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Vilhelmsson A, Rylander L, Jöud A, Lindh CH, Mattsson K, Liew Z, Guo P, Ritz B, Källén K, Thacher JD. Exposure to per- and polyfluoroalkyl substances in early pregnancy and risk of cerebral palsy in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 899:165622. [PMID: 37474063 DOI: 10.1016/j.scitotenv.2023.165622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/30/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Most cerebral palsy (CP) cases have an unexplained etiology, but a role for environmental exposures has been suggested. One purported environmental risk factor is exposure to endocrine-disrupting pollutants specifically per- and polyfluoroalkyl substances (PFAS). OBJECTIVES We investigated the association between prenatal PFAS exposures and CP in Swedish children. METHODS In this case-control study, 322 CP cases, 343 population controls, and 258 preterm controls were identified from a birth registry in combination with a CP follow-up program from 1995 to 2014 and linked to a biobank which contains serum samples from week 10-14 of pregnancy. Maternal serum concentrations of four PFAS compounds: perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorooctane sulfonate (PFOS) were analyzed using liquid chromatography-tandem-mass-spectrometry. We estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for CP and each PFAS in quartiles and as continuous variables controlling for various sociodemographic and lifestyle factors. RESULTS In crude and adjusted analyses, we did not find consistent evidence of associations between serum PFHxS, PFOA, PFNA, PFOS and concentrations in early pregnancy and CP, except in preterm infants. The ORs comparing the highest PFAS quartiles to the lowest were 1.05 (95 % CI: 0.63-1.76), 0.96 (95 % CI: 0.55-1.68), 0.71 (95 % CI: 0.41-1.25), and 1.17 (95 % CI: 0.61-2.26), for PFHxS, PFOA, PFNA, and PFOS, respectively. Some positive associations were observed for preterm infants, but the results were imprecise. Similar patterns were observed in analyses treating PFAS as continuous variables. CONCLUSIONS In this study, we found little evidence that early pregnancy prenatal exposure to PFHxS, PFOA, PFNA, or PFOS increases the risk of CP. However, some positive associations were observed for preterm cases and warrant further investigation.
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Affiliation(s)
- Andreas Vilhelmsson
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Anna Jöud
- Division of Occupational and Environmental Medicine, Lund University, Sweden; Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, Sweden; Health Technology Assessment Skåne, Skåne University Hospital, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Kristina Mattsson
- Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA
| | - Pengfei Guo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, USA; Department of Neurology, School of Medicine, UCLA, Los Angeles, USA
| | - Karin Källén
- Division of Occupational and Environmental Medicine, Lund University, Sweden; Tornblad Institute, Lund University, Sweden
| | - Jesse D Thacher
- Division of Occupational and Environmental Medicine, Lund University, Sweden.
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Eleftheriou G, Butera R, Lonati D, Ferruzzi M, Costa M, Ferani R, Sesana G, Zanon V. Open issues in management of carbon monoxide poisoning in pregnancy: practical suggestions. J OBSTET GYNAECOL 2022; 42:2540-2541. [PMID: 35648870 DOI: 10.1080/01443615.2022.2058356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Carbon monoxide (CO) poisoning during pregnancy may cause deleterious effects to the fetus. Hyperbaric oxygen therapy (HBO) in pregnancy is proven to be safe and it is considered to be beneficial, reducing the severity of the fetal injuries. However, a number of issues are still to be discussed, among them the question of the carboxyhemoglobin (COHb) levels that trigger HBO therapy in pregnant CO poisoned patients. In this letter we report some practical suggestions for organizations wishing to develop their own protocols.
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Affiliation(s)
| | | | | | | | - Marco Costa
- ILMI - Lombard Institute for Hyperbaric Medicine, Milan, Italy
| | | | | | - Vincenzo Zanon
- Hyperbaric Medicine Unit, Clinical Institute Città di Brescia, Brescia, Italy
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Liew Z, von Ehrenstein OS, Ling C, Yuan Y, Meng Q, Cui X, Park AS, Uldall P, Olsen J, Cockburn M, Ritz B. Ambient Exposure to Agricultural Pesticides during Pregnancy and Risk of Cerebral Palsy: A Population-Based Study in California. TOXICS 2020; 8:toxics8030052. [PMID: 32751992 PMCID: PMC7560316 DOI: 10.3390/toxics8030052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022]
Abstract
Cerebral palsy (CP) is the most common neuro-motor disability in young children. Disruptions of maternal hormone function during pregnancy have been linked to CP risk. We investigated whether prenatal exposure to pesticide compounds with endocrine-disrupting action affect CP risk. We conducted a case-control study of 3905 CP cases and 39,377 controls born between 1998 and 2010 in California to mothers who lived in proximity (within 2 km) to any agricultural pesticide application recorded in the California Pesticide Use Reporting (PUR) system. We focused on 23 pesticides considered endocrine disruptors that are frequently used, and we found that exposure to any of the 23 pesticides in the first trimester was associated with elevated CP risks in female offspring (OR = 1.19; 95% CI: 1.05-1.35) but not males (OR = 0.99; 95% CI: 0.89-1.09) compared to the unexposed offspring. Positive associations were estimated for 15 pesticides suspected to affect the estrogen and 7 pesticides suspected to affect the thyroid hormone system. Our study suggests that first trimester exposure to pesticides that are suspected endocrine disruptors are associated with CP risk in female offspring. Pesticide exposures in early pregnancy may have sex-specific influences on the neuro-motor development of the fetus by interfering with endocrine systems.
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Affiliation(s)
- Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA
- Correspondence: ; Tel.: +1-203-764-9727
| | - Ondine S. von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA;
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Yuying Yuan
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Qi Meng
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Xin Cui
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA 94305, USA;
- California Perinatal Quality Care Collaborative, Palo Alto, CA 94305, USA
| | - Andrew S. Park
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
| | - Peter Uldall
- Department of Paediatrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8000 C Aarhus, Denmark;
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO 80045, USA
- Colorado Comprehensive Cancer Center, University of Colorado, Aurora, CO 80045, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA; (C.L.); (Y.Y.); (Q.M.); (A.S.P.); (B.R.)
- Department of Neurology, School of Medicine, UCLA, Los Angeles, CA 90095, USA
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Carbon Monoxide and Cyanide Poisoning in the Burned Pregnant Patient: An Indication for Hyperbaric Oxygen Therapy. Ann Plast Surg 2019; 80:S106-S112. [PMID: 29461288 DOI: 10.1097/sap.0000000000001351] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Carbon monoxide (CO) is a small molecule poison released as a product of incomplete combustion. Carbon monoxide binds hemoglobin, reducing oxygen delivery. This effect is exacerbated in the burned pregnant patient by fetal hemoglobin that binds CO 2.5- to 3-fold stronger than maternal hemoglobin. With no signature clinical symptom, diagnosis depends on patient injury history, elevated carboxyhemoglobin levels, and alterations in mental status. The standard of care for treatment of CO intoxication is 100% normobaric oxygen, which decreases the half-life of CO in the bloodstream from 5 hours to 1 hour. Hyperbaric oxygen (HBO2) is a useful adjunct to rapidly reduce the half-life of CO to 20 minutes and the incidence of delayed neurologic sequelae. Because of the slow disassociation of CO from hemoglobin in the fetus, there is a far stronger indication for HBO2 in the burned pregnant patient than in other burn patient populations.Cyanide intoxication is often a comorbid disease with CO in inhalation injury from an enclosed fire, but may be the predominant toxin. It acts synergistically with CO to effectively lower the lethal doses of both cyanide and CO. Diagnosis is best made in the presence of high lactate levels, carboxyhemoglobin concentrations greater than 10%, injury history of smoke inhalation from an enclosed fire, and alterations in consciousness. While treatment with hydroxocobalamin is the standard of care and has the effect of reducing concomitant CO toxicity, data indicate cyanide may also be displaced by HBO2.Carbon monoxide and cyanide poisoning presents potential complications impacting care. This review addresses the mechanism of action, presentation, diagnosis, and treatment of CO and cyanide poisonings in the burned pregnant patient and the use of HBO2 therapy.
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Le Corfec T, Maurin O, Foucher S, Bertho K, Lefort H. [Carbon monoxide poisoning, treatment and orientation]. REVUE DE L'INFIRMIERE 2018; 67:18-20. [PMID: 29907171 DOI: 10.1016/j.revinf.2018.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Colourless and odourless, each year carbon monoxide is responsible for several thousand cases of poisoning. Often collective, their symptoms are non specific and can result in serious neurological sequelae or even death, if they are not detected in time. The (pre-) hospital emergency nurse plays an important role in the management of these patients, in terms of assessment, treatment and monitoring as well as the organisation of the admittance of victims, categorisation and medical triage. As part of a team, the nurse ensures that the patient enters an adapted, regulated pathway, with the most serious cases being directed towards a hospital equipped with a hyperbaric medicine facility.
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Affiliation(s)
- Thibaut Le Corfec
- Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, 75017 Paris, France
| | - Olga Maurin
- Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, 75017 Paris, France
| | - Stéphane Foucher
- Service d'accueil des urgences, Hôpital d'instruction des armées (HIA) Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - Kilian Bertho
- Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, 75017 Paris, France
| | - Hugues Lefort
- Structure des urgences, HIA Legouest, 27, avenue de Plantières, 57000 Metz, France.
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Abstract
IMPORTANCE Carbon monoxide (CO) is the leading cause of poisoning in the United States and is associated with high maternal and fetal mortality rates. Given the nonspecific signs and symptoms of toxicity, cases may go unsuspected or attributed to other etiologies. As CO adversely affects both mother and fetus, it is important for practitioners to recognize and treat poisoning in a timely manner. OBJECTIVE We seek to assist practitioners with understanding the physiology and recognizing the presentations of both acute and chronic CO poisoning, as well as provide information on diagnosis and treatment options. We also conducted a review of cases described in the literature during the past half century to show varying presentations and treatment methodologies. EVIDENCE ACQUISITION A qualitative literature search was conducted using PubMed and Google Scholar for articles published between 1970 and 2014 that assessed cases of CO poisoning during pregnancy. Excluded studies were not in English or contained nonhuman subjects. RESULTS Nineteen published reports of CO poisoning during pregnancy described in varying levels of detail were found in the literature from 1971 to 2010. CONCLUSIONS AND RELEVANCE Carbon monoxide poisoning requires a high degree of suspicion. Diagnosis is made based on initial history and physical evaluation and assessment of environmental CO levels; presenting carboxyhemoglobin levels may be poor indicators of severity of disease. Oxygen therapy should be initiated promptly in all possible cases with consideration of hyperbaric oxygen therapy in cases of significant maternal exposure. Treatment requires a longer duration for fetal CO elimination than in the nonpregnant patients. Importantly, practitioners should educate pregnant patients on prevention.
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Levy RJ. Carbon monoxide pollution and neurodevelopment: A public health concern. Neurotoxicol Teratol 2015; 49:31-40. [PMID: 25772154 DOI: 10.1016/j.ntt.2015.03.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 12/18/2022]
Abstract
Although an association between air pollution and adverse systemic health effects has been known for years, the effect of pollutants on neurodevelopment has been underappreciated. Recent evidence suggests a possible link between air pollution and neurocognitive impairment and behavioral disorders in children, however, the exact nature of this relationship remains poorly understood. Infants and children are uniquely vulnerable due to the potential for exposure in both the fetal and postnatal environments during critical periods in development. Carbon monoxide (CO), a common component of indoor and outdoor air pollution, can cross the placenta to gain access to the fetal circulation and the developing brain. Thus, CO is of particular interest as a known neurotoxin and a potential public health threat. Here we review overt CO toxicity and the policies regulating CO exposure, detail the evidence suggesting a potential link between CO-associated ambient air pollution, tobacco smoke, and learning and behavioral abnormalities in children, describe the effects of subclinical CO exposure on the brain during development, and provide mechanistic insight into a potential connection between CO exposure and neurodevelopmental outcome. CO can disrupt a number of critical processes in the developing brain, providing a better understanding of how this specific neurotoxin may impair neurodevelopment. However, further investigation is needed to better define the effects of perinatal CO exposure on the immature brain. Current policies regarding CO standards were established based on evidence of cardiovascular risk in adults with pre-existing comorbidities. Thus, recent and emerging data highlighted in this review regarding CO exposure in the fetus and developing child may be important to consider when the standards and guidelines are evaluated and revised in the future.
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Affiliation(s)
- Richard J Levy
- Department of Anesthesiology, Columbia University Medical Center, 622 W. 168th Street, New York, NY 10032, United States.
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Bothuyne-Queste E, Joriot S, Mathieu D, Mathieu-Nolf M, Favory R, Houfflin-Debarge V, Vaast P, Closset E, Subtil D. [Ten practical issues concerning acute poisoning with carbon monoxide in pregnant women]. ACTA ACUST UNITED AC 2013; 43:281-7. [PMID: 23562321 DOI: 10.1016/j.jgyn.2013.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/20/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known. PURPOSE AND METHOD Make an inventory of knowledge about carbon monoxide poisoning during pregnancy. RESULT The CO causes maternal then fetal tissue hypoxia primarily by binding to hemoglobin with which it has a high affinity. Its transplacental passage may cause fetal harm, predominantly in the brain. Severity seems correlated with maternal symptoms during exposure. In the absence of maternal symptoms, however, the available data are reassuring. Hyperbaric oxygen therapy may reduce the risk to the fetus. DISCUSSION Oxygen therapy should be offered in all cases of CO poisoning, especially if there are maternal symptoms during exposure. In addition, a fetal echography directed on the cephalic pole - even a fetal magnetic resonance imaging three weeks after exposure - should also be proposed.
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Affiliation(s)
- E Bothuyne-Queste
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France.
| | - S Joriot
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France
| | - D Mathieu
- Centre d'oxygénothérapie hyperbare, université Lille Nord de France, hôpital Calmette, 59000 Lille, France
| | - M Mathieu-Nolf
- Centre anti-poisons, université Lille Nord de France, CHRU de Lille, 59000 Lille, France
| | - R Favory
- Centre d'oxygénothérapie hyperbare, université Lille Nord de France, hôpital Calmette, 59000 Lille, France
| | - V Houfflin-Debarge
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France
| | - P Vaast
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France
| | - E Closset
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France
| | - D Subtil
- Université Lille Nord de France, hôpital Jeanne de Flandre, pôle Femme-Mère-Nouveau-né, 2, avenue Oscar-Lambret, 59000 Lille cedex, France; EA 2694, université Lille Nord de France, 59000 Lille, France
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Dix-Cooper L, Eskenazi B, Romero C, Balmes J, Smith KR. Neurodevelopmental performance among school age children in rural Guatemala is associated with prenatal and postnatal exposure to carbon monoxide, a marker for exposure to woodsmoke. Neurotoxicology 2011; 33:246-54. [PMID: 21963523 DOI: 10.1016/j.neuro.2011.09.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 11/30/2022]
Abstract
We investigated whether early life chronic exposure to woodsmoke, using personal passive 48-h carbon monoxide (CO) as an indicator, is associated with children's neurodevelopmental and behavioral performance. CO measures were collected every 3 months from 2002 to 2005 among mother-child dyads during the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial in San Marcos, Guatemala. From March to June, 2010, study children of age 6-7 years, performed a follow-up non-verbal, culturally adapted neurodevelopmental assessment. We found inverse associations between CO exposure of pregnant mothers during their 3rd trimesters (m=3.8ppm ± 3.0ppm; range: 0.6-12.5 ppm) and child neuropsychological performance. Scores on 4 out of 11 neuropsychological tests were significantly associated with mothers' 3rd trimester CO exposures, including visuo-spatial integration (p<0.05), short-term memory recall (p<0.05), long-term memory recall (p<0.05), and fine motor performance (p<0.01) measured using the Bender Gestalt-II's Copy, Immediate Recall, and an adapted version of a Delayed Recall Figures drawing, and the Reitan-Indiana's Finger Tapping Tests, respectively. These 4 significant finding persisted with adjustment for child sex, age, visual acuity, and household assets (socio-economic status). Summary performance scores were also significantly associated with maternal 3rd trimester CO when adjusted for these covariates. Other variables accounting for variance but were excluded in our final multiple regression models included the following: HOME environment stimulation score, child examiner, WHO height-for-age percentile, and age that the infant stopped breastfeeding. This seems to be the first study on woodsmoke exposure and neurodevelopment, and the first longitudinal birth cohort study on chronic early life CO exposures, determined by high quality measures of mothers' and infants' personal CO exposures, and using well-established, reliable child neuropsychological tests. Further research is needed to replicate our results and inform future interventions and air quality standards for woodsmoke and CO.
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Affiliation(s)
- Linda Dix-Cooper
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720-7360, USA
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Açikalin A, Satar S, Sebe A, Köse A, Akpinar O. H-FABP in cases of carbon monoxide intoxication admitted to the emergency room. Hum Exp Toxicol 2010; 30:443-7. [PMID: 21075804 DOI: 10.1177/0960327110389836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Carbon monoxide (CO) intoxication causes cardiovascular problems as a result of diffuse tissue hypoxia. Cardiac biochemical markers and electrocardiographic changes have been reported in CO intoxications. Human fatty acid-binding protein (H-FABP) has been recently used as a reliable marker in identifying early cardiac damage. In this prospective study, we aimed to investigate the advantages of the use of H-FABP, in evaluating the findings of myocardial ischemia in patients with CO intoxication in our region. METHODS Twenty four successive patients admitted to the emergency department with acute CO intoxication were included in our study. Serum traditional markers and H-FABP were also taken in the earliest period for evaluation of cardiac damage. RESULTS The creatinine kinase MB (CKMB) levels were positive in 11 of the patients; however, H-FABP and troponin T levels were positive in only 3 of them. One of these subjects had elevated level of H-FABP in the short-term and increasing troponin T level increasing level of troponin T during the follow-up period. CONCLUSION The obtained data supports the use of H-FABP, a specific indicator in identifying the cardiotoxicity of CO intoxications at an early phase.
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Affiliation(s)
- Ayça Açikalin
- Department of Emergency Medicine, 25 Aralık Government Hospital, Gaziantep, Turkey.
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A rare cause of perinatal asphyxia: maternal carbon monoxide poisoning. Arch Gynecol Obstet 2009; 281:251-4. [DOI: 10.1007/s00404-009-1139-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 05/19/2009] [Indexed: 10/20/2022]
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