Trimester-specific associations of maternal exposure to disinfection by-products, oxidative stress, and neonatal neurobehavioral development

A simultaneous detection method for eight iodinated, brominated, and chlorinated haloacetic acid disinfection byproducts in human urine: liquid-liquid extraction-acidified methanol derivatization-gas chromatography

Haloacetic acids (HAAs) are among the most common drinking water disinfection byproducts (DBPs) and are of widespread concern due to their potential carcinogenicity and reproductive health risks. However, data on human exposure to HAAs are scarce. HAAs in urine have been identified as useful biomarkers for assessing exposure to DBPs via drinking chlorinated water. In this study, a suitable method for determining eight HAAs (including iodoacetic acid (IAA)) in human urine was developed and validated based on USEPA 552.3. HAAs were extracted from 5 mL of urine with methyl tert-butyl ether (MTBE), derivatized with acidified methanol and analyzed via gas chromatography with an electron capture detector (GC-ECD). Several optimization experiments were performed for the sample pretreatment step to establish a more sensitive and efficient analysis scheme. The method was tested in terms of linearity, accuracy, precision, and detection limits. The linear range of the method was 0.1-100 μg L-1, with recovery rates from blank matrix-spiked samples ranging from 84.9% to 122.6%, relative standard deviations between 1.7% and 14.2%, detection limits from 0.013 to 0.3 μg L-1, and quantitation limits from 0.043 to 1.0 μg L-1. Finally, the method was applied to detect HAAs in actual human urine samples. Six HAAs were detected in 460 urine samples to varying degrees, with geometric mean concentrations ranging from 0.07 to 0.89 μg L-1. The results demonstrate that the method is practical, and suitable for routine biomonitoring of HAAs in populations.

Neurodevelopmental toxicity of a ubiquitous disinfection by-product, bromoacetic acid, in Zebrafish (Danio rerio)

Disinfection of public drinking water and swimming pools is crucial for preventing waterborne diseases, but it can produce harmful disinfection by-products (DBPs), increasing the risk of various diseases for those frequently exposed to such environments. Bromoacetic acid (BAA) is a ubiquitous DBP, with toxicity studies primarily focused on its in vitro cytotoxicity, and insufficient research on its neurodevelopmental toxicity. Utilizing zebrafish as a model organism, this study comprehensively explored BAA's toxic effects and uncovered the molecular mechanisms through neurobehavioral analysis, in vivo two-photon imaging, transcriptomic sequencing, pharmacological intervention and molecular biological detection. Results demonstrated BAA induced significant changes on various indicators in the early development of zebrafish. Furthermore, BAA disrupted behavioral patterns in zebrafish larvae across locomotion activity, light-dark stimulation, and vibration stimulation paradigms. Subsequent investigation focused on larvae revealed BAA inhibited neuronal development, activated neuroinflammatory responses, and altered vascular morphology. Transcriptomic analysis revealed BAA-stressed zebrafish exhibited downregulation of visual transduction-related genes and activation of ferroptosis and cellular apoptosis. Neurobehavioral disorders were recovered by inhibiting ferroptosis and apoptosis. This study elucidates the neurodevelopmental toxicity associated with BAA, which is crucial for understanding health risks of DBPs and for the development of more effective detection methods and regulatory strategies.

Gestational Exposure to PM2.5 and Specific Constituents, Meconium Metabolites, and Neonatal Neurobehavioral Development: A Cohort Study

Exposure to fine particulate matter (PM2.5) during pregnancy has been inversely associated with neonatal neurological development. However, the associations of exposure to specific PM2.5 constituents with neonatal neurological development remain unclear. We investigated these associations and examined the mediating role of meconium metabolites in a Chinese birth cohort consisting of 294 mother-infant pairs. Our results revealed that exposure to PM2.5 and its specific constituents (i.e., organic matter, black carbon, sulfate, nitrate, and ammonium) in the second trimester, but not in the first or third trimester, was inversely associated with the total neonatal behavioral neurological assessment (NBNA) scores. The PM2.5 constituent mixture in the second trimester was also inversely associated with NBNA scores, and sulfate was identified as the largest contributor. Furthermore, meconium metabolome analysis identified four metabolites, namely, threonine, lysine, leucine, and saccharopine, that were associated with both PM2.5 constituents and NBNA scores. Threonine was identified as an important mediator, accounting for a considerable proportion (14.53-15.33%) of the observed inverse associations. Our findings suggest that maternal exposure to PM2.5 and specific constituents may adversely affect neonatal behavioral development, in which meconium metabolites may play a mediating role.

Prenatal antibiotics exposure and preschoolers' internalizing and externalizing problems: A biomonitoring-based prospective birth cohort study

BACKGROUND

Biomonitoring-based epidemiological studies on prenatal antibiotic exposure and behavioral problems in preschoolers are lacking. The present study aimed to investigate the relationship between prenatal antibiotic exposure and internalizing and externalizing problems in preschoolers.

METHODS

Data from 2449 mother-child pairs were analyzed. Urine samples were repeatedly collected across three trimesters, and 43 antibiotics and 2 metabolites were measured, including preferred as veterinary antibiotics (PVAs), VAs, preferred as human antibiotics and human antibiotics. Preschoolers' internalizing and externalizing problems were evaluated by the Achenbach Child Behavior Checklist. Poisson regression models with generalized estimating equations were used to estimate risk ratios (RRs) and 95 % confidence intervals (CIs) for preschoolers' internalizing, externalizing and total problems across tertiles of antibiotic concentrations during three periods of pregnancy, and performed several subgroup analyses.

RESULTS

First-trimester urinary oxytetracycline (RR = 1.69, 95%CI: 1.20, 2.39, P-FDR = 0.011), tetracycline (RR = 1.91, 95%CI: 1.36, 2.68, P-FDR < 0.001), doxycycline (RR = 1.66, 95%CI: 1.28, 2.17, P-FDR < 0.001) and PVAs (RR = 1.79, 95%CI: 1.29, 2.48, P-FDR < 0.001) concentrations in the highest tertile were related to an elevated risk of internalizing problems compared with concentrations in the lowest tertile. First-trimester urinary doxycycline concentrations in the third tertile were also associated with an increased risk of externalizing problems compared with the first tertile (RR = 2.00, 95%CI: 1.28, 3.15, P-FDR = 0.042). Compared with concentrations in the lowest tertile, first-trimester urinary doxycycline (RR = 1.63, 95%CI: 1.19, 2.22, P-FDR = 0.028) and PVAs (RR = 1.67, 95%CI: 1.14, 2.43, P-FDR = 0.047) concentrations in the middle tertile were related to an increased risk of total problems. Furthermore, the type of main caregiver and children's outdoor activities time modified the relationships between specific prenatal antibiotic exposure and preschoolers' behavioral problems.

CONCLUSIONS

Exposure to specific antibiotics during the first trimester may be related to an increased risk of internalizing and externalizing problems in preschoolers.

Characteristics and potential cytotoxicity of halogenated organic compounds in shale gas wastewater-impacted surface waters in Chongqing area， China

Recent screening surveys have shown the presence of unknown source halogenated organic compounds (HOCs) in shale gas wastewater. However, their occurrence, profile, transport in surrounding surface water and environmental risk potentials remain unclear. Here, a method for the extraction and quantitative determination of 13 HOCs in water by solid phase extraction combined with gas chromatography-mass spectrometry (GC-MS) was established. All of the targeted HOCs were detected and peaked at the outfall, while these contaminants were generally not detected in samples upstream of the outfall, suggesting that these contaminants originated from the discharge of shale gas wastewater; this was further supported by the fact that these pollutants were generally detected in downstream samples, with a tendency for pollutant concentrations to decrease progressively with increasing distance from the outfall. However，different HOCs had different transport potential in water. In addition, the toxicological effects of typical HOCs were evaluated using HepG2 as a model cell. The results indicated that diiodoalkanes suppressed HepG2 cell proliferation and induced ROS generation in a concentration-dependent manner. Mechanistic studies showed that diiodoalkanes induced apoptosis in HepG2 cells via the ROS-mediated mitochondrial pathway, decreasing mitochondrial membrane potential and increasing intercellular ATP and Ca2+ levels. On the other hand, RT-qPCR and Western blot assays revealed that the SLC7A11/GPX4 signaling pathway and HO-1 regulation of ferritin autophagy-dependent degradation (HO-1/FTL) pathway were involved in the ferroptosis pathway induced by diiodoalkane in HepG2 cells. Our study not only elucidates the contamination profiles and transport of HOCs in surface water of typical shale gas extraction areas in China, but also reveals the toxicity mechanism of typical diiodoalkane.

Measurement of haloacetic acids in human urine samples from six megacities of China using a refined detection method

Haloacetic acids (HAAs) are common disinfection by-products in chlorine disinfected water. Humans are extensively exposed to them. However, nationwide biomonitoring data were not available for any country. This study developed a labor-efficient and sensitive method for the detection of urinary HAAs, including trichloroacetic acid (TCAA) and dichloroacetic acid (DCAA), and conducted an exposure assessment in a Chinese population. A total of 850 first-morning-void urine samples were collected from adults in six megacities in China: Wuhan (central), Lanzhou (northwest), Chengdu (southwest), Taiyuan (north), Shanghai (east), and Dalian (northeast). Each participant (n = 425) provided a pair of urine samples during the warm (September to October 2018) and cold (December 2018 to January 2019) seasons. The detection method achieved good retention of the target analytes using a Fluoro-Phenyl column and excellent selectivity using in-source fragmentation ions as precursor ions in multiple reaction monitoring. The detection rate of urinary TCAA in Chinese populations was high (78.5%) but varied among different regions (54.0% to 98.0%). DCAA was rarely detected (<10%). The overall median value of specific gravity adjusted TCAA concentrations was 5.70 μg/L in the warm season and 3.87 μg/L in the cold season, respectively. Higher urinary TCAA concentrations were more likely to occur in Wuhan (Yangtze River Basin), urban areas, and during the warm season. The upstream region of the Yangtze River Basin (Chengdu) typically has lower TCAA concentrations. TCAA formation in coastal cities such as Shanghai and Dalian may be impacted by seawater intrusion. Estimated daily intakes of TCAA were lower than its chronic reference dose of 20 μg/kg-bw/day. This detection method can be applied to future biomonitoring of urinary HAAs. More attention should be paid to the highly exposed subgroups when exploring the health effects of long-term TCAA exposure.

Perspectives and understanding on the occurrence, toxicity and abatement technologies of disinfection by-products in drinking water

Disinfection by-products (DBPs) are one of the significant emerging contaminants that have caught the attention of researchers worldwide due to their pervasiveness. Their presence in drinking water, even in shallow concentrations (in levels of parts per billion), poses considerable health risks. Therefore, it is crucial to understand their kinetics to understand better their formation and persistence in the water supply systems. This manuscript demonstrates different aspects of research carried out on DBPs in the past. A systematic approach was adopted for the bibliographical research that started with choosing appropriate keywords and identifying the most relevant manuscripts through the screening process. This follows a quantitative assessment of the extracted literature sample, which included the most productive and influential journal sources, the most widely used keywords, the most influential authors active in the research domain, the most cited articles, and the countries most actively engaged in the research field. Critical observations on the literature sample led to the qualitative assessment, wherein the past and current research trends were observed and reported. Finally, we identified the essential gaps in the available literature, which further led to recommending the course ahead in the research domain. This study will prove fruitful for young and established researchers who are or wish to work in this emerging field of research.

Pressure-driven membrane filtration technology for terminal control of organic DBPs: A review

Disinfection by-products (DBPs), a series of undesired secondary contaminants formed during the disinfection processes, deteriorate water quality, threaten human health and endanger ecological safety. Membrane-filtration technologies are commonly used in the advanced water treatment and have shown a promising performance for removing trace contaminants. In order to gain a clearer understanding of the behavior of DBPs in membrane-filtration processes, this work dedicated to: (1) comprehensively reviewed the retention efficiency of microfiltration (MF), ultrafiltration (UF), nanofiltration (NF) and reverse osmosis (RO) for DBPs. (2) summarized the mechanisms involved size exclusion, electrostatic repulsion and adsorption in the membrane retention of DBPs. (3) In conjunction with principal component analysis, discussed the influence of various factors (such as the characteristics of membrane and DBPs, feed solution composition and operating conditions) on the removal efficiency. In general, the characteristics of the membranes (salt rejection, molecular weight cut-off, zeta potential, etc.) and DBPs (molecular size, electrical property, hydrophobicity, polarity, etc.) fundamentally determine the membrane-filtration performance on retaining DBPs, and the actual operating environmental factors (such as solute concentration, coexisting ions/NOMs, pH and transmembrane pressure) exert a positive/negative impact on performance to some extent. Current researches indicate that NF and RO can be effective in removing DBPs, and looking forward, we recommend that multiple factors should be taken into account that optimize the existed membrane-filtration technologies, rationalize the selection of membrane products, and develop novel membrane materials targeting the removal of DBPs.

Association of urinary arsenic metabolism with type 2 diabetes and glucose homeostasis: Cross-sectional and longitudinal associations

BACKGROUND

Previous researches have assessed the relationships of urinary arsenic metabolism with type 2 diabetes (T2D) and glucose-insulin homeostasis, but the results were controversial, and potential mechanisms remain largely unclear.

OBJECTIVES

This study aimed to investigate the cross-sectional and longitudinal associations of urinary arsenic metabolism with T2D prevalence and glucose changes in relatively higher arsenic exposure, and further to evaluate the underlying roles of oxidative damage in these relationships.

METHODS

We included 796 participants at baseline, among them 509 participants were followed up after 2 years. Logistic regression model and leave-one-out approach were applied to evaluate the associations of arsenic metabolism with T2D prevalence. Linear mixed model was conducted to estimate the relationship of arsenic metabolism with glycemic changes over two years. The associations between arsenic metabolism and indicators of oxidative stress were assessed with a linear regression model. We further performed mediation analysis to investigate the role of oxidative stress in the associations of arsenic metabolism with 2-year change of glucose levels.

RESULTS

Higher urinary MMA% increased T2D prevalence and baseline glucose levels. MMA% was positively associated with 2-year change of glucose levels. Moreover, we observed significant dose-response relationship between MMA% and 8-hydroxy-2-deoxyguanosine (8-OHdG). However, the mediating role of 8-OHdG in the association of MMA% and 2-year change of glucose levels was not observed in this population.

CONCLUSIONS

In this population exposure to relatively higher arsenic levels, higher MMA% contributed to increased T2D prevalence and glucose homeostasis disorder. Arsenic metabolism also affected oxidative stress levels, especially 8-OHdG. Further studies are required to investigate the potential mechanisms.

Associations of Trimester-Specific Exposure to Perchlorate, Thiocyanate, and Nitrate with Childhood Neurodevelopment: A Birth Cohort Study in China

Studies about the impacts of maternal exposure to perchlorate, thiocyanate, and nitrate on offspring neurodevelopment are scarce. Based on a birth cohort in China, 1,028 mothers provided urine samples at three trimesters for determination of the three target analytes, and their offspring neurodevelopment was evaluated at 2 years old. Associations of maternal exposure to the three chemicals with offspring neurodevelopment were estimated using three statistical methods. Trimester-specific analyses using generalized estimating equation models showed that double increment of thiocyanate and nitrate during the first trimester was associated with 1.56 (95% CI: -2.82, -0.30) and 1.22 (-2.40, -0.03) point decreases in the offspring mental development index (MDI), respectively. Weighted quantile sum (WQS) regression analyses showed that the mixture exposure at the first and second trimesters was negatively associated with the offspring MDI (β = -2.39, 95% CI: -3.85, -0.93; β = -1.75, 95% CI: -3.04, -0.47, respectively) and thiocyanate contributed the most to the association (65.0 and 91.6%, respectively). Bayesian kernel machine regression analyses suggested an inverted U-shape relationship of maternal urinary thiocyanate with the offspring MDI. These findings suggested that prenatal exposure to the three chemicals (at current levels), especially thiocyanate and nitrate, may impair neurodevelopment. Early pregnancy seems to be the sensitive window.

Exploration of optimal disinfection model based on groundwater risk assessment in disinfection process

Under the influence of different types of disinfectants and disinfection environments, the removal level of pathogens and the formation potential of disinfection by-products (DBPs) will have a dual impact on the groundwater environment. The key points for sustainable groundwater safety management are how to balance the positive and negative relationship and formulate a scientific disinfection model in combination with risk assessment. In this study, the effects of sodium hypochlorite (NaClO) and peracetic acid (PAA) concentrations on pathogenic E. coli and DBPs were investigated using static-batch and dynamic-column experiments, as well as the optimal disinfection model for groundwater risk assessment was explored using quantitative microbial risk assessment and disability-adjusted life years (DALYs) models. Compared to static disinfection, deposition and adsorption were the dominant factors causing E. coli migration at lower NaClO levels of 0-0.25 mg/L under dynamic state, while disinfection was its migration factor at higher NaClO levels of 0.5-6.5 mg/L. In contrast, E. coli removed by PAA was the result of the combined action of deposition, adsorption, and disinfection. The disinfection effects of NaClO and PAA on E. coli differed under dynamic and static conditions. At the same NaClO level, the health risk associated with E. coli in groundwater was higher, whereas, under the same PAA conditions, the health risk was lower. Under dynamic conditions, the optimal disinfectant dosage required for NaClO and PAA to reach the same acceptable risk level was 2 and 0.85 times (irrigation) or 0.92 times (drinking) of static disinfection, respectively. The results may help prevent the misuse of disinfectants and provide theoretical support for managing twin health risks posed by pathogens and DBPs in water treatment.

Exposures to volatile organic compounds, serum vitamin D, and kidney function: association and interaction assessment in the US adult population

The relationships of exposures to volatile organic compounds (VOCs) with vitamin D and kidney function remain unclear. Our analyses included 6070 adults from 2003 to 2010 survey cycles of the National Health and Nutrition Examination Survey to explore associations of six VOCs with serum vitamin D, albumin-to-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR). The results suggested that dibromochloromethane was positively associated with ACR, and chloroform was inversely associated with ACR. U-shaped associations of toluene, m-/p-xylene, bromodichloromethane, and 1,4-dichlorobenzene with ACR were observed. Toluene, m-/p-xylene, and 1,4-dichlorobenzene were associated with eGFR in U-shaped manners, while bromodichloromethane and chloroform were inversely associated with eGFR. Elevation in 1,4-dichlorobenzene was associated with decrease in vitamin D, while chloroform and m-/p-xylene were in U-shaped associations with vitamin D. VOCs mixture was U-shaped associated with ACR, inversely associated with eGFR, and inversely associated with vitamin D. Vitamin D was in a U-shaped association with ACR. Vitamin D significantly interacted with VOCs on the two kidney parameters. In the US adult population, exposures to VOCs were associated with kidney function and serum vitamin D level decline, and the serum vitamin D may have interaction effects with VOCs exposures on kidney function.

Application Effect Analysis of Clinical Nursing Pathway in the Care of Neonatal Hypoxic-Ischemic Encephalopathy

This research focuses on the effectiveness of the clinical nursing pathway (CNP) in the treatment of infant hypoxic-ischemic encephalopathy (NHIE). This research enrolled 120 cases of NHIE admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, including 70 cases (research group, the Res) who received CNP intervention and 50 cases (control group, the Con) treated by routine nursing pathway intervention. The psychomotor development index (PDI), mental development index (MDI), neurodevelopment (ND), physique growth, and incidence of adverse events (AEs) were recorded and analyzed. The results identified that in comparison with the Con (1) the PDI and MDI were obviously better in the Res 6 months postintervention; (2) the Res had significantly superior ND of behavioral capacity, passive tone, active tone, primitive reflex, and general assessment 1 month after intervention, as well as physical development of body weight, height, and head circumference after 40 days of birth, (3) the incidence of total AEs within 40 days was statistically lower in the Res. As a result, CNP is considerably superior to the traditional nursing pathway in the treatment of NHIE, and it merits clinical promotion.