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Hussey MR, Suter MK, Mohanty AF, Enquobahrie DA. Placental cadmium, placental genetic variations, and birth size. J Matern Fetal Neonatal Med 2021; 35:8594-8602. [PMID: 34666587 DOI: 10.1080/14767058.2021.1989404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Maternal cadmium (Cd) burden has been associated with offspring birth size measures, yet associations of placental Cd with birth size are less clear. Further, the role of genetics in these associations has not been examined. We investigated associations of placental Cd with birth size and placental genotypes. We also examined the potential role of placental genotypes as modifiers of placental Cd and birth size associations. METHODS Participants were 490 mother-child pairs from the Omega and Placenta Microarray studies based in Seattle, WA. Placental Cd was measured using Agilent 7500 ICP-MS. The birth size was characterized using birth weight (BW), ponderal index (PI), and head circumference (HC). Eleven placental single nucleotide polymorphisms (SNPs) related to metal transport, growth regulation, endocrine response, and cell signaling were genotyped. Adjusted multivariable linear regression models were used to examine overall and sex-specific associations of placental Cd with birth size (BW, PI and HC), as well as associations of placental genotypes with placental Cd. Effect modification of placenta Cd and birth size associations by placental SNPs was examined using interaction terms and stratified analyses. RESULTS Mean maternal age was 33.6 years (SD = 4.4). Mean and median placental Cd levels were 4.0 ng/g tissue (SD = 2.7 ng/g tissue) and 3.6 ng/g (IQR 2.5 - 5.2 ng/g), respectively. Overall, compared with infants in the lowest quartile for placental Cd, infants in the second (ß = -102.8 g, 95% CI: -220.7, 15.1), third (ß = -83.2 g, 95% CI: -199.3, 32.9) and fourth (ß = -109.2 g, 95% CI: -225.4, 7.1) quartiles had lower BW, though associations were not statistically significant (all p-values > .05, trend p-value = .11). Among male infants, infants in the second (ß = -203.3 g, 95% CI: -379.7, -27.0) and fourth quartiles (ß = -198.3 g, 95% CI: -364.2, -32.5) had lower BW compared with those in the first quartiles (p-values < .05, trend p-value = .08). Similar relationships were not observed among female infants, though infant sex-placental Cd interaction terms were not significant. Similarly, male, but not female, infants had marginally significant positive associations between placental Cd and ponderal index (trend p-value = .06). The minor rs3811647 allele of the placental transferrin gene (NCBI Gene ID: 7018) was associated with an increase in Cd among all infants (p-value = .04). We did not find differences in associations of placental Cd with birth size markers among infants stratified by rs3811647 genotype. CONCLUSIONS Placental Cd was inversely associated with BW among male infants. The rs3811647 SNP of the transferrin gene was associated with placental Cd.
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Affiliation(s)
- Michael R Hussey
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Megan K Suter
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - April F Mohanty
- Informatics, Decision Enhancement, and Analytic Sciences Center (IDEAS), VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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Suter MK, Enquobahrie D, Karr C, Sathyanarayana S, Flynn JT, Lamadrid-Figueroa H, Hernandez-Avilla M, Peterson K, Hu H, Tellez-Rojo MM. Abstract P206: Prenatal Cadmium Burden, Birth Weight, And Offspring Adolescent Blood Pressure. Hypertension 2020. [DOI: 10.1161/hyp.76.suppl_1.p206] [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: 11/16/2022]
Abstract
Background:
Cadmium is a ubiquitous, toxic heavy metal associated with several adverse health outcomes, including high blood pressure, in adults. The impact of maternal cadmium burden on offspring birth weight and have not been thoroughly explored. We investigated associations of prenatal cadmium burden with birth weight and offspring blood pressure in childhood and adolescence.
Methods:
We analyzed data from 202 mother-child pairs who were recruited for the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) study in Mexico City (1997-2000). Prenatal cadmium burden was characterized using maternal urine collected in the third trimester of pregnancy - continuous and quartile specific-gravity adjusted cadmium (log-UCd, μg/L). Outcomes were offspring birth weight and blood pressure (measured at age 7-15 years). Blood pressure status (normal, elevated, stage 1 hypertension) was defined based on the 2017 American Academy of Pediatrics Guidelines. Those with elevated or stage 1 hypertension were categorized as having high blood pressure. Linear and logistic regression models were used to examine associations, adjusted for potential confounders. Potential effect modification by offspring sex was assessed using interaction terms and sex-stratified models.
Results:
Study participants included 93 males and 109 females, with a mean age of 10.0 (SD=1.5) years. Median third trimester urinary cadmium concentration was 0.17 μg/L (IQR=0.12, 0.26). The prevalence of high blood pressure was 19.3% (39/202). Prenatal cadmium was not associated with birthweight (β=-58.94 grams, 95%CI: -138.07, 20.19), offspring systolic blood pressure (β=-0.90 mmHg, 95%CI: -2.87, 1.06), diastolic blood pressure (β=-1.21 mmHg, 95%CI: -2.68, 0.26), or high blood pressure (OR=0.64, 95%CI: 0.34, 1.21). We found similar results when prenatal cadmium was modeled with quartiles. There was no evidence of effect modification by sex for any of the outcomes.
Conclusions:
In the current study, maternal third trimester was not associated with offspring blood pressure or birth weight, however future studies are needed to confirm these findings.
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Shaffer RM, Sellers SP, Baker MG, de Buen Kalman R, Frostad J, Suter MK, Anenberg SC, Balbus J, Basu N, Bellinger DC, Birnbaum L, Brauer M, Cohen A, Ebi KL, Fuller R, Grandjean P, Hess JJ, Kogevinas M, Kumar P, Landrigan PJ, Lanphear B, London SJ, Rooney AA, Stanaway JD, Trasande L, Walker K, Hu H. Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors. Environ Health Perspect 2019; 127:105001. [PMID: 31626566 PMCID: PMC6867191 DOI: 10.1289/ehp5496] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/20/2019] [Accepted: 09/25/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals. OBJECTIVES We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease-Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden-both current and projected. METHODS We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment. DISCUSSION A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure-risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD's current methods do not fully account for lead's impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk-outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD's estimates and better guide prevention policy. https://doi.org/10.1289/EHP5496.
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Affiliation(s)
- Rachel M. Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Samuel P. Sellers
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - Marissa G. Baker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Rebeca de Buen Kalman
- Evans School of Public Policy and Governance, University of Washington, Seattle, Washington, USA
| | - Joseph Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA
| | - Megan K. Suter
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Susan C. Anenberg
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - John Balbus
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - David C. Bellinger
- Department of Neurology, Harvard Medical School, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Linda Birnbaum
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron Cohen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Health Effects Institute, Boston, Massachusetts, USA
| | - Kristie L. Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | | | - Philippe Grandjean
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jeremy J. Hess
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | | | - Pushpam Kumar
- United Nations Programme on the Environment, Nairobi, Kenya
| | - Philip J. Landrigan
- Program in Global Public Health and the Common Good, Boston College, Chestnut Hill, Massachusetts, USA
- Global Observatory on Pollution and Health, Boston College, Chestnut Hill, Massachusetts, USA
| | - Bruce Lanphear
- Simon Fraser University, Vancouver, British Columbia, Canada
| | - Stephanie J. London
- Epidemiology Branch, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Andrew A. Rooney
- Division of the National Toxicology Program, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Jeffrey D. Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- NYU Global Institute of Public Health, New York University, New York, New York, USA
| | - Katherine Walker
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Howard Hu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Suter MK, Miller KA, Anggraeni I, Ebi KL, Game ET, Krenz J, Masuda YJ, Sheppard L, Wolff NH, Spector JT. Association between work in deforested, compared to forested, areas and human heat strain: An experimental study in a rural tropical environment. Environ Res Lett 2019; 14:084012. [PMID: 31485260 PMCID: PMC6724538 DOI: 10.1088/1748-9326/ab2b53] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND With climate change, adverse human health effects caused by heat exposure are of increasing public health concern. Forests provide beneficial ecosystem services for human health, including local cooling. Few studies have assessed the relationship between deforestation and heat-related health effects in tropical, rural populations. We sought to determine whether deforested compared to forested landscapes are associated with increased physiological heat strain in a rural, tropical environment. METHODS We analyzed data from 363 healthy adult participants from ten villages who participated in a two-by-two factorial, randomized study in East Kalimantan, Indonesia from 10/1/17 to 11/6/17. Using simple randomization, field staff allocated participants equally to different conditions to conduct a 90-minute outdoor activity, representative of typical work. Core body temperature was estimated at each minute during the activity using a validated algorithm from baseline oral temperatures and sequential heart rate data, measured using chest band monitors. We used linear regression models, clustered by village and with a sandwich variance estimator, to assess the association between deforested versus forested conditions and the number of minutes each participant spent above an estimated core body temperature threshold of 38.5°C. RESULTS Compared to those in the forested condition (n=172), participants in the deforested condition (n=159) spent an average of 3.08 (95% CI 0.57, 5.60) additional minutes with an estimated core body temperature exceeding 38.5°C, after adjustment for age, sex, body mass index, and experiment start time, with a larger difference among those who began the experiment after 12 noon (5.17 [95% CI 2.20, 8.15]). CONCLUSIONS In this experimental study in a tropical, rural setting, activity in a deforested versus a forested setting was associated with increased objectively measured heat strain. Longer durations of hyperthermia can increase the risk of serious health outcomes. Land use decisions should consider the implications of deforestation on local heat exposure and health as well as on forest services, including carbon storage functions that impact climate change mitigation.
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Affiliation(s)
- Megan K. Suter
- Department of Epidemiology, University of Washington, Seattle, Washington, United States
| | - Kristin A. Miller
- Department of Epidemiology, University of Washington, Seattle, Washington, United States
| | - Ike Anggraeni
- Faculty of Public Health, Mulawarman University, Samarinda, Indonesia
| | - Kristie L. Ebi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, United States
- Department of Global Health, University of Washington, Seattle, Washington, United States
| | - Edward T. Game
- Global Science, The Nature Conservancy, Arlington, Virginia, United States
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, United States
| | - Yuta J. Masuda
- Global Science, The Nature Conservancy, Arlington, Virginia, United States
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, United States
- Department of Biostatistics, University of Washington, Seattle, Washington, United States
| | - Nicholas H. Wolff
- Global Science, The Nature Conservancy, Arlington, Virginia, United States
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, United States
- Department of Medicine, University of Washington, Seattle, Washington, United States
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