study. β-Hexachlorocyclohexane (β-HCH) was the only chemical associated with ASD, after adjusting for 26 other chemicals. Mothers with the highest levels of β-HCH in their milk had a significant increased risk of having a child with ASD (OR = 1.82, 95 % CI: 1.20, 2.77 for an interquartile range increase in ln-transformed β-HCH concentration). The median concentration of β-HCH in breast milk was 4.37 ng/g lipid (interquartile range: 2.92-6.47), and the estimated daily intake (EDI) for Norwegian children through breastfeeding was 0.03 µg/kg of body weight. The neurodevelopmental and social behavioral effects of β-HCH were established in zebrafish embryos and larvae across various concentrations, with further analysis suggesting that perturbation of dopaminergic neuron development may underlie the neurotoxicity associated with β-HCH. CONCLUSIONS Prenatal exposure to β-HCH was associated with an increased risk of specialist-confirmed diagnoses of ASD among Norwegian children, and the EDI surpasses the established threshold. Zebrafish experiments confirm β-HCH neurotoxicity, suggesting dopaminergic neuron disruption as a potential underlying mechanism.
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Affiliation(s)
- Anteneh Assefa Desalegn
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway; Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Wietske van der Ent
- Chemical Neuroscience Group, Centre for Molecular Medicine Norway (NCMM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Virissa Lenters
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Hein Stigum
- Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Jan Ludvig Lyche
- Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway
| | - Vidar Berg
- Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway
| | - Karolina J Kirstein-Smardzewska
- Chemical Neuroscience Group, Centre for Molecular Medicine Norway (NCMM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Camila Vicencio Esguerra
- Chemical Neuroscience Group, Centre for Molecular Medicine Norway (NCMM), Faculty of Medicine, University of Oslo, Oslo, Norway; Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Merete Eggesbø
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway; Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway.
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4
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Hallberg I, Björvang RD, Hadziosmanovic N, Koekkoekk J, Pikki A, van Duursen M, Lenters V, Sjunnesson Y, Holte J, Berglund L, Persson S, Olovsson M, Damdimopoulou P. Associations between lifestyle factors and levels of per- and polyfluoroalkyl substances (PFASs), phthalates and parabens in follicular fluid in women undergoing fertility treatment. J Expo Sci Environ Epidemiol 2023; 33:699-709. [PMID: 37481638 PMCID: PMC10541317 DOI: 10.1038/s41370-023-00579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/21/2023] [Accepted: 06/29/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Concerns have been raised whether exposure to endocrine-disrupting chemicals (EDCs) can alter reproductive functions and play a role in the aetiology of infertility in women. With increasing evidence of adverse effects, information on factors associated with exposure is necessary to form firm recommendations aiming at reducing exposure. OBJECTIVE Our aim was to identify associations between lifestyle factors including the home environment, use of personal care products (PCP), and dietary habits and concentrations of EDCs in ovarian follicular fluid. METHODS April-June 2016, 185 women undergoing ovum pick-up for in vitro fertilisation in Sweden were recruited. Correlation analyses were performed between self-reported lifestyle factors and concentration of EDCs analysed in follicular fluid. Habits related to cleaning, PCPs, and diet were assessed together with concentration of six per- and polyfluoroalkyl substances (PFASs) [PFHxS, PFOA, PFOS, PFNA, PFDA and PFUnDA], methyl paraben and eight phthalate metabolites [MECPP, MEHPP, MEOHP, MEHP, cxMinCH, cxMiNP, ohMiNP, MEP, MOHiBP]. Spearman's partial correlations were adjusted for age, parity and BMI. RESULTS Significant associations were discovered between multiple lifestyle factors and concentrations of EDCs in ovarian follicular fluid. After correcting p values for multiple testing, frequent use of perfume was associated with MEP (correlation ρ = 0.41 (confidence interval 0.21-0.47), p < 0.001); hens' egg consumption was positively associated with PFOS (ρ = 0.30 (0.15-0.43), p = 0.007) and PFUnDA (ρ = 0.27 (0.12-0.40), p = 0.036). White fish consumption was positively associated with PFUnDA (ρ = 0.34 (0.20-0.47), p < 0.001) and PFDA (ρ = 0.27 (0.13-0.41), p = 0.028). More correlations were discovered when considering the raw uncorrected p values. Altogether, our results suggest that multiple lifestyle variables affect chemical contamination of follicular fluid. IMPACT STATEMENT This study shows how lifestyle factors correlate with the level of contamination in the ovary by both persistent and semi-persistent chemicals in women of reproductive age. Subsequently, these data can be used to form recommendations regarding lifestyle to mitigate possible negative health outcomes and fertility problems associated with chemical exposure, and to inform chemical policy decision making. Our study can also help form the basis for the design of larger observational and intervention studies to examine possible effects of lifestyle changes on exposure levels, and to unravel the complex interactions between biological factors, lifestyle and chemical exposures in more detail.
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Affiliation(s)
- Ida Hallberg
- Department of Women´s and Children´s Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Richelle D Björvang
- Department of Women´s and Children´s Health, Uppsala University, SE-751 85, Uppsala, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-141 86, Stockholm, Sweden
| | | | - Jacco Koekkoekk
- Environment and Health, Amsterdam Institute for Life and Environment, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Anne Pikki
- Carl von Linnékliniken, SE-751 83, Uppsala, Sweden
| | - Majorie van Duursen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, 3584 CG, Utrecht, the Netherlands
| | - Virissa Lenters
- Environment and Health, Amsterdam Institute for Life and Environment, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, 3584 CG, Utrecht, the Netherlands
| | - Ylva Sjunnesson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07, Uppsala, Sweden
| | - Jan Holte
- Department of Women´s and Children´s Health, Uppsala University, SE-751 85, Uppsala, Sweden
- Carl von Linnékliniken, SE-751 83, Uppsala, Sweden
| | - Lars Berglund
- School of Health and Welfare, Dalarna University, SE-791 88, Falun, Sweden
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-751 22, Uppsala, Sweden
| | - Sara Persson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women´s and Children´s Health, Uppsala University, SE-751 85, Uppsala, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-141 86, Stockholm, Sweden
| | - Pauliina Damdimopoulou
- Uppsala clinical Research Center, Uppsala University, SE-751 85, Uppsala, Sweden
- Department of Reproductive Medicine, Karolinska University Hospital Huddinge, SE-14186, Stockholm, Sweden
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5
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Cai A, Portengen L, Ertaylan G, Legler J, Vermeulen R, Lenters V, Remy S. Prenatal Exposure to Metabolism-Disrupting Chemicals, Cord Blood Transcriptome Perturbations, and Birth Weight in a Belgian Birth Cohort. Int J Mol Sci 2023; 24:ijms24087607. [PMID: 37108768 PMCID: PMC10141364 DOI: 10.3390/ijms24087607] [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: 02/27/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Prenatal exposure to metabolism-disrupting chemicals (MDCs) has been linked to birth weight, but the molecular mechanisms remain largely unknown. In this study, we investigated gene expressions and biological pathways underlying the associations between MDCs and birth weight, using microarray transcriptomics, in a Belgian birth cohort. Whole cord blood measurements of dichlorodiphenyldichloroethylene (p,p'-DDE), polychlorinated biphenyls 153 (PCB-153), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and transcriptome profiling were conducted in 192 mother-child pairs. A workflow including a transcriptome-wide association study, pathway enrichment analysis with a meet-in-the-middle approach, and mediation analysis was performed to characterize the biological pathways and intermediate gene expressions of the MDC-birth weight relationship. Among 26,170 transcriptomic features, we successfully annotated five overlapping metabolism-related gene expressions associated with both an MDC and birth weight, comprising BCAT2, IVD, SLC25a16, HAS3, and MBOAT2. We found 11 overlapping pathways, and they are mostly related to genetic information processing. We found no evidence of any significant mediating effect. In conclusion, this exploratory study provides insights into transcriptome perturbations that may be involved in MDC-induced altered birth weight.
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Affiliation(s)
- Anran Cai
- Department of Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Lützen Portengen
- Department of Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - Gökhan Ertaylan
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Juliette Legler
- Department of Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - Roel Vermeulen
- Department of Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Virissa Lenters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
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Sidorenkov G, Stadhouders R, Jacobs C, Mohamed Hoesein FAA, Gietema HA, Nackaerts K, Saghir Z, Heuvelmans MA, Donker HC, Aerts JG, Vermeulen R, Uitterlinden A, Lenters V, van Rooij J, Schaefer-Prokop C, Groen HJM, de Jong PA, Cornelissen R, Prokop M, de Bock GH, Vliegenthart R. Multi-source data approach for personalized outcome prediction in lung cancer screening: update from the NELSON trial. Eur J Epidemiol 2023; 38:445-454. [PMID: 36943671 PMCID: PMC10082103 DOI: 10.1007/s10654-023-00975-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/31/2023] [Indexed: 03/23/2023]
Abstract
Trials show that low-dose computed tomography (CT) lung cancer screening in long-term (ex-)smokers reduces lung cancer mortality. However, many individuals were exposed to unnecessary diagnostic procedures. This project aims to improve the efficiency of lung cancer screening by identifying high-risk participants, and improving risk discrimination for nodules. This study is an extension of the Dutch-Belgian Randomized Lung Cancer Screening Trial, with a focus on personalized outcome prediction (NELSON-POP). New data will be added on genetics, air pollution, malignancy risk for lung nodules, and CT biomarkers beyond lung nodules (emphysema, coronary calcification, bone density, vertebral height and body composition). The roles of polygenic risk scores and air pollution in screen-detected lung cancer diagnosis and survival will be established. The association between the AI-based nodule malignancy score and lung cancer will be evaluated at baseline and incident screening rounds. The association of chest CT imaging biomarkers with outcomes will be established. Based on these results, multisource prediction models for pre-screening and post-baseline-screening participant selection and nodule management will be developed. The new models will be externally validated. We hypothesize that we can identify 15-20% participants with low-risk of lung cancer or short life expectancy and thus prevent ~140,000 Dutch individuals from being screened unnecessarily. We hypothesize that our models will improve the specificity of nodule management by 10% without loss of sensitivity as compared to assessment of nodule size/growth alone, and reduce unnecessary work-up by 40-50%.
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Affiliation(s)
- Grigory Sidorenkov
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Ralph Stadhouders
- Department of Pulmonary Medicine, University Medical Center Rotterdam, Erasmus, Rotterdam, MC, The Netherlands
| | - Colin Jacobs
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Hester A Gietema
- Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands
| | - Kristiaan Nackaerts
- Department of Respiratory Oncology, KU Leuven-University Hospital Leuven, Leuven, Belgium
| | - Zaigham Saghir
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marjolein A Heuvelmans
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Hylke C Donker
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Joachim G Aerts
- Department of Pulmonary Medicine, University Medical Center Rotterdam, Erasmus, Rotterdam, MC, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Andre Uitterlinden
- Department of Internal Medicine, University Medical Center Rotterdam, Erasmus, Rotterdam, MC, The Netherlands
| | - Virissa Lenters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jeroen van Rooij
- Department of Pulmonary Medicine, University Medical Center Rotterdam, Erasmus, Rotterdam, MC, The Netherlands
| | | | - Harry J M Groen
- Department of Pulmonary diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Robin Cornelissen
- Department of Pulmonary Medicine, University Medical Center Rotterdam, Erasmus, Rotterdam, MC, The Netherlands
| | - Mathias Prokop
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Geertruida H de Bock
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Rozemarijn Vliegenthart
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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Cai A, Portengen L, Govarts E, Martin LR, Schoeters G, Legler J, Vermeulen R, Lenters V, Remy S. Prenatal exposure to persistent organic pollutants and changes in infant growth and childhood growth trajectories. Chemosphere 2023; 314:137695. [PMID: 36587911 DOI: 10.1016/j.chemosphere.2022.137695] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children are born with a burden of persistent organic pollutants (POPs) which may have endocrine disrupting properties and have been postulated to contribute to the rise in childhood obesity. The current evidence is equivocal, which may partly because many studies investigate the effects at one time point during childhood. We assessed associations between prenatal exposure to POPs and growth during infancy and childhood. METHODS We used data from two Belgian cohorts with cord blood measurements of five organochlorines [(dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB), polychlorinated biphenyls (PCB-138, -150, -180)] (N = 1418) and two perfluoroalkyl substances [perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)] (N = 346). We assessed infant growth, defined as body mass index (BMI) z-score change between birth and 2 years, and childhood growth, characterized as BMI trajectory from birth to 8 years. To evaluate associations between POP exposures and infant growth, we applied a multi-pollutant approach, using penalized elastic net regression with stability selection, controlling for covariates. To evaluate associations with childhood growth, we used single-pollutant linear mixed models with random effects for child individual, parametrized using a natural cubic spline formulation. RESULTS PCB-153 was associated with increased and p,p'-DDE with decreased infant growth, although these results were imprecise. No clear association between any of the exposures and longer-term childhood growth trajectories was observed. We did not find evidence of effect modification by child sex. CONCLUSION Our results suggest that prenatal exposure to PCB-153 and p,p'-DDE may affect infant growth in the first two years, with no evidence of more persistent effects.
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Affiliation(s)
- Anran Cai
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht, the Netherlands; VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht, the Netherlands
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Greet Schoeters
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Juliette Legler
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Department of Population Health Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Virissa Lenters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
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Bellavia A, Zou R, Björvang RD, Roos K, Sjunnesson Y, Hallberg I, Holte J, Pikki A, Lenters V, Portengen L, Koekkoek J, Lamoree M, Van Duursen M, Vermeulen R, Salumets A, Velthut-Meikas A, Damdimopoulou P. Association between chemical mixtures and female fertility in women undergoing assisted reproduction in Sweden and Estonia. Environ Res 2023; 216:114447. [PMID: 36181890 PMCID: PMC9729501 DOI: 10.1016/j.envres.2022.114447] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Women of reproductive age are exposed to ubiquitous chemicals such as phthalates, parabens, and per- and polyfluoroalkyl substances (PFAS), which have potential endocrine disrupting properties and might affect fertility. Our objective was to investigate associations between potential endocrine-disrupting chemicals (EDCs) and female fertility in two cohorts of women attending fertility clinics. METHODS In a total population of 333 women in Sweden and Estonia, we studied the associations between chemicals and female fertility, evaluating ovarian sensitivity index (OSI) as an indicator of ovarian response, as well as clinical pregnancy and live birth from fresh and frozen embryo transfers. We measured 59 chemicals in follicular fluid samples and detected 3 phthalate metabolites, di-2-ethylhexyl phthalate (DEHP) metabolites, 1 paraben, and 6 PFAS in >90% of the women. Associations were evaluated using multivariable-adjusted linear or logistic regression, categorizing EDCs into quartiles of their distributions, as well as with Bayesian Kernel Machine Regression. RESULTS We observed statistically significant lower OSI at higher concentrations of the sum of DEHP metabolites in the Swedish cohort (Q4 vs Q1, β = -0.21, 95% CI: -0.38, -0.05) and methylparaben in the Estonian cohort (Q3 vs Q1, β = -0.22, 95% CI: -0.44, -0.01). Signals of potential associations were also observed at higher concentrations of PFUnDA in both the combined population (Q2 vs. Q1, β = -0.16, 95% CI -0.31, -0.02) and the Estonian population (Q2 vs. Q1, β = -0.27, 95% CI -0.45, -0.08), and for PFOA in the Estonian population (Q4 vs. Q1, β = -0.31, 95% CI -0.61, -0.01). Associations of chemicals with clinical pregnancy and live birth presented wide confidence intervals. CONCLUSIONS Within a large chemical mixture, we observed significant inverse associations levels of DEHP metabolites and methylparaben, and possibly PFUnDA and PFOA, with OSI, suggesting that these chemicals may contribute to altered ovarian function and infertility in women.
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Affiliation(s)
- Andrea Bellavia
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Runyu Zou
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Richelle D Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Kristine Roos
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia; Nova Vita Clinic AS, Tallinn, Estonia
| | - Ylva Sjunnesson
- Department of Clinical Sciences, Division of Reproduction, The Center for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ida Hallberg
- Department of Clinical Sciences, Division of Reproduction, The Center for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jan Holte
- Carl von Linnékliniken, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anne Pikki
- Carl von Linnékliniken, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Virissa Lenters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Jacco Koekkoek
- Amsterdam Institute for Life and Environment, Section Environment and Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marja Lamoree
- Amsterdam Institute for Life and Environment, Section Environment and Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Majorie Van Duursen
- Amsterdam Institute for Life and Environment, Section Environment and Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Andres Salumets
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Competence Center on Health Technologies, Tartu, Estonia; Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Agne Velthut-Meikas
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Tallinn, Estonia.
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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9
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van den Brekel L, Lenters V, Mackenbach JD, Hoek G, Wagtendonk AJ, Lakerveld J, Grobbee DE, Vaartjes I. Ethnic and socioeconomic inequalities in relation to air pollution exposure in the Netherlands. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.563] [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
Air pollution (AP) contributes to a large disease burden and some populations are disproportionately exposed. It is unclear to what extent AP exposure differs across ethnic groups in the Netherlands and how this intersects with socioeconomic position (SEP). First, we identified differences in AP exposures between ethnic groups in the Netherlands. Second, we examined the interrelationships between ethnicity and SEP in relation to AP exposures.
Methods
We assessed AP exposures for residents of the Netherlands in 2019 (N = 17,251,511). Home address AP levels were estimated by dispersion models of the National Institute of Public Health and the Environment (RIVM). We linked exposure estimations of particulate matter <10 or < 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and elemental carbon (EC) to demographic data gathered by Statistics Netherlands. Absolute and relative differences in AP levels across ethnic groups were assessed. We conducted multivariable linear regression analyses and estimated marginal mean exposures to evaluate differences by ethnicity, SEP, age and sex within urban and rural areas. We tested for interactions and stratified accordingly.
Results
For the 40 largest minority ethnic groups (N > 18,314 per group), exposure to all pollutants was higher than for ethnic Dutch, with up to 1.5-fold differences for NO2. After stratification for urbanity and SEP, ethnic exposure inequalities persisted. For ethnic Dutch and some migrant groups, we found the lowest AP exposures in the middle SEP group (i.e. U-shaped trends), while we found linear patterns in other large migrant groups, with higher exposures at lower SEP.
Conclusions
Exposure to PM10, PM2.5, NO2, and EC was consistently higher in minority ethnic groups compared to ethnic Dutch. The association between SEP and AP levels showed different patterns between the majority ethnic Dutch and some of the largest minority ethnic groups. Further research is needed to define the equity and health implications.
Key messages
• Minority ethnic groups in the Netherlands are consistently exposed to higher levels of air pollution (PM10, PM2.5, NO2, and EC) than the ethnic Dutch population.
• Depending on the ethnic group, the association between SEP and air pollution exposure was either linear (i.e. lower exposures at higher SEP) or U-shaped (i.e. lower exposures in the middle SEP group).
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Affiliation(s)
- L van den Brekel
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center , Utrecht, Netherlands
| | - V Lenters
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center , Utrecht, Netherlands
- Institute for Risk Assessment Sciences, Utrecht University , Utrecht, Netherlands
| | - JD Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
- Upstream Team , Amsterdam , Amsterdam, Netherlands
- UMC, Vrije Universiteit Amsterdam , Amsterdam , Amsterdam, Netherlands
| | - G Hoek
- Institute for Risk Assessment Sciences, Utrecht University , Utrecht, Netherlands
| | - AJ Wagtendonk
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
- Upstream Team , Amsterdam , Amsterdam, Netherlands
- UMC, Vrije Universiteit Amsterdam , Amsterdam , Amsterdam, Netherlands
| | - DE Grobbee
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center , Utrecht, Netherlands
| | - I Vaartjes
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center , Utrecht, Netherlands
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10
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Dahl C, Stigum H, Valeur J, Iszatt N, Lenters V, Peddada S, Bjørnholt JV, Midtvedt T, Mandal S, Eggesbø M. Preterm infants have distinct microbiomes not explained by mode of delivery, breastfeeding duration or antibiotic exposure. Int J Epidemiol 2019; 47:1658-1669. [PMID: 29688458 DOI: 10.1093/ije/dyy064] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 12/21/2022] Open
Abstract
Background Preterm infants have low gut microbial diversity and few anaerobes. It is unclear whether the low diversity pertains to prematurity itself or is due to differences in delivery mode, feeding mode or exposure to antibiotics. Methods The Norwegian Microbiota Study (NoMIC) was established to examine the colonization of the infant gut and health outcomes. 16S rRNA gene Illumina amplicon-sequenced samples from 519 children (160 preterms), collected at 10 days, 4 months and 1 year postnatally, were used to calculate alpha diversity. Short-chain fatty acids (SCFA) were analysed with gas chromatography and quantified using flame ionization detection. We regressed alpha diversity on gestational age, taking into account possible confounding and mediating factors, such as breastfeeding and antibiotics. Taxonomic differences were tested using Analysis of Composition of Microbiomes (ANCOM) and SCFA profile (as a functional indicator of the microbiota) was tested by Wilcoxon rank-sum. Results Preterm infants had 0.45 Shannon units lower bacterial diversity at 10 days postnatally compared with infants born at term (95% confidence interval: -0.60, -0.32). Breastfeeding status and antibiotic exposure were not significant mediators of the gestational age-diversity association, although time spent in the neonatal intensive care unit was. Vaginally born, exclusively breastfed preterm infantss not exposed to antibiotics at 10 days postnatally had fewer Firmicutes and more Proteobacteria than children born at term and an SCFA profile indicating lower saccharolytic fermentation. Conclusions Preterm infants had distinct gut microbiome composition and function in the early postnatal period, not explained by factors more common in preterms, such as shorter breastfeeding duration, more antibiotics or caesarean delivery.
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Affiliation(s)
- Cecilie Dahl
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Hein Stigum
- Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Jørgen Valeur
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Virissa Lenters
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Shyamal Peddada
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jørgen V Bjørnholt
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore Midtvedt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Siddhartha Mandal
- Center for Environmental Health, Public Health Foundation of India, Gurgaon, India
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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11
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Lenters V, Iszatt N, Forns J, Čechová E, Kočan A, Legler J, Leonards P, Stigum H, Eggesbø M. Early-life exposure to persistent organic pollutants (OCPs, PBDEs, PCBs, PFASs) and attention-deficit/hyperactivity disorder: A multi-pollutant analysis of a Norwegian birth cohort. Environ Int 2019; 125:33-42. [PMID: 30703609 DOI: 10.1016/j.envint.2019.01.020] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 11/20/2018] [Accepted: 01/07/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Numerous ubiquitous environmental chemicals are established or suspected neurotoxicants, and infants are exposed to a mixture of these during the critical period of brain maturation. However, evidence for associations with the risk of attention-deficit/hyperactivity disorder (ADHD) is sparse. We investigated early-life chemical exposures in relation to ADHD. METHODS We used a birth cohort of 2606 Norwegian mother-child pairs enrolled 2002-2009 (HUMIS), and studied a subset of 1199 pairs oversampled for child neurodevelopmental outcomes. Concentrations of 27 persistent organic pollutants (14 polychlorinated biphenyls, 5 organochlorine pesticides, 6 brominated flame retardants, and 2 perfluoroalkyl substances) were measured in breast milk, reflecting the child's early-life exposures. We estimated postnatal exposures in the first 2 years of life using a pharmacokinetic model. Fifty-five children had a clinical diagnosis of ADHD (hyperkinetic disorder) by 2016, at a median age of 13 years. We used elastic net penalized logistic regression models to identify associations while adjusting for co-exposure confounding, and subsequently used multivariable logistic regression models to obtain effect estimates for the selected exposures. RESULTS Breast milk concentrations of perfluorooctane sulfonate (PFOS) and β‑hexachlorocyclohexane (β-HCH) were associated with increased odds of ADHD: odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.16, 2.72 and OR = 1.75, 95% CI: 1.22, 2.53, per interquartile range increase in ln-transformed concentrations, respectively. Stronger associations were observed among girls than boys for PFOS (pinteraction = 0.025). p,p'‑Dichlorodiphenyltrichloroethane (p,p'-DDT) levels were associated with lower odds of ADHD (OR = 0.64, 95% CI: 0.42, 0.97). Hexachlorobenzene (HCB) had a non-linear association with ADHD, with increasing risk in the low-level exposure range that switched to a decreasing risk at concentrations above 8 ng/g lipid. Postnatal exposures showed similar results, whereas effect estimates for other chemicals were weaker and imprecise. CONCLUSIONS In a multi-pollutant analysis of four classes of chemicals, early-life exposure to β-HCH and PFOS was associated with increased risk of ADHD, with suggestion of sex-specific effects for PFOS. The unexpected inverse associations between p,p'-DDT and higher HCB levels and ADHD could be due to live birth bias; alternatively, results may be due to chance findings.
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Affiliation(s)
- Virissa Lenters
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway.
| | - Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway.
| | - Joan Forns
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway.
| | - Eliška Čechová
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice; 753/5, 625 00 Brno, Czech Republic.
| | - Anton Kočan
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, Kamenice; 753/5, 625 00 Brno, Czech Republic.
| | - Juliette Legler
- Institute for Environmental Studies, VU University Amsterdam, De Boelelaan 1087, 1081 HV Amsterdam, the Netherlands.
| | - Pim Leonards
- Institute for Environmental Studies, VU University Amsterdam, De Boelelaan 1087, 1081 HV Amsterdam, the Netherlands.
| | - Hein Stigum
- Department of Non-Communicable Diseases, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway.
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway.
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12
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Iszatt N, Janssen S, Lenters V, Dahl C, Stigum H, Knight R, Mandal S, Peddada S, González A, Midtvedt T, Eggesbø M. Environmental toxicants in breast milk of Norwegian mothers and gut bacteria composition and metabolites in their infants at 1 month. Microbiome 2019; 7:34. [PMID: 30813950 PMCID: PMC6393990 DOI: 10.1186/s40168-019-0645-2] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/03/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Early disruption of the microbial community may influence life-long health. Environmental toxicants can contaminate breast milk and the developing infant gut microbiome is directly exposed. We investigated whether environmental toxicants in breastmilk affect the composition and function of the infant gut microbiome at 1 month. We measured environmental toxicants in breastmilk, fecal short-chain fatty acids (SCFAs), and gut microbial composition from 16S rRNA gene amplicon sequencing using samples from 267 mother-child pairs in the Norwegian Microbiota Cohort (NoMIC). We tested 28 chemical exposures: polychlorinated biphenyls (PCBs), polybrominated flame retardants (PBDEs), per- and polyfluoroalkyl substances (PFASs), and organochlorine pesticides. We assessed chemical exposure and alpha diversity/SCFAs using elastic net regression modeling and generalized linear models, adjusting for confounders, and variation in beta diversity (UniFrac), taxa abundance (ANCOM), and predicted metagenomes (PiCRUSt) in low, medium, and high exposed groups. RESULTS PBDE-28 and the surfactant perfluorooctanesulfonic acid (PFOS) were associated with less microbiome diversity. Some sub-OTUs of Lactobacillus, an important genus in early life, were lower in abundance in samples from infants with relative "high" (> 80th percentile) vs. "low" (< 20th percentile) toxicant exposure in this cohort. Moreover, breast milk toxicants were associated with microbiome functionality, explaining up to 34% of variance in acetic and propionic SCFAs, essential signaling molecules. Per one standard deviation of exposure, PBDE-28 was associated with less propionic acid (- 24% [95% CI - 35% to - 14%] relative to the mean), and PCB-209 with less acetic acid (- 15% [95% CI - 29% to - 0.4%]). Conversely, PFOA and dioxin-like PCB-167 were associated with 61% (95% CI 35% to 87%) and 22% (95% CI 8% to 35%) more propionic and acetic acid, respectively. CONCLUSIONS Environmental toxicant exposure may influence infant gut microbial function during a critical developmental window. Future studies are needed to replicate these novel findings and investigate whether this has any impact on child health.
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MESH Headings
- Adult
- Humans
- Infant, Newborn
- Bacteria/classification
- Bacteria/drug effects
- Bacteria/genetics
- Biodiversity
- Cohort Studies
- DNA, Bacterial/genetics
- DNA, Ribosomal/genetics
- Environmental Pollutants/adverse effects
- Environmental Pollutants/analysis
- Fatty Acids, Volatile/analysis
- Feces/chemistry
- Feces/microbiology
- Flame Retardants/adverse effects
- Flame Retardants/analysis
- Gastrointestinal Microbiome/drug effects
- Hydrocarbons, Chlorinated/adverse effects
- Hydrocarbons, Chlorinated/analysis
- Maternal Age
- Metabolomics
- Milk, Human/chemistry
- Norway
- Pesticides/adverse effects
- Pesticides/analysis
- Polychlorinated Biphenyls/adverse effects
- Polychlorinated Biphenyls/analysis
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA/methods
- Female
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Affiliation(s)
- Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Stefan Janssen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich-Heine University Dusseldorf, Dusseldorf, Germany
| | - Virissa Lenters
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Cecilie Dahl
- Department of Community Medicine and Global Health, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, 0450 Oslo, Norway
| | - Hein Stigum
- Department of Non-communicable Disease, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Center for Microbiome Innovation, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Department of Computer Science and Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Siddhartha Mandal
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area Gurgaon, Gurgaon 122002, India
| | - Shyamal Peddada
- Biostatistics Branch, National Institute of Environmental Health Sciences (NIEHS), 111 T.W. Alexander Drive, Durham, NC 27709 USA
| | - Antonio González
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Tore Midtvedt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Nobels väg 16, Solna Campus, Box 280, SE-171 77 Stockholm, Sweden
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
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13
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Martens AL, Reedijk M, Smid T, Huss A, Timmermans D, Strak M, Swart W, Lenters V, Kromhout H, Verheij R, Slottje P, Vermeulen RCH. Modeled and perceived RF-EMF, noise and air pollution and symptoms in a population cohort. Is perception key in predicting symptoms? Sci Total Environ 2018; 639:75-83. [PMID: 29778684 DOI: 10.1016/j.scitotenv.2018.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/23/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Psychosocial research has shown that perceived exposure can influence symptom reporting, regardless of actual exposure. The impact of this phenomenon on the interpretation of results from epidemiological research on environmental determinants of symptoms is unclear. OBJECTIVE Our aim was to compare associations between modeled exposures, the perceived level of these exposures and reported symptoms (non-specific symptoms, sleep disturbances, and respiratory symptoms) for three different environmental exposures (radiofrequency electromagnetic fields (RF-EMF), noise, and air pollution). These environmental exposures vary in the degree to which they can be sensorially observed. METHODS Participant characteristics, perceived exposures, and self-reported health were assessed with a baseline (n = 14,829, 2011/2012) and follow-up (n = 7905, 2015) questionnaire in the Dutch population-based Occupational and Environmental Health Cohort (AMIGO). Environmental exposures were estimated at the home address using spatial models. Cross-sectional and longitudinal regression models were used to examine the associations between modeled and perceived exposures, and reported symptoms. RESULTS The extent to which exposure sources could be observed by participants likely influenced correlations between modeled and perceived exposure as correlations were moderate for air pollution (rSp = 0.34) and noise (rSp = 0.40), but less so for RF-EMF (rSp = 0.11). Perceived exposures were consistently associated with increased symptom scores (respiratory, sleep, non-specific). Modeled exposures, except RF-EMF, were associated with increased symptom scores, but these associations disappeared or strongly diminished when accounted for perceived exposure in the analyses. DISCUSSION Perceived exposure has an important role in symptom reporting. When environmental determinants of symptoms are studied without acknowledging the potential role of both modeled and perceived exposures, there is a risk of bias in health risk assessment. However, the etiological role of exposure perceptions in relation to symptom reporting requires further research.
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Affiliation(s)
- Astrid L Martens
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Marije Reedijk
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Universiteitsweg 100, 3584CG Utrecht, The Netherlands.
| | - Tjabe Smid
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Anke Huss
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Danielle Timmermans
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands; National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721MA Bilthoven, The Netherlands.
| | - Maciej Strak
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Wim Swart
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721MA Bilthoven, The Netherlands.
| | - Virissa Lenters
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands.
| | - Robert Verheij
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513CR Utrecht, The Netherlands.
| | - Pauline Slottje
- Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorstraat 7, 1081BT Amsterdam, The Netherlands.
| | - Roel C H Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Yalelaan 2, 3508TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Universiteitsweg 100, 3584CG Utrecht, The Netherlands; Imperial College, Department of Epidemiology and Public Health, South Kensington Campus, SW7 2AZ London, United Kingdom.
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14
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Reedijk M, Lenters V, Slottje P, Pijpe A, Peeters PH, Korevaar JC, Bueno-de-Mesquita B, Verschuren WMM, Verheij RA, Pieterson I, van Leeuwen FE, Rookus MA, Kromhout H, Vermeulen RCH. Cohort profile: LIFEWORK, a prospective cohort study on occupational and environmental risk factors and health in the Netherlands. BMJ Open 2018; 8:e018504. [PMID: 29431129 PMCID: PMC5829595 DOI: 10.1136/bmjopen-2017-018504] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE LIFEWORK is a large federated prospective cohort established in the Netherlands to quantify the health effects of occupational and environmental exposures. This cohort is also the Dutch contribution to the international Cohort Study of Mobile Phone Use and Health (COSMOS). In this paper, we describe the study design, ongoing data collection, baseline characteristics of participants and the repeatability of key questionnaire items. PARTICIPANTS 88 466 participants were enrolled in three cohort studies in 2011-2012. Exposure information was collected by a harmonised core questionnaire, or modelled based on occupational and residential histories; domains include air pollution (eg, nitrogen dioxide (NO2), particulate matter with diameter ≤2.5 µm (PM2.5)), noise, electromagnetic fields (EMF), mobile phone use, shift work and occupational chemical exposures. Chronic and subacute health outcomes are assessed by self-report and through linkage with health registries. FINDINGS TO DATE Participants had a median age of 51 years at baseline (range 19-87), and the majority are female (90%), with nurses being over-represented. Median exposure levels of NO2, PM2.5, EMF from base stations and noise at the participants' home addresses at baseline were 22.9 µg/m3, 16.6 µg/m3, 0.003 mWm2 and 53.1 dB, respectively. Twenty-two per cent of participants reported to have started using a mobile phone more than 10 years prior to baseline. Repeatability for self-reported exposures was moderate to high (weighted kappa range: 0.69-1) for a subset of participants (n=237) who completed the questionnaire twice. FUTURE PLANS We are actively and passively observing participants; we plan to administer a follow-up questionnaire every 4-5 years-the first follow-up will be completed in 2018-and linkage to cause-of-death and cancer registries occurs on a (bi)annual basis. This prospective cohort offers a unique, large and rich resource for research on contemporary occupational and environmental health risks and will contribute to the large international COSMOS study on mobile phone use and health.
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Affiliation(s)
- Marije Reedijk
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Pauline Slottje
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Utrecht, The Netherlands
| | - Anouk Pijpe
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biostatistics and Epidemiology, Imperial College London, London, UK
| | - Joke C Korevaar
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Bas Bueno-de-Mesquita
- Department of Biostatistics and Epidemiology, Imperial College London, London, UK
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - W M Monique Verschuren
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Robert A Verheij
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Inka Pieterson
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Flora E van Leeuwen
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Matti A Rookus
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Hans Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biostatistics and Epidemiology, Imperial College London, London, UK
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Rosenquist AH, Høyer BB, Julvez J, Sunyer J, Pedersen HS, Lenters V, Jönsson BAG, Bonde JP, Toft G. Prenatal and Postnatal PCB-153 and p, p'-DDE Exposures and Behavior Scores at 5–9 Years of Age among Children in Greenland and Ukraine. Environ Health Perspect 2017; 125:107002. [PMID: 28974479 PMCID: PMC5933308 DOI: 10.1289/ehp553] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Studies have reported some evidence of adverse effects of organochlorine exposures on child development, but the results have been inconsistent, and few studies have evaluated associations with child behavior. OBJECTIVE We investigated the association between prenatal and early-life exposures to 2,2',4,4',5,5'-hexachlorobiphenyl (PCB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE) and behaviors in children between 5 and 9 y of age. METHODS In the Biopersistent organochlorines in diet and human fertility: Epidemiologic studies of time to pregnancy and semen quality in Inuit and European populations (INUENDO) cohort, consisting of mother-child pairs from Greenland and Ukraine (n=1,018), maternal serum PCB-153 and p,p'-DDE concentrations were measured during pregnancy, and cumulative postnatal exposures during the first 12 months after delivery were estimated using a pharmacokinetic model. Parents completed the Strengths and Difficulties Questionnaire (SDQ), and children's behaviors were dichotomized as abnormal (high) versus normal/borderline for five SDQ subscales and the total difficulties score. RESULTS The total difficulties score, an overall measure of abnormal behavior, was not clearly associated with pre- or postnatal exposures to PCB-153 or to p,p'-DDE. However, pooled adjusted odds ratios (ORs) for high conduct problem scores with a doubling of exposure were 1.19 (95% CI: 0.99, 1.42) and 1.16 (95% CI: 0.96, 1.41) for pre- and postnatal PCB-153, respectively, and 1.25 (95% CI: 1.04, 1.51) and 1.24 (95% CI: 1.01, 1.51) for pre- and postnatal p,p'-DDE, respectively. Corresponding ORs for high hyperactivity scores were 1.24 (95% CI: 0.94, 1.62) and 1.08 (95% CI: 0.81, 1.45) for pre- and postnatal PCB-153, respectively, and 1.43 (95% CI: 1.06, 1.92) and 1.27 (95% CI: 0.93, 1.73) for pre- and postnatal p,p'-DDE, respectively. CONCLUSION Prenatal and early postnatal exposures to p,p'-DDE and PCB-153 were associated with a higher prevalence of abnormal scores for conduct and hyperactivity at 5–9 y of age in our study population. These findings provide further support for the importance of minimizing organochlorine exposures to young children and to women of childbearing age. https://doi.org/10.1289/EHP553.
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Affiliation(s)
- Aske Hess Rosenquist
- Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus, Denmark
| | - Birgit Bjerre Høyer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital , Copenhagen, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus, Denmark
| | - Jordi Julvez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Catalonia, Spain
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Catalonia, Spain
| | | | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University , Utrecht, Netherlands
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Lund University , Lund, Sweden
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital , Copenhagen, Denmark
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus, Denmark
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Lenters V, Vermeulen R, Portengen L. Performance of variable selection methods for assessing the health effects of correlated exposures in case-control studies. Occup Environ Med 2017; 75:522-529. [PMID: 28947495 DOI: 10.1136/oemed-2016-104231] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 08/16/2017] [Accepted: 08/22/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES There is growing recognition that simultaneously assessing multiple exposures may reduce false positive discoveries and improve epidemiological effect estimates. We evaluated the performance of statistical methods for identifying exposure-outcome associations across various data structures typical of environmental and occupational epidemiology analyses. METHODS We simulated a case-control study, generating 100 data sets for each of 270 different simulation scenarios; varying the number of exposure variables, the correlation between exposures, sample size, the number of effective exposures and the magnitude of effect estimates. We compared conventional analytical approaches, that is, univariable (with and without multiplicity adjustment), multivariable and stepwise logistic regression, with variable selection methods: sparse partial least squares discriminant analysis, boosting, and frequentist and Bayesian penalised regression approaches. RESULTS The variable selection methods consistently yielded more precise effect estimates and generally improved selection accuracy compared with conventional logistic regression methods, especially for scenarios with higher correlation levels. Penalised lasso and elastic net regression both seemed to perform particularly well, specifically when statistical inference based on a balanced weighting of high sensitivity and a low proportion of false discoveries is sought. CONCLUSIONS In this extensive simulation study with multicollinear data, we found that most variable selection methods consistently outperformed conventional approaches, and demonstrated how performance is influenced by the structure of the data and underlying model.
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Affiliation(s)
- Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Departmentof Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lützen Portengen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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17
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Criswell R, Lenters V, Mandal S, Stigum H, Iszatt N, Eggesbø M. Persistent Environmental Toxicants in Breast Milk and Rapid Infant Growth. Ann Nutr Metab 2017; 70:210-216. [PMID: 28301833 DOI: 10.1159/000463394] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/13/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Many environmental toxicants are passed to infants in utero and through breast milk. Exposure to toxicants during the perinatal period can alter growth patterns, impairing growth or increasing obesity risk. Previous studies have focused on only a few toxicants at a time, which may confound results. We investigated levels of 26 toxicants in breast milk and their associations with rapid infant growth, a risk factor for later obesity. METHODS We used data from the Norwegian HUMIS study, a multi-center cohort of 2,606 mothers and newborns enrolled between 2002 and 2008. Milk samples collected 1 month after delivery from a subset of 789 women oversampled by overweight were analyzed for toxicants including polychlorinated biphenyls (PCBs), heavy metals, and pesticides. Growth was defined as change in weight-for-age z-score between 0 and 6 months among the HUMIS population, and rapid growth was defined as change in z-score above 0.67. We used a Bayesian variable selection method to determine the exposures that most explained variation in the outcome. Identified toxicants were included in logistic and linear regression models to estimate associations with growth, adjusting for maternal age, smoking, education, pre-pregnancy body mass index (BMI), gestational weight gain, parity, child sex, cumulative breastfeeding, birth weight, gestational age, and preterm status. RESULTS Of 789 infants, 19.2% displayed rapid growth. The median maternal age was 29.6 years, and the median pre-pregnancy BMI was 24.0 kg/m2, with 45.3% of mothers overweight or obese. Rapid growers were more likely to be firstborn. Hexachlorobenzene, β-hexachlorocyclohexane (β-HCH), and PCB-74 were identified in the variable selection method. An interquartile range (IQR) increase in β-HCH exposure was associated with a lower odds of rapid growth (OR 0.63, 95% CI 0.42-0.94). Newborns exposed to high levels of β-HCH showed reduced infant growth (β = -0.03, 95% CI -0.05 to -0.01 for IQR increase in breast milk concentration). No other significant associations were found. CONCLUSIONS Our results suggest that early life β-HCH exposure may be linked to slowed growth. Further research is warranted on the potential mechanism behind this association and the longer-term metabolic effects of perinatal β-HCH exposure.
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Affiliation(s)
- Rachel Criswell
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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18
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Lenters V, Portengen L, Rignell-Hydbom A, Jönsson BA, Lindh CH, Piersma AH, Toft G, Bonde JP, Heederik D, Rylander L, Vermeulen R. Prenatal Phthalate, Perfluoroalkyl Acid, and Organochlorine Exposures and Term Birth Weight in Three Birth Cohorts: Multi-Pollutant Models Based on Elastic Net Regression. Environ Health Perspect 2016; 124:365-72. [PMID: 26115335 PMCID: PMC4786980 DOI: 10.1289/ehp.1408933] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 06/23/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Some legacy and emerging environmental contaminants are suspected risk factors for intrauterine growth restriction. However, the evidence is equivocal, in part due to difficulties in disentangling the effects of mixtures. OBJECTIVES We assessed associations between multiple correlated biomarkers of environmental exposure and birth weight. METHODS We evaluated a cohort of 1,250 term (≥ 37 weeks gestation) singleton infants, born to 513 mothers from Greenland, 180 from Poland, and 557 from Ukraine, who were recruited during antenatal care visits in 2002-2004. Secondary metabolites of diethylhexyl and diisononyl phthalates (DEHP, DiNP), eight perfluoroalkyl acids, and organochlorines (PCB-153 and p,p´-DDE) were quantifiable in 72-100% of maternal serum samples. We assessed associations between exposures and term birth weight, adjusting for co-exposures and covariates, including prepregnancy body mass index. To identify independent associations, we applied the elastic net penalty to linear regression models. RESULTS Two phthalate metabolites (MEHHP, MOiNP), perfluorooctanoic acid (PFOA), and p,p´-DDE were most consistently predictive of term birth weight based on elastic net penalty regression. In an adjusted, unpenalized regression model of the four exposures, 2-SD increases in natural log-transformed MEHHP, PFOA, and p,p´-DDE were associated with lower birth weight: -87 g (95% CI: -137, -340 per 1.70 ng/mL), -43 g (95% CI: -108, 23 per 1.18 ng/mL), and -135 g (95% CI: -192, -78 per 1.82 ng/g lipid), respectively; and MOiNP was associated with higher birth weight (46 g; 95% CI: -5, 97 per 2.22 ng/mL). CONCLUSIONS This study suggests that several of the environmental contaminants, belonging to three chemical classes, may be independently associated with impaired fetal growth. These results warrant follow-up in other cohorts.
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Affiliation(s)
- Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Address correspondence to V. Lenters, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584CM Utrecht, the Netherlands. Telephone: 31-30-253-9527. E-mail:
| | - Lützen Portengen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Anna Rignell-Hydbom
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Bo A.G. Jönsson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Christian H. Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aldert H. Piersma
- Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Gunnar Toft
- Danish Ramazzini Center, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Góralczyk K, Pachocki KA, Hernik A, Struciński P, Czaja K, Lindh CH, Jönsson BAG, Lenters V, Korcz W, Minorczyk M, Matuszak M, Ludwicki JK. Perfluorinated chemicals in blood serum of inhabitants in central Poland in relation to gender and age. Sci Total Environ 2015; 532:548-555. [PMID: 26100734 DOI: 10.1016/j.scitotenv.2015.06.050] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/11/2015] [Accepted: 06/13/2015] [Indexed: 06/04/2023]
Abstract
The goal of this paper is to determine concentrations of seven selected perfluoroalkylated substances (PFASs): perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA) in the blood serum of men and women of reproductive age from the central region of Poland. The relation between sex of tested subjects and the levels of compounds in blood serum of humans will also be considered and analysed as an element of the risk assessment. The study was made on the blood serum samples collected from 253 women and 176 men of reproductive age between 20 and 44 years from Warsaw and surrounding areas. Higher concentrations of five (PFOS, PFOA, PFNA, PFDA, PFUnDA) from among seven selected PFASs were observed in men in comparison to women from the same populations. Only the concentrations of PFHxS and PFDoDA were slightly higher in women than in men. These differences were statistically significant in all cases, except for PFUnDA. The hypothesis that the concentrations of said compounds increase with age of the test subjects, regardless of gender has not been confirmed.
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Affiliation(s)
- Katarzyna Góralczyk
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Krzysztof A Pachocki
- Department of Radiation Hygiene and Radiobiology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Agnieszka Hernik
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Paweł Struciński
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Katarzyna Czaja
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Sweden Lund University, S-221 85 Lund, Sweden.
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Sweden Lund University, S-221 85 Lund, Sweden.
| | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands.
| | - Wojciech Korcz
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Maria Minorczyk
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Małgorzata Matuszak
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Jan K Ludwicki
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
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Góralczyk K, Struciński P, Wojtyniak B, Rabczenko D, Lindh CH, Jönsson BA, Toft G, Lenters V, Czaja K, Hernik A, Bonde JP, Pedersen HS, Zvyezday V, Ludwicki JK. Is the fact of parenting couples cohabitation affecting the serum levels of persistent organohalogen pollutants? Int J Hyg Environ Health 2015; 218:392-400. [DOI: 10.1016/j.ijheh.2015.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/05/2015] [Accepted: 03/07/2015] [Indexed: 01/31/2023]
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Smit LAM, Lenters V, Høyer BB, Lindh CH, Pedersen HS, Liermontova I, Jönsson BAG, Piersma AH, Bonde JP, Toft G, Vermeulen R, Heederik D. Prenatal exposure to environmental chemical contaminants and asthma and eczema in school-age children. Allergy 2015; 70:653-60. [PMID: 25753462 DOI: 10.1111/all.12605] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emerging evidence suggests that prenatal or early-life exposures to environmental contaminants may contribute to an increased risk of asthma and allergies in children. We aimed to the explore associations of prenatal exposures to a large set of environmental chemical contaminants with asthma and eczema in school-age children. METHODS We studied 1024 mother-child pairs from Greenland and Ukraine from the INUENDO birth cohort. Data were collected by means of an interview-based questionnaire when the children were 5-9 years of age. Questions from the ISAAC study were used to define asthma, eczema, and wheeze. We applied principal components analysis (PCA) to sixteen contaminants in maternal serum sampled during pregnancy, including perfluoroalkyl substances (PFASs), metabolites of diethylhexyl (DEHP) and diisononyl (DiNP) phthalates, PCB-153, and p,p'-DDE. Scores of five principal components (PCs) explaining 70% of the variance were included in multiple logistic regression models. RESULTS In a meta-analysis that included both populations, the PC2 score, reflecting exposure to DiNP, was negatively associated with current eczema (OR 0.71, 95% CI 0.52-0.96). Other associations were not consistent between the two populations. In Ukrainian children, the PC3 score (DEHP) was positively associated with current wheeze (adjusted OR 1.56, 95% CI 1.03-2.37), whereas the PC5 score, dominated by perfluorooctanoic acid (PFOA), was inversely associated with current wheeze (OR 0.64, 0.41-0.99). In Greenlandic children, a negative association of PC4 (organochlorines) with ever eczema (OR 0.78, 0.61-0.99) was found. CONCLUSIONS We found limited evidence to support a link between prenatal exposure to environmental chemical contaminants and childhood asthma and eczema.
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Affiliation(s)
- L. A. M. Smit
- IRAS; Division of Environmental Epidemiology; Utrecht University; Utrecht The Netherlands
| | - V. Lenters
- IRAS; Division of Environmental Epidemiology; Utrecht University; Utrecht The Netherlands
| | - B. B. Høyer
- Danish Ramazzini Centre; Department of Occupational Medicine; Aarhus University Hospital; Aarhus Denmark
| | - C. H. Lindh
- Division of Occupational and Environmental Medicine; Department of Laboratory Medicine; Lund University; Lund Sweden
| | - H. S. Pedersen
- Centre for Arctic Environmental Medicine; Dronning Ingrids Hospital; Nuuk Greenland
| | - I. Liermontova
- Department of Social Medicine and Organization of Public Health; Kharkiv National Medical University; Kharkiv Ukraine
| | - B. A. G. Jönsson
- Division of Occupational and Environmental Medicine; Department of Laboratory Medicine; Lund University; Lund Sweden
| | - A. H. Piersma
- Laboratory for Health Protection Research; National Institute for Public Health and the Environment (RIVM); Bilthoven The Netherlands
| | - J. P. Bonde
- Department of Occupational and Environmental Medicine; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - G. Toft
- Danish Ramazzini Centre; Department of Occupational Medicine; Aarhus University Hospital; Aarhus Denmark
| | - R. Vermeulen
- IRAS; Division of Environmental Epidemiology; Utrecht University; Utrecht The Netherlands
| | - D. Heederik
- IRAS; Division of Environmental Epidemiology; Utrecht University; Utrecht The Netherlands
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Ludwicki JK, Góralczyk K, Struciński P, Wojtyniak B, Rabczenko D, Toft G, Lindh CH, Jönsson BAG, Lenters V, Heederik D, Czaja K, Hernik A, Pedersen HS, Zvyezday V, Bonde JP. Hazard quotient profiles used as a risk assessment tool for PFOS and PFOA serum levels in three distinctive European populations. Environ Int 2015; 74:112-118. [PMID: 25454227 DOI: 10.1016/j.envint.2014.10.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/29/2014] [Accepted: 10/02/2014] [Indexed: 06/04/2023]
Abstract
Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) blood levels are commonly used as biomarkers of human environmental exposure to these compounds. Many biomonitoring studies indicate 100% detection for PFOS and PFOA thus justifying a concern of possible risk for the most exposed individuals. This study addresses the predictive value of hazard quotients (HQs) calculated on the basis of serum PFOS and PFOA in male and female populations of reproductive age in Greenland, Poland and Ukraine. Overall, 2026 results of PFOS and PFOA serum concentrations (589 males, 1437 females) were obtained from the INUENDO database. HQs were calculated from the actual biomonitoring results and literature-based animal data linking toxicological outcomes and critical PFOS/PFOA serum levels. HQs for serum PFOS were calculated based on Points of Departure (PoD) at 13μgmL(-1) (cynomolgus monkeys, 183days, changes in THS and T3) and for PFOA at 7.1μgmL(-1) serum (male rats, 90days, hepatocellular necrosis, increased liver weight). Uncertainty factors were applied to reflect interspecies differences and human variability. Serum HQs were expressed as a ratio relative to the point of departure for each PFOS and PFOA. Only in the three cases of males in Greenland were there serum PFOS levels showing HQ values exceeding 1, so indicating that such serum levels may be of concern. The mean serum concentration of PFOS was significantly higher in male than in female populations. Despite significant differences between HQ profiles for PFOS and PFOA in donors from Greenland, Poland and Ukraine, the concentrations of these perfluoroalkylated compounds do not indicate a cause for concern, except for the three aforementioned cases from Greenland. This study demonstrates that the HQ approach can help to interpret human biomonitoring data and thus serve as a valuable tool in further risk assessment priority settings and may also be used as a basis for taking decisions in risk management.
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Affiliation(s)
- Jan K Ludwicki
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Katarzyna Góralczyk
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Paweł Struciński
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Bogdan Wojtyniak
- Centre of Monitoring and Analyses of Population Health, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Daniel Rabczenko
- Centre of Monitoring and Analyses of Population Health, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Gunnar Toft
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 2c, 8000 Aarhus C, Denmark.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, S-221 85 Lund, Sweden.
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Lund University, S-221 85 Lund, Sweden.
| | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80.178, 3508 TD Utrecht, The Netherlands.
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80.178, 3508 TD Utrecht, The Netherlands.
| | - Katarzyna Czaja
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Agnieszka Hernik
- Department of Toxicology and Risk Assessment, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | | | - Valentyna Zvyezday
- Department of Social Medicine and Organization of Public Health, Kharkiv National Medical University, 61022 Kharkiv, Ukraine.
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
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Jørgensen KT, Specht IO, Lenters V, Bach CC, Rylander L, Jönsson BAG, Lindh CH, Giwercman A, Heederik D, Toft G, Bonde JP. Perfluoroalkyl substances and time to pregnancy in couples from Greenland, Poland and Ukraine. Environ Health 2014; 13:116. [PMID: 25533644 PMCID: PMC4391306 DOI: 10.1186/1476-069x-13-116] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/03/2014] [Indexed: 05/05/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are suggested to affect human fecundity through longer time to pregnancy (TTP). We studied the relationship between four abundant PFAS and TTP in pregnant women from Greenland, Poland and Ukraine representing varying PFAS exposures and pregnancy planning behaviors. METHODS We measured serum levels of perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) in 938 women from Greenland (448 women), Poland (203 women) and Ukraine (287 women). PFAS exposure was assessed on a continuous logarithm transformed scale and in country-specific tertiles. We used Cox discrete-time models and logistic regression to estimate fecundability ratios (FRs) and infertility (TTP >13 months) odds ratios (ORs), respectively, and 95% confidence intervals (CI) according to PFAS levels. Adjusted analyses of the association between PFAS and TTP were done for each study population and in a pooled sample. RESULTS Higher PFNA levels were associated with longer TTP in the pooled sample (log-scale FR = 0.80; 95% CI 0.69-0.94) and specifically in women from Greenland (log-scale FR = 0.72; 95% CI 0.58-0.89). ORs for infertility were also increased in the pooled sample (log-scale OR = 1.53; 95% CI 1.08-2.15) and in women from Greenland (log-scale OR = 1.97; 95% CI 1.22-3.19). However, in a sensitivity analysis of primiparous women these associations could not be replicated. Associations with PFNA were weaker for women from Poland and Ukraine. PFOS, PFOA and PFHxS were not consistently associated with TTP. CONCLUSIONS Findings do not provide consistent evidence that environmental exposure to PFAS is impairing female fecundity by delaying time taken to conceive.
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Affiliation(s)
- Kristian T Jørgensen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Ina O Specht
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
| | - Cathrine C Bach
- Perinatal Epidemiology Research Unit, Aarhus University Hospital, Skejby, Denmark.
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Malmö University Hospital, Lund University, Malmö, Sweden.
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
| | - Gunnar Toft
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Aarhus, Denmark.
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
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Lenters V, Portengen L, Smit LAM, Jönsson BAG, Giwercman A, Rylander L, Lindh CH, Spanò M, Pedersen HS, Ludwicki JK, Chumak L, Piersma AH, Toft G, Bonde JP, Heederik D, Vermeulen R. Phthalates, perfluoroalkyl acids, metals and organochlorines and reproductive function: a multipollutant assessment in Greenlandic, Polish and Ukrainian men. Occup Environ Med 2014; 72:385-93. [DOI: 10.1136/oemed-2014-102264] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/20/2014] [Indexed: 11/03/2022]
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Specht IO, Toft G, Hougaard KS, Lindh CH, Lenters V, Jönsson BAG, Heederik D, Giwercman A, Bonde JPE. Associations between serum phthalates and biomarkers of reproductive function in 589 adult men. Environ Int 2014; 66:146-156. [PMID: 24583187 DOI: 10.1016/j.envint.2014.02.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 06/03/2023]
Abstract
Phthalates which are widely used, are ubiquitous in the environment and in some human tissues. It is generally accepted that phthalates exert their toxic action by inhibiting Leydig cell synthesis of testosterone, but in vitro studies have also shown anti-androgenic effects at the receptor level. Some cross-sectional studies have shown inverse associations between urinary levels of phthalates and reproductive hormones, but results are conflicting and the evidence base is limited. The aim of this study was to investigate if levels of di-2-ethylhexyl phthalate (DEHP) and diisononyl phthalate (DiNP) metabolites in serum are associated with serum concentrations of male reproductive hormones and semen quality. A secondary aim was to investigate metabolic pathways of DEHP and DiNP on semen quality and reproductive hormones. A cross-sectional sample of 589 spouses of pregnant women from Greenland, Poland and Ukraine were enrolled between 2002 and 2004. The men gave semen and blood samples and were interviewed. Six phthalate metabolites of DEHP and DiNP were measured by liquid chromatography tandem mass spectrometry in serum. The metabolites were summed according to their molar weight. We observed significant inverse associations between serum levels of the metabolites, the proxies and serum testosterone. Negative associations were also discovered between some metabolites and sex hormone-binding globulin, semen volume and total sperm count. Findings are compatible with a weak anti-androgenic action of DEHP metabolites, but less so for DiNP metabolites. Metabolic pathways differed significantly between the three study sites, but without major effect on semen quality or reproductive hormones.
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Affiliation(s)
- Ina Olmer Specht
- Department of Occupational and Environmental Medicine, University Hospital of Copenhagen, DK-2400 Copenhagen NV, Denmark.
| | - Gunnar Toft
- Department of Occupational Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
| | - Karin S Hougaard
- National Research Centre for the Working Environment, DK-2100 Copenhagen Ø, Denmark.
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
| | - Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, NL-3584 CM Utrecht, The Netherlands.
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, NL-3584 CM Utrecht, The Netherlands
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Malmö University Hospital, Lund University, Malmö SE-20502, Sweden.
| | - Jens Peter E Bonde
- Department of Occupational and Environmental Medicine, University Hospital of Copenhagen, DK-2400 Copenhagen NV, Denmark.
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Lenters V, Thomsen C, Smit LAM, Jönsson BAG, Pedersen HS, Ludwicki JK, Zviezdai V, Piersma AH, Toft G, Bonde JP, Becher G, Vermeulen R, Heederik D. Serum concentrations of polybrominated diphenyl ethers (PBDEs) and a polybrominated biphenyl (PBB) in men from Greenland, Poland and Ukraine. Environ Int 2013; 61:8-16. [PMID: 24091254 DOI: 10.1016/j.envint.2013.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/08/2013] [Accepted: 09/02/2013] [Indexed: 06/02/2023]
Abstract
Many brominated flame retardants (BFRs)-including polybrominated diphenyl ethers (PBDEs)-have been shown to persist in the environment, and some have been associated with adverse health effects. The aim of the present study was to quantify serum concentrations of common brominated flame retardants in Inuit men from across Greenland, and in men from Warsaw, Poland and Kharkiv, Ukraine. Serum was sampled between 2002 and 2004 from men 19 to 50years of age. 299 samples were analyzed for BDE-28, 47, 99, 100, 153, 154 and 183 and the brominated biphenyl BB-153 using gas chromatography-high resolution mass spectrometry. BDE-47 and BDE-153 were detected in more than 95% of samples from all three populations. All other congeners, except BDE-154, were detected in more than 70% of samples from Greenland; lower detection frequencies were observed in Polish and Ukrainian samples. Concentrations of individual congeners were 2.7 to 15 fold higher in Greenlandic relative to Polish and Ukrainian men. Geometric mean concentrations of the sum of the most abundant PBDEs of the Penta-BDE commercial mixture (BDE-47, 99, 100, 153 and 154) were 6.1, 1.7 and 0.87ng/g lipids in the Greenlandic, Polish and Ukrainian men, respectively. Furthermore, significant geographical differences in BFR concentrations were observed within Greenland. Principal component analysis revealed distinct clustering of samples by country of origin. The associations between ΣPBDEs and age were inconsistent, varying from no association in Greenlandic and Polish study populations to a U-shaped relationship in Ukrainians. We report BFR levels for three populations for which sparse biomonitoring data exists.
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Affiliation(s)
- Virissa Lenters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80.178, 3508 TD Utrecht, The Netherlands.
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van der Bij S, Koffijberg H, Lenters V, Portengen L, Moons KGM, Heederik D, Vermeulen RCH. Lung cancer risk at low cumulative asbestos exposure: meta-regression of the exposure-response relationship. Cancer Causes Control 2012. [PMID: 23187858 DOI: 10.1007/s10552-012-0107-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Existing estimated lung cancer risks per unit of asbestos exposure are mainly based on, and applicable to, high exposure levels. To assess the risk at low cumulative asbestos exposure, we provide new evidence by fitting flexible meta-regression models, a notably new and more robust method. METHODS Studies were selected if lung cancer risk per cumulative asbestos exposure in at least two exposure categories was reported. From these studies (n = 19), we extracted 104 risk estimates over a cumulative exposure range of 0.11-4,710 f-y/ml. We fitted linear and natural spline meta-regression models to these risk estimates. A natural spline allows risks to vary nonlinearly with exposure, such that estimates at low exposure are less affected by estimates in the upper exposure categories. Associated relative risks (RRs) were calculated for several low cumulative asbestos exposures. RESULTS A natural spline model fitted our data best. With this model, the relative lung cancer risk for cumulative exposure levels of 4 and 40 f-y/ml was estimated between 1.013 and 1.027, and 1.13 and 1.30, respectively. After stratification by fiber type, a non-significant three- to fourfold difference in RRs between chrysotile and amphibole fibers was found for exposures below 40 f-y/ml. Fiber-type-specific risk estimates were strongly influenced by a few studies. CONCLUSIONS The natural spline regression model indicates that at lower asbestos exposure levels, the increase in RR of lung cancer due to asbestos exposure may be larger than expected from previous meta-analyses. Observed potency differences between different fiber types are lower than the generally held consensus. Low-exposed industrial or population-based cohorts with quantitative estimates of asbestos exposure a required to substantiate the risk estimates at low exposure levels from our new, flexible meta-regression.
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Affiliation(s)
- Sjoukje van der Bij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.
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Affiliation(s)
- Virissa Lenters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Lindh CH, Rylander L, Toft G, Axmon A, Rignell-Hydbom A, Giwercman A, Pedersen HS, Góalczyk K, Ludwicki JK, Zvyezday V, Vermeulen R, Lenters V, Heederik D, Bonde JP, Jönsson BAG. Blood serum concentrations of perfluorinated compounds in men from Greenlandic Inuit and European populations. Chemosphere 2012; 88:1269-75. [PMID: 22494529 DOI: 10.1016/j.chemosphere.2012.03.049] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 05/02/2023]
Abstract
Perfluorinated compounds (PFCs), such as perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), are used in large quantities. They are persistent and found in measurable levels in human serum around the world. They have been associated with developmental, hepatic, and carcinogenic effects in animal studies. The aim of the present study was to describe levels of PFCs in serum among Inuits from Greenland and inhabitants from Warsaw, Poland and Kharkiv, Ukraine. Furthermore, the aim was to define social- and lifestyle related determinants of exposure for these compounds. Serum levels of seven PFCs were analyzed by liquid chromatography/tandem mass spectrometry (LC/MS/MS). The concentrations of PFOS and PFOA were the highest of all PFCs in all three populations with a total amount of almost 90% of the PFCs. The mean levels of PFOS and PFOA were in the Greenlandic Inuits 52 and 4.8 ng mL(-1), in Poland 19 and 5.2 ng mL(-1), and in Ukraine 8.1 and 1.9 ng mL(-1), respectively. Thus, levels of PFCs in the serum of Inuits on Greenland were among the highest described in a general population whereas the levels in Poland were similar to other industrialized countries. The exposure in Ukraine was rather low. In the Greenlandic Inuit population, intake of seafood, tea, age and area of living were significant determinants of PFOS concentrations and explained about 22% of the variation. For the other populations no strong determinants were found.
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Affiliation(s)
- Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
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Saberi Hosnijeh F, Lenters V, Boers D, Portengen L, Baeten E, Bueno-de-Mesquita HB, Heederik DJJ, Bloem AC, Vermeulen R. Changes in lymphocyte subsets in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Occup Environ Med 2012; 69:781-6. [DOI: 10.1136/oemed-2011-100463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Toft G, Jönsson B, Lindh C, Giwercman A, Spano M, Heederik D, Lenters V, Vermeulen R, Rylander L, Pedersen H, Ludwicki J, Zviezdai V, Bonde J. Exposure to perfluorinated compounds and human semen quality in arctic and European populations. Hum Reprod 2012; 27:2532-40. [DOI: 10.1093/humrep/des185] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lenters V, Vermeulen R, Dogger S, Stayner L, Portengen L, Burdorf A, Heederik D. A meta-analysis of asbestos and lung cancer: is better quality exposure assessment associated with steeper slopes of the exposure-response relationships? Environ Health Perspect 2011; 119:1547-55. [PMID: 21708512 PMCID: PMC3226488 DOI: 10.1289/ehp.1002879] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 06/27/2011] [Indexed: 05/26/2023]
Abstract
BACKGROUND Asbestos is a well-recognized cause of lung cancer, but there is considerable between-study heterogeneity in the slope of the exposure-response relationship. OBJECTIVE We considered the role of quality of the exposure assessment to potentially explain heterogeneity in exposure-response slope estimates. DATA SOURCES We searched PubMed MEDLINE (1950-2009) for studies with quantitative estimates of cumulative asbestos exposure and lung cancer mortality and identified 19 original epidemiological studies. One was a population-based case-control study, and the others were industry-based cohort studies. DATA EXTRACTION Cumulative exposure categories and corresponding risks were abstracted. Exposure-response slopes [KL (lung cancer potency factor of asbestos)] were calculated using linear relative risk regression models. DATA SYNTHESIS We assessed the quality of five exposure assessment aspects of each study and conducted random effects univariate and multivariate meta-regressions. Heterogeneity in exposure-response relationships was greater than expected by chance (I2 = 64%). Stratification by exposure assessment characteristics revealed that studies with well-documented exposure assessment, larger contrast in exposure, greater coverage of the exposure history by exposure measurement data, and more complete job histories had higher meta-KL values than did studies without these characteristics. The latter two covariates were most strongly associated with the KL value. Meta-KL values increased when we incrementally restricted analyses to higher-quality studies. CONCLUSIONS This meta-analysis indicates that studies with higher-quality asbestos exposure assessment yield higher meta-estimates of the lung cancer risk per unit of exposure. Potency differences for predominantly chrysotile versus amphibole asbestos-exposed cohorts become difficult to ascertain when meta-analyses are restricted to studies with fewer exposure assessment limitations.
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Affiliation(s)
- Virissa Lenters
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
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van der Bij S, Koffijberg H, Lenters V, Portengen L, Moons K, Heederik D, Vermeulen R. Lung cancer risk at low asbestos exposure: meta-regression of the exposure-response relationship. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McElvenny DM, Hurley MA, Lenters V, Heederik D, Wilkinson S, Coggon D. Lung cancer mortality in a cohort of UK cotton workers: an extended follow-up. Br J Cancer 2011; 105:1054-60. [PMID: 21847124 PMCID: PMC3185933 DOI: 10.1038/bjc.2011.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: A recent systematic review and meta-analysis suggested that occupational exposure to endotoxins protects against lung cancer. To explore this hypothesis further, the follow-up of mortality of a cohort of 3551 workers, who were employed in the British cotton industry during 1966–1971, was extended by 23 years. Methods: Subjects had originally been recruited to a survey of respiratory disease, which collected information about occupation and smoking habits. Cumulative exposures to endotoxins were estimated from data on endotoxin levels by work areas in cotton mills. Risks of lung cancer were estimated using survival modelling. Results: During follow-up, 2018 deaths were recorded before the age of 90 years, including 128 deaths from lung cancer. After adjustment for smoking, hazard ratios (95% confidence intervals) for cumulative endotoxin exposures of ⩽30 000, >30 000 and ⩽200 000, >200 000 and ⩽400 000, >400 000 and ⩽600 000 and >600 000 endotoxin units (EU) m−3 years were 1, 0.8 (0.5–1.6), 0.7 (0.4–1.3), 0.6 (0.3–1.0) and 0.5 (0.3–0.9), respectively (P for trend=0.005). Conclusion: Our findings strengthen the evidence that occupational exposure to endotoxins protects against lung cancer, and suggest that the effect depends on cumulative dose and persists after exposure ceases.
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Affiliation(s)
- D M McElvenny
- School of Health, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK.
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Zuurbier M, Hoek G, Oldenwening M, Lenters V, Meliefste K, van den Hazel P, Brunekreef B. Commuters' exposure to particulate matter air pollution is affected by mode of transport, fuel type, and route. Environ Health Perspect 2010; 118:783-9. [PMID: 20185385 PMCID: PMC2898854 DOI: 10.1289/ehp.0901622] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 02/25/2010] [Indexed: 05/19/2023]
Abstract
BACKGROUND Commuters are exposed to high concentrations of air pollutants, but little quantitative information is currently available on differences in exposure between different modes of transport, routes, and fuel types. OBJECTIVES The aim of our study was to assess differences in commuters' exposure to traffic-related air pollution related to transport mode, route, and fuel type. METHODS We measured particle number counts (PNCs) and concentrations of PM2.5 (particulate matter <or= 2.5 microm in aerodynamic diameter), PM10, and soot between June 2007 and June 2008 on 47 weekdays, from 0800 to 1000 hours, in diesel and electric buses, gasoline- and diesel-fueled cars, and along two bicycle routes with different traffic intensities in Arnhem, the Netherlands. In addition, each-day measurements were taken at an urban background location. RESULTS We found that median PNC exposures were highest in diesel buses (38,500 particles/cm3) and for cyclists along the high-traffic intensity route (46,600 particles/cm3) and lowest in electric buses (29,200 particles/cm3). Median PM10 exposure was highest from diesel buses (47 microg/m3) and lowest along the high- and low-traffic bicycle routes (39 and 37 microg/m3). The median soot exposure was highest in gasoline-fueled cars (9.0 x 10-5/m), diesel cars (7.9 x 10-5/m), and diesel buses (7.4 x 10-5/m) and lowest along the low-traffic bicycle route (4.9 x 10-5/m). Because the minute ventilation (volume of air per minute) of cyclists, which we estimated from measured heart rates, was twice the minute ventilation of car and bus passengers, we calculated that the inhaled air pollution doses were highest for cyclists. With the exception of PM10, we found that inhaled air pollution doses were lowest for electric bus passengers. CONCLUSIONS Commuters' rush hour exposures were significantly influenced by mode of transport, route, and fuel type.
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Affiliation(s)
- Moniek Zuurbier
- Public Health Services Gelderland Midden, Arnhem, the Netherlands.
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Lenters V, Basinas I, Beane-Freeman L, Boffetta P, Checkoway H, Coggon D, Portengen L, Sim M, Wouters IM, Heederik D, Vermeulen R. Endotoxin exposure and lung cancer risk: a systematic review and meta-analysis of the published literature on agriculture and cotton textile workers. Cancer Causes Control 2009; 21:523-55. [PMID: 20012774 PMCID: PMC2839468 DOI: 10.1007/s10552-009-9483-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 11/20/2009] [Indexed: 01/21/2023]
Abstract
Objective To examine the association between exposure to endotoxins and lung cancer risk by conducting a systematic review and meta-analysis of epidemiologic studies of workers in the cotton textile and agricultural industries; industries known for high exposure levels of endotoxins. Methods Risk estimates were extracted from studies published before 2009 that met predefined quality criteria, including 8 cohort, 1 case–cohort, and 2 case–control studies of cotton textile industry workers, and 15 cohort and 2 case–control studies of agricultural workers. Summary risk estimates were calculated using random effects meta-analyses. Potential sources of heterogeneity were explored through subgroup analyses. Results The summary risk of lung cancer was 0.72 (95% CI, 0.57–0.90) for textile workers and 0.62 (0.52–0.75) for agricultural workers. The relative risk of lung cancer was below 1.0 for most subgroups defined according to sex, study design, outcome, smoking adjustment, and geographic area. Two studies provided quantitative estimates of endotoxin exposure and both studies tended to support a dose–dependent protective effect of endotoxins on lung cancer risk. Conclusion Despite several limitations, this meta-analysis based on high-quality studies adds weight to the hypothesis that occupational exposure to endotoxin in cotton textile production and agriculture is protective against lung cancer.
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Affiliation(s)
- Virissa Lenters
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD, Utrecht, The Netherlands
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Lee KH, Vermeulen R, Lenters V, Cho SH, Strickland PT, Kang D. Determinants of urinary 1-hydroxypyrene glucuronide in South Korean children. Int Arch Occup Environ Health 2008; 82:961-8. [PMID: 19020893 DOI: 10.1007/s00420-008-0385-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 11/03/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study was conducted to investigate the dominant sources of the urinary pyrene metabolite, 1-hydroxypyrene glucuronide (1-OHPG), in South Korean children. METHODS Urine samples were collected from 102 non-smoking children (aged 10-14). Urinary 1-OHPG was assayed by synchronous fluorescence spectroscopy, following immuno-affinity purification using monoclonal antibody 8E11. Urinary cotinine, a metabolite of nicotine, was measured by GC/MS. Information on environmental tobacco smoke (ETS) exposure, diet, fuel type for heating home, and other possible sources of PAH exposure was collected by self-administered questionnaires. RESULTS Mean (+/-SE) 1-OHPG levels were 1.64 (+/-0.06) ng/ml (range 0.04-3.27 ng/ml). Two multiple linear regression analyses (differing in how ETS was approximated: by parental smoking or urinary cotinine) revealed a positive association between urinary 1-OHPG levels and parental smoking at home (P = 0.007), log urinary cotinine (P = 0.165), frequent grilled (shell)fish consumption (P = 0.061), and living in a commercial/other zone (P = 0.007) versus a residential or industrial zone. No consistent associations were found between 1-OHPG and the child's sex, grilled meat consumption, or fuels used to heat the home. CONCLUSIONS These results support that ETS, frequent grilled fish consumption, and the ambient environment are important predictors of urinary 1-OHPG levels in South Korean children.
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Affiliation(s)
- Kyoung-Ho Lee
- Biomedical Research Group, Hanyang Brain Korea 21, Hanyang University, Seoul, Republic of Korea
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