Differences in personal care product use by race/ethnicity among women in California: implications for chemical exposures

Associations of personal care product use during pregnancy and the postpartum period with markers of postpartum glycemic control - Results from the ERGO Study

BACKGROUND

Personal care products frequently contain endocrine disrupting chemicals (EDCs) including parabens and phthalates, which can alter glucose metabolism. The postpartum period is a time of rapid metabolic change, but whether EDC-associated product use impacts postpartum glucose metabolism is unknown.

METHODS

We included 270 participants from the Boston, MA-based Environmental Reproductive and Glucose Outcomes (ERGO) pregnancy cohort with data on self-reported personal care product use at ≤4 pregnancy visits (median: 11, 19, 26, 36 weeks of gestation) and 1 postpartum visit (median: 9 weeks). We quantified postpartum hemoglobin A1c (HbA1c), fasting insulin, fasting- and 2-h glucose post-75-g oral glucose tolerance test, and calculated homeostatic model assessment for insulin sensitivity (HOMA2-S) and beta-cell function (HOMA2-B). Using covariate-adjusted linear regression, we estimated visit-specific associations of product use with postpartum glycemic outcomes.

RESULTS

Associations of product use with postpartum glycemic measures were mixed. Users of certain hair products had lower postpartum insulin sensitivity compared to non-users (e.g., Visit1 hair gel/spray: 22.8% difference [95% CI: 39.2, -1.9] in mean HOMA2-S). Conversely, users of products like deodorant, liquid- and bar soap, had higher insulin sensitivity and lower glucose levels (e.g., postpartum deodorant: 32.1% difference [95% CI: 7.0, 63.1] in mean HOMA2-S; -3.1 mg/dL [95% CI: 6.3, -0.04] mean fasting glucose). Associations with other products were inconsistent across timepoints or null.

CONCLUSION

Use of certain personal care products during the perinatal period was associated with altered postpartum glucose metabolism. Larger studies are needed to understand the impacts of product use patterns on glycemic outcomes.

Chemicals of concern in select packaged hair relaxers available on the Kenyan market: an examination of ingredient labels and measurement of pH

Background

There is an emerging interest in the investigation of hair relaxers as important sources of exposure to chemicals of concern (CoCs) and their associated adverse health effects. We focused on documentation of CoCs by examining labels of selected relaxers currently available on the market in Nakuru and Embu Counties, Kenya and measured the pH profiles to ensure compliance with Kenya Bureau of Standards.

Methods

We enrolled 746 women aged 15-50 years in a cross-sectional study, which ascertained participants' sociodemographic characteristics, personal care products use in the last 7-14 days and ever use of hair dyes and chemical relaxers including the brand names of products used. Based on participants' questionnaire responses and product availability at beauty shops and supermarkets, we purchased 22 different relaxer products. The label of each product was reviewed and we recorded relaxer strength, manufacturer and location, listed ingredients, and other claims. To identify CoCs, we cross-checked the list of ingredients against the Campaign for Safe Cosmetics' (CSC) Red List and European Union's prohibited and restricted substances (Annex II and III respectively), Regulation 1223/2009 on cosmetics. The pH profiles of each product were determined using a benchtop pH meter.

Results

Twenty-seven CoCs were documented upon examination with each relaxer listing more than one CoC. Thirteen out of 27 (48.2%) were fragrance chemicals with d-limonene/limonene and linalool, each being listed as an ingredient in 9 products. Fourteen (63.6%) relaxers had undisclosed ingredients listed as 'fragrance' and/or 'parfum'. Six of the identified CoCs are classified as Tier 1 (Do not use for everyone) per CSC Red List while 14.8% (4) are prohibited and 55.6% (15) are restricted substances per EU regulations. The pH values of the relaxers were within Kenya Bureau of Standards required range of 11-13.

Conclusion

These findings create awareness of CoCs listed on labels of selected hair relaxers. This justifies the need for consumer education on potentially harmful chemicals and their associated risks. Further, our findings justify the need for laboratory study to evaluate and quantify CoCs that are listed as well as those that are not listed on the label.

Exposure experiments and machine learning revealed that personal care products can significantly increase transdermal exposure of SVOCs from the environment

We investigated the impacts of personal care products (PCPs) on dermal exposure to semi-volatile organic compounds (SVOCs), including phthalates, organophosphate esters, polycyclic aromatic hydrocarbons (PAHs), ultraviolet filters, and p-phenylenediamines, through an experiment from volunteers, explored the impact mechanisms of PCP ingredients on dermal exposure, and predicted the PCP effects on SVOC concentrations in human serum using machine learning. After applying PCPs, namely lotion, baby oil, sunscreen, and blemish balm, the dermal adsorption of SVOCs increased significantly by 1.63 ± 0.62, 1.97 ± 0.73, 1.91 ± 0.48, and 2.03 ± 0.59 times, respectively, probably due to the absorption effects of PCP ingredients. Ingredient tocopherol can increase dermal adsorption of SVOCs by 2.59 ± 1.60 times. PCPs can either increase or decrease the SVOC transdermal exposure risks, depending on the properties of their ingredients. Blemish balm caused the highest hazard quotient for certain SVOCs, while tris(2-chloroethyl) phosphate (TCEP) exhibited the highest hazard quotient. We predicted the SVOC concentrations in serum before and after applying PCPs based on the PCP-increased skin permeation doses and machine learning. PCPs can significantly increase the serum concentrations of PAHs with 2-3 rings and TCEP. This study first revealed that PCPs can significantly increase the dermal exposure of SVOCs from the surroundings, resulting in potentially higher health risks.

The interactive role of odor associations in friendship preferences

Who we choose to befriend is highly personal, driven by idiosyncratic preferences about other individuals, including sensory cues. How does a person's unique sensory evaluation of others' body odor affect friendship formation? Female participants took part in a speed-friending event where they made judgments of friendship potential (FP) following a 4-minute live interaction. Prior to and following the speed-friending event, participants judged the FP of these women based solely on diplomatic odor (including daily perfume/hygiene products) presented on worn t-shirts. Participants also judged FP based on facial appearance (a 100-ms presentation of portrait photographs). Judgments based solely on diplomatic odor predicted FP judgments following in-person interactions, beyond the predictive ability of photograph-based judgments. Moreover, judgments based on the live interaction predicted changes in the second round of diplomatic odor judgments, suggesting that the quality of the live interaction modified olfactory perception. Results were driven more strongly by idiosyncratic preferences than by global perceiver or target effects. Findings highlight the dynamic role of ecologically relevant social olfactory cues in informing friendship judgments, as well as the involvement of odor-based associative learning during the early stages of friendship formation.

Racial/ethnic disparities in the association of environmental exposure to phthalates and bisphenols mixtures with diabetes mellitus: NHANES 2013-2016

We evaluated the association between urinary concentrations of phthalates/bisphenols mixtures and diabetes mellitus (DM) and poorly controlled DM, stratified by sex, and race/ethnicity in 2718 adults from the 2013 to 2016 National Health and Nutrition Examination Survey. DM was self-reported or defined by glucose tests/hypoglycemic use. Poorly controlled DM was defined by HbA1c ≥ 8%. Principal component analyses allowed to identify three mixtures: (1) DEHP (di(2-ethylhexyl) phthalate metabolites), (2) LMW/BPs (bisphenol A, F, S, and low molecular weight phthalates), and (3) high molecular weight phthalates. Group weighted quantile sum regression showed that the DEHP mixture was associated with lower DM prevalence in women and "other races" participants. Conversely, the LMW/BPs mixture was associated with higher DM odds, mainly among Mexican Americans. Race/ethnicity seems to determine the association between the different exposure mixtures and DM prevalence and poorly controlled DM.

Evaluating personal care product use by Environmental Working Group hazard scores in relation to consumers' sociodemographic characteristics, purchasing behaviors, and product safety perceptions

BACKGROUND

Personal care products (PCPs) are a source of environmental chemical exposures. Little research has examined the specific PCPs people use, the environmental hazards posed by those PCPs, and factors informing PCP selection.

OBJECTIVE

To examine chemical hazards of the specific products used in relation to sociodemographic factors, purchasing behaviors, and perceptions about PCP safety.

METHODS

In a cross-sectional, university-based sample (NJ, USA, N = 593), participants reported on sociodemographics, PCP purchasing behaviors and perceptions, and PCP use in the last 24-48 h (including brand and product name). Those PCPs were linked to product hazard scores (1=least hazardous, 10=most hazardous) in the Environmental Working Group's Skin Deep® database. For each participant, we calculated average hazard scores across all PCPs used and by category (e.g., haircare, skincare) and evaluated use of PCPs with high hazard scores (7-10). We fitted adjusted regression models examining associations of sociodemographic factors and participants' perceptions and purchasing behaviors with product hazard scores.

RESULTS

Of 9349 unique PCPs used by participants, 68% matched to Skin Deep®. Average hazard scores varied by participant characteristics (e.g., age) for perfumes/colognes, beauty, and skin care products. The relative risk (RR) of recent use of a hair product with a high hazard score was twice as high in non-Hispanic Black women compared to non-Hispanic White women (RR:1.99; 95%CI:1.37, 2.89). Frequent use of healthy product apps (β = -0.49, 95%CI:-0.77, -0.21), reading product ingredient labels (β = -0.26; 95%CI:-0.82, -0.30), and seeking eco-friendly products (β = -0.17; 95%CI:-0.36, -0.01) were associated with use of skin care products with lower hazard scores. Results for hair and beauty products were similar. Concerns about PCP health impacts and regulation were associated with using products with lower hazard scores.

IMPACT STATEMENT

Personal care products (PCPs) can contain numerous endocrine disrupting and carcinogenic chemicals. In a U.S. university-based sample, we linked the PCPs used by participants in the last 24-48 h to hazard scores in the Skin Deep® database. Average hazard scores of the PCPs used by participants varied by sociodemographic factors. Participant behaviors (e.g., use of healthy product apps) and perceptions of PCP safety and regulation were associated with the average hazard scores of the PCPs they used. Our findings suggest that education and tools to inform PCP choice may help consumers choose safer products and potentially, reduce chemical exposures.

Young infants' exposure to parabens: lotion use as a potential source of exposure

BACKGROUND

Parabens are widely used as antimicrobials in personal care products and pharmaceuticals. While previous studies demonstrate paraben exposure is ubiquitous, data investigating infants' exposure is limited.

OBJECTIVE

We sought to characterize infants' exposure to parabens and identify factors associated with higher levels of exposure.

METHODS

Families enrolled in the CHildren's Immune ResPonse Study between 2016-2018. Parents completed questionnaires, providing information on demographics and lifestyle factors. Urine samples were collected when infants were 1 to 3 months old (n = 71) and 12 months old (n = 29), with 18 infants evaluated at both ages. Parabens were measured in urine samples using liquid chromatography tandem mass spectrometry and served as an indicator of exposure.

RESULTS

Methylparaben (MP), ethylparaben (EP), and propylparaben (PP) were detected in >70% of urine samples, and concentrations ranged several orders of magnitude (specific-gravity-corrected medians: MP = 25.4 PP = 3.55; EP = 0.90 ng/mL). Butylparaben was detected less frequently (<50%). Paraben concentrations were lower than those reported for older children and adults; however, we did not find statistically significant differences in paraben concentrations by infant age. Correlations between measurements taken over time were poor, suggesting paraben exposure is variable, and multiple measurements are needed to capture cumulative exposure information. We observed differences in exposure by race/ethnicity and socioeconomic status; non-White infants and infants whose parents completed less education had higher paraben exposure. Recent lotion usage strongly predicted paraben exposure in 1-3-month-olds. For example, infants using lotion in the past seven days had urinary MP concentrations 355% higher than infants without lotion usage (eß = 4.55, 95% Confidence Interval = 1.68, 12.55, p < 0.001). Together, our results suggest infants are ubiquitously exposed to parabens and personal care product use may be an important source of exposure.

IMPACT

To the best of our knowledge, this is the first paper to report paraben levels and evaluate predictors of exposure in infants. This study supports the hypothesis that universal exposure to parabens extends to infants, as indicated by urinary biomarker concentrations. Of the predictors evaluated, lotion use in the last seven days was the strongest predictor of exposure in 1-3-month-olds. Given infant paraben levels are strongly correlated to lotion use, there may be an opportunity for parents to reduce paraben exposure by limiting its application or consulting ingredient labels to ensure no parabens are present.

Incorporating Singaporean habits and practices for cosmetics and personal care products into a global consumer aggregate exposure model

Understanding consumer habits and practices of cosmetics and personal care products (PCP) is essential to generate realistic product exposure data for the safety assessment of ingredients such as fragrance materials. Product usages can vary across regions due to differences in cultural norms, seasonal and climate conditions, and the availability of different product forms, yet there is limited data published on cosmetics and PCP use outside of North America and Europe. This study reports the habits and practices of cosmetics and PCP (such as frequency and amount of use) in Singapore where participants (n = 494, aged 21-64 years) recorded their product usages and had their products weighed over a two-week period. Overall, similar use patterns were observed across demographic groups within the Singapore population for most of the products surveyed, as were the expected usage amounts. Additionally, the Singaporean dataset was mapped onto the Creme-RIFM aggregate exposure model to assess exposure estimates. Preliminary comparisons with product exposures observed in the United States (US) and Europe suggest that exposures in Singapore are comparable. Findings from this study will contribute to the Creme-RIFM model, expanding its geographic scope and applicability for the global safety assessment of fragrance ingredients and fragranced products.

Validating the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS) Among Black Breast Cancer Survivors

Personal care products containing toxic chemicals (e.g., endocrine-disrupting chemicals) may increase breast cancer risk, especially for Black women who use these products more than other racial groups. There are limited tools that examine the intersections of identity, behaviors, and attitudes surrounding product use, perceived safety, and breast cancer risk; thus, the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS) was developed to bridge this gap. While initial validations lacked diverse survivor representation, this study seeks to validate the BHBS among Black survivors.

METHODS

This study is a part of the Bench to Community Initiative (BCI), where respondents (n = 167) completed a 41-item survey including the BHBS between 2020 and 2022. The use of Principal Component Analysis (PCA) and confirmatory factor analysis (CFA) established the underlying component structures and model fit. CFA measures used to confirm component structures included the Root Mean Square Error of Approximation, the Comparative Fit Index, and the Tucker Lewis Index.

RESULTS

Black survivors on average were diagnosed with breast cancer before age 40 (37.41 ± 8.8) with Stage 1 (45%) disease. Sixty-three percent of the total variance resulted in a two-component structure. Subscale 1 (S1) measures the sociocultural perspectives about hair and identity (28% of the total variance; α = 0.73; 95% CI = 0.71-0.82). Subscale 2 (S2) can be used to assess perceived breast cancer risk related to hair product use (35% of the total variance; α = 0.86; 95% CI = 0.81-0.94). The two-component structure was confirmed with Root Mean Square Error of Approximation = 0.034, Comparative Fit Index = 0.93, and Tucker Lewis Index = 0.89.

DISCUSSION/CONCLUSIONS

The BHBS is a valid tool to measure identity, attitudes, and behaviors about product use and breast cancer risk among survivors. Hair is a significant cultural identity expression, and the health effects of styling products should be considered in future interventions.

Associations of prenatal maternal urinary concentrations of triclosan and benzophenone-3 with cognition in 7.5-month-old infants

BACKGROUND

Endocrine-disrupting chemicals (EDCs) have been linked to adverse health outcomes and prenatal exposure is known to impact infant and child development. However, few studies have assessed early developmental consequences of prenatal exposure to two common phenolic compounds, benzophenone-3 (BP-3) and triclosan (TCS).

OBJECTIVE

We evaluated the relationship of prenatal exposure to BP-3 and TCS with infant cognition at 7.5 months via performance on a visual recognition memory (VRM) task.

METHODS

Drawing from the Illinois Kids Development Study (IKIDS) cohort, prenatal exposure to BP-3 and TCS was assessed in pools of five urine samples collected from each woman across pregnancy. Cognition was measured in 310 infants using a VRM task assessing information processing speed, attention, and recognition memory through infrared eye-tracking. Generalized linear regression estimated exposure-outcome associations, followed by stratification to investigate modification of associations by infant sex and stimulus set.

RESULTS

Sampled mothers were more likely to be white, college educated, and middle or high income relative to the US population. Mean chemical exposures were significantly higher than those of adult women in the NHANES cohort. In models adjusted for income, gestational age at birth, and testing age, prenatal BP-3 exposure was associated with an increase in run duration (average time spent looking at the stimuli before looking away) (β = 0.0011, CI -0.0001:0.0022), indicating slower information processing speed, while TCS was associated with significantly longer time to familiarization (time to accrue a total of 20 s of looking time to the stimuli) (β = 0.0686, CI 0.0203:0.1168, p < 0.01), indicating poorer attention. Stratum-specific analyses isolated both effects to male infants who viewed the second of two stimulus sets.

CONCLUSION

Higher prenatal exposure to triclosan was associated with poorer attention in infancy, while benzophenone-3 may be associated with slower information processing speed, particularly among males.

Exposure to Environmental Chemicals and Infertility Among US Reproductive-Aged Women

Environmental chemical exposure has been rising over the past few decades but its impact on fertility remains uncertain. We assessed exposures to 23 common chemicals across a range of sociodemographic characteristics and their relationship with self-reported infertility. The analytic sample was non-pregnant women aged 18-49 years without a history of hysterectomy or oophorectomy (n = 2579) from the National Health and Nutrition Examination Survey (2013-2016). Environmental chemical exposure was assessed with biospecimens and dichotomized as high and low levels of exposure based on the median. Logistic regression models estimated the adjusted odds ratio (aOR) and 95% confidence intervals (CIs) for the association between high levels of exposure and infertility, adjusted for age, race, education level, family income, and smoking status. We observed associations between infertility and cadmium [aOR: 1.88; 95% CI: 1.02-3.47] and arsenic [aOR: 1.88 (1.05-3.36)]. Two pesticides hexachlorobenzene [OR: 2.04 (1.05-3.98)] and oxychlordane [OR: 2.04 (1.12-3.69)] were also associated with infertility in unadjusted analyses. There were negative associations with two Per- and polyfluoroalkyl substances with n-perfluorooctanoic acid [aOR: 0.51: (0.30-0.86)] and n-perfluorooctane sulfonic acid [aOR: 0.51: (0.26-0.97). Specific chemicals may contribute to infertility risk, highlighting the need for targeted public health strategies to mitigate exposure.

Indoor air pollution and airway health

Because of the disproportionate amount of time that people spend indoors and the complexities of air pollutant exposures found there, indoor air pollution is a growing concern for airway health. Both infiltration of outdoor air pollution into the indoor space and indoor sources (such as smoke from tobacco products, cooking or heating practices and combustion of associated fuels, and household materials) contribute to unique exposure mixtures. Although there is substantial literature on the chemistry of indoor air pollution, research focused on health effects is only beginning to emerge and remains an important area of need to protect public health. We provide a review of emerging literature spanning the past 3 years and relating indoor air exposures to airway health, with a specific focus on the impact of either individual pollutant exposures or common combustion sources on the lower airways. Factors defining susceptibility and/or vulnerability are reviewed with consideration for priority populations and modifiable risk factors that may be targeted to advance health equity.

Wristband Personal Passive Samplers and Suspect Screening Methods Highlight Gender Disparities in Chemical Exposures

Wristband personal samplers enable human exposure assessments for a diverse range of chemical contaminants and exposure settings with a previously unattainable scale and cost-effectiveness. Paired with nontargeted analyses, wristbands can provide important exposure monitoring data to expand our understanding of the environmental exposome. Here, a custom scripted suspect screening workflow was developed in the R programming language for feature selection and chemical annotations using gas chromatography-high-resolution mass spectrometry data acquired from the analysis of wristband samples collected from five different cohorts. The workflow includes blank subtraction, internal standard normalization, prediction of chemical uses in products, and feature annotation using multiple library search metrics and metadata from PubChem, among other functionalities. The workflow was developed and validated against 104 analytes identified by targeted analytical results in previously published reports of wristbands. A true positive rate of 62 and 48% in a quality control matrix and wristband samples, respectively, was observed for our optimum set of parameters. Feature analysis identified 458 features that were significantly higher on female-worn wristbands and only 21 features that were significantly higher on male-worn wristbands across all cohorts. Tentative identifications suggest that personal care products are a primary driver of the differences observed.

Impact of Skin Care Products on Phthalates and Phthalate Replacements in Children: the ECHO-FGS

BACKGROUND

Phthalates and their replacements have been implicated as developmental toxicants. Young children may be exposed to phthalates/replacements when using skin care products (SCPs).

OBJECTIVES

Our objective is to assess the associations between use of SCPs and children's urinary phthalate/replacement metabolite concentrations.

METHODS

Children (4-8 years old) from the Environmental Influences on Child Health Outcomes-Fetal Growth Study (ECHO-FGS) cohort provided spot urine samples from 2017 to 2019, and mothers were queried about children's SCP use in the past 24 h (n = 906 ). Concentrations of 16 urinary phthalate/replacement metabolites were determined by liquid chromatography-tandem mass spectrometry (n = 630 ). We used linear regression to estimate the child's use of different SCPs as individual predictors of urinary phthalate/replacement metabolites, adjusted for urinary specific gravity, age, sex assigned at birth, body mass index, and self-reported race/ethnic identity, as well as maternal education, and season of specimen collection. We created self-organizing maps (SOM) to group children into "exposure profiles" that reflect discovered patterns of use for multiple SCPs.

RESULTS

Children had lotions applied (43.0%) frequently, but "2-in-1" hair-care products (7.5%), sunscreens (5.9%), and oils (4.3%) infrequently. Use of lotions was associated with 1.17-fold [95% confidence interval (CI): 1.00, 1.34] greater mono-benzyl phthalate and oils with 2.86-fold (95% CI: 1.89, 4.31) greater monoethyl phthalate (MEP), 1.43-fold (95% CI: 1.09, 1.90) greater monobutyl phthalate (MBP), and 1.40-fold (95% CI: 1.22, 1.61) greater low-molecular-weight phthalates (LMW). Use of 2-in-1 haircare products was associated with 0.84-fold (95% CI: 0.72, 0.97) and 0.78-fold (95% CI: 0.62, 0.98) lesser mono(3-carboxypropyl) phthalate (MCPP) and MBP, respectively. Child's race/ethnic identity modified the associations of lotions with LMW, oils with MEP and LMW, sunscreen with MCPP, ointments with MEP, and hair conditioner with MCPP. SOM identified four distinct SCP-use exposure scenarios (i.e., profiles) within our population that predicted 1.09-fold (95% CI: 1.03, 1.15) greater mono-carboxy isononyl phthalate, 1.31-fold (95% CI: 0.98, 1.77) greater mono-2-ethyl-5-hydroxyhexyl terephthalate, 1.13-fold (95% CI: 0.99, 1.29) greater monoethylhexyl phthalate, and 1.04-fold (95% CI: 1.00, 1.09) greater diethylhexyl phthalate.

DISCUSSION

We found that reported SCP use was associated with urinary phthalate/replacement metabolites in young children. These results may inform policymakers, clinicians, and parents to help limit children's exposure to developmental toxicants. https://doi.org/10.1289/EHP13937.

Chemical and non-chemical stressors in a postpartum cohort through wristband and self report data: Links between increased chemical burden, economic, and racial stress

Multiple external stressors are known to have adverse impacts on health and development. Certain groups are more vulnerable and/or more likely to be exposed toenvironmental, psychological, and social stressors simultaneously. Yet, few studies have examined combined exposure to environmental toxicants and psychosocial stress. Here, we integrated environmental chemical exposure data collected using silicone wristbands and self-report social stressor data within the Brain and Early Experience (BEE) perinatal cohort to understand co-exposure to environmental chemicals and social stress. Silicone wristbands were worn for one week by mothers throughout central North Carolina who were 6 months postpartum (n = 97). Exposure to 110 environmental chemicals across eight chemical classes was quantified on silicone wristbands using gas chromatography mass spectrometry. Social stress was evaluated using eight established self-report questionnaires (e.g., Brief Symptom Inventory, Perceived Stress Scale), quantifying experiences such as race-related stress, economic strain, and relationship conflict. Hair cortisol levels were measured as an additional metric of stress. The chemical exposure landscape and associations among chemical exposure, demographic characteristics, and social stress were characterized through individual variable analyses, cluster and data reduction, and compiled scoring approaches to comprehensively evaluate chemical and social stress burdens. We found that chemicals contain co-occurring patterns largely based on chemical class, with phthalates representing the chemical class with highest exposure and polychlorinated biphenyls the lowest. Chemicals showed differential exposure across racial groups, with diethyl phthalate, triphenyl phosphate, and tris(3,5-dimethyl phenyl) phosphate at higher levels in Black participants compared with White participants. Integrating social stressor profiling with chemical exposure data identified one particularly vulnerable subset of participants in which high chemical exposure burden coincided with high experiences of racism and economic stress. These findings demonstrate co-occurring chemical and social stress, warranting further investigation to better understand how these combined stressors may contribute to disparities in maternal and child health.

Body dissatisfaction widens the racial disparities of Benzophenone-3, a chemical biomarker of personal care and consumer product usage

Background

Body dissatisfaction can drive individuals to use personal care products, exposing themselves to Benzophenone-3 (BP3). Yet, no study has examined the link between body dissatisfaction and elevated chemical exposures.

Objectives

Our study examines how body dissatisfaction impacts the racial differences in BP3 exposures.

Methods

Using NHANES 2003-2016 data for 3,072 women, we ascertained body dissatisfaction with a questionnaire on weight perception. We ran two generalized linear models with log10-transformed urinary concentrations of BP3 as the outcome variable and the following main predictors: one with race/ethnicity and another combining race/ethnicity and body dissatisfaction. We also conducted stratified analyses by race/ethnicity. We adjusted for poverty income ratio, BMI, urinary creatinine, and sunscreen usage.

Results

BP3 levels in Mexican American, Other Hispanic, Other Race, non-Hispanic White, and non-Hispanic Asian women were on average 59%, 56%, 33%, 16%, and 9% higher, respectively, compared to non-Hispanic Black women. Racial differences in BP3 levels are accentuated with body dissatisfaction. For example, Other Hispanic women perceiving themselves as overweight had 69% higher BP3 levels than non-Hispanic Black women (p-value = 0.01), while those perceiving themselves as at the right weight had 32% higher levels (p-value = 0.31). Moreover, minority women perceiving themselves as overweight tended to have higher BP3 levels than those who do not. For example, BP3 levels in Other Hispanic women perceiving themselves as overweight are significantly higher compared to those who do not (73%, p-value = 0.03). In contrast, such differences in the non-Hispanic White women are minimal (-0.5%, p-value = 0. 98).

Discussion

Minority women with body dissatisfaction show elevated BP3 exposure independent of sunscreen usage, implying that their elevated exposures may stem from using other personal care and consumer products. Further research is needed to determine if increases of exposure to potential toxicants occur among minority women with body dissatisfaction.

The bench to community initiative: community-based participatory research model for translating research discoveries into community solutions

Community-based participatory research (CBPR) is an effective methodology for translating research findings from academia to community interventions. The Bench to Community Initiative (BCI), a CBPR program, builds on prior research to engage stakeholders across multiple disciplines with the goal of disseminating interventions to reduce breast cancer disparities and improve quality of life of Black communities.

Methods

The BCI program was established to understand sociocultural determinants of personal care product use, evaluate the biological impact of endocrine disrupting chemicals, and develop community interventions. The three pillars of the program include research, outreach and engagement as well as advocacy activities. The research pillar of the BCI includes development of multidisciplinary partnerships to understand the sociocultural and biological determinants of harmful chemical (e.g., endocrine disrupting chemicals) exposures from personal care products and to implement community interventions. The outreach and engagement pillar includes education and translation of research into behavioral practice. The research conducted through the initiative provides the foundation for advocacy engagement with applicable community-based organizations. Essential to the mission of the BCI is the participation of community members and trainees from underrepresented backgrounds who are affected by breast cancer disparities.

Results

Two behavioral interventions will be developed building on prior research on environmental exposures with the focus on personal care products including findings from the BCI. In person and virtual education activities include tabling at community events with do-it-yourself product demonstrations, Salon Conversations-a virtual platform used to bring awareness, education, and pilot behavior change interventions, biennial symposiums, and social media engagement. BCI's community advisory board members support activities across the three pillars, while trainees participate in personal and professional activities that enhance their skills in research translation.

Discussion

This paper highlights the three pillars of the BCI, lessons learned, testimonies from community advisory board members and trainees on the impact of the initiative, as well as BCI's mission driven approaches to achieving health equity.

A Personalized Intervention to Increase Environmental Health Literacy and Readiness to Change in a Northern Nevada Population: Effects of Environmental Chemical Exposure Report-Back

BACKGROUND

Interventions are needed to help people reduce exposure to harmful chemicals from everyday products and lifestyle habits. Report-back of individual exposures is a potential pathway to increasing environmental health literacy (EHL) and readiness to reduce exposures.

OBJECTIVES

Our objective was to determine if report-back of endocrine-disrupting chemicals (EDCs) can reduce EDC exposure, increase EHL, and increase readiness to change (i.e., to implement EDC exposure-reduction behaviors).

METHODS

Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 174) a report-back intervention. Participants used mail-in kits to measure urinary biomarkers of EDCs. The report-back of results included urinary levels, information about health effects, sources of exposure, and personalized recommendations to reduce exposure.

RESULTS

EHL was generally very high at baseline, especially for questions related to the general pollution. For questions related to chemical exposures, responses varied across several demographics. Statistically reliable improvements in EHL responses were seen after report-back. For readiness to change, 72% were already or planning to change their behaviors. Post-intervention, women increased their readiness (p = 0.053), while men decreased (p = 0.007). When asked what challenges they faced in reducing exposure, 79% cited not knowing what to do. This dropped to 35% after report-back. Participants with higher propylparaben were younger (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02-0.003 and p = 0.001-0.003, respectively). After report-back, monobutyl phthalate decreased among the 48 participants who had valid urine tests before and after the intervention (p < 0.001).

CONCLUSIONS

The report-back intervention was successful as evidenced by increased EHL behaviors, increased readiness to change among women, and a decrease in monobutyl phthalate. An EHL questionnaire more sensitive to chemical exposures would help differentiate high and low literacy. Future research will focus on understanding why men decreased their readiness to change and how the intervention can be improved for all participants.

Analysis of chemical exposures in racial populations in Canada: An investigation based on the Canadian health measures survey

Despite demonstrated disparities in environmental chemical exposures by racial identity, no Canadian study has systematically assessed the feasibility of using a nationally representative dataset to examine differences in chemical concentrations by race. We assessed the feasibility and constraints of analysing chemical exposures in racial populations, including visible minorities and populations of Indigenous identity, using biomonitoring data collected through the Canadian Health Measures Survey (CHMS). Our primary objectives were to assess the ability to 1) generate geometric means and percentiles of chemical concentrations for racial populations by age or sex, 2) statistically compare concentrations among racial populations, and 3) calculate time trends of concentrations by race. We conducted these analyses for several priority chemicals: lead, cadmium, benzene, bisphenol A (BPA), and di(2-ethylhexyl) phthalate (DEHP). Survey participants self-identified as one of the following: White, Black, East and Southeast Asian, South Asian, Middle Eastern, Latin American, First Nations, Metis, and Inuit. Analyses were conducted for individual and combined cycles of the CHMS. Using data from the latest CHMS cycle in which each chemical was measured, we observed that sample sizes were sufficient to report geometric mean concentrations for all races except Inuit. Due to privacy considerations associated with small sample sizes, the 5th and 95th percentile concentrations could not be consistently reported for all racial populations in this analysis. While we were able to statistically compare concentrations among racial populations, the analysis was constrained by the limited number of statistical degrees of freedom available in a single CHMS cycle. Both of these constraints were alleviated by combining multiple cycles of data. The analysis of time trends was less subject to privacy and statistical limitations; we were able to calculate time trends of chemical concentrations for all racial populations. Our findings provide an important baseline for follow-up investigations of descriptive and etiological analyses of environmental chemical exposures and race in the CHMS.

Frequency of personal care product use among reproductive-aged Black individuals and associations with socio-demographic characteristics

BACKGROUND

Compared to White women, Black women in the United States are more likely to use personal care products (PCPs) with higher concentrations of endocrine-disrupting chemicals (EDCs) and harsher chemical formulations. This may contribute to differential health outcomes in Black women such as increased risk of breast cancer, cardiometabolic outcomes, adverse birth outcomes, and uterine fibroids.

OBJECTIVE

Classify distinct PCP use patterns across multiple types of products and examine how patterns vary by socio-demographic characteristics.

METHODS

The Study of Environment, Lifestyle and Fibroids is a cohort study of reproductive-aged Black individuals living around Detroit, Michigan. Using self-reported data on frequency of PCP collected between 2013-2018, we employed latent class analysis to identify distinct groups of participants with similar PCP use. Socio-demographic characteristics were compared across latent classes.

RESULTS

Among 1562 participants, we identified 6 latent classes: Lower Overall; Higher Nailcare; Higher Skincare; Moderate Overall; Higher Makeup/Haircare/Skincare; Higher Overall. Makeup and nailcare usage were the most predictive for classifying participants into groups. Participants in classes with less frequent use of all PCPs and those with only high use of nailcare products, were more likely to report lower socio-economic status (SES), be current smokers, have a body mass index of ≥35 kg/m2, and have ≥3 births. In comparison, participants in classes with average and more frequent use of PCPs were more likely to report higher SES, be non-smokers, be nulliparous, and have ever used oral contraceptives.

IMPACT STATEMENT

This study is one of the first detailed assessments of PCP usage among a large cohort of young adult Black women that considers multiple product categories including makeup, hair, skin, nail, and vaginal products. Latent class analysis was used to capture complex patterns of PCP use and identify distinct groups of individuals with similar product use. Although the latent classes are specific to this study population, the identified socio-demographic characteristics or behaviors associated with latent classes may inform targeted and impactful exposure reduction strategies in similar populations.

Recent use of consumer and personal care products and exposures to select endocrine disrupting chemicals among urban children with asthma

BACKGROUND

Emerging studies suggest that endocrine disrupting chemicals (EDCs) in personal care and other consumer products are linked with various adverse health effects, including respiratory and reproductive effects. Despite Black persons using more personal care products than other demographic groups and having a high asthma burden, little is known regarding their consumer product use patterns and associated EDC exposures.

OBJECTIVE

To examine the association between recent exposure to select EDCs with specific consumer products and behaviors in a cohort of 110 predominantly Black children with asthma, ages 8-17 years, living in Baltimore City, Maryland.

METHODS

We quantified concentrations of bisphenol A (BPA), bisphenol S (BPS), bisphenol F, two dichlorophenols, four parabens, triclosan, benzophenone-3, and triclocarban in spot urine samples. Questionnaires were used to capture recent (last 24-h) consumer product use and behaviors. Associations between EDCs and consumer product uses/behaviors were assessed using multivariable linear regression, adjusting for age, gender, race/ethnicity, and caregiver income level. Effect estimates were expressed as geometric mean ratios of biomarker concentrations of product-users vs non-users.

RESULTS

Increased concentrations to select EDCs were associated with recent use of air freshener (ratios; BPA: 1.9, 95%CI 1.4-2; BPS 1.7, 95%CI 1-2.97; propyl paraben: 3.0, 95%CI 1.6-5.6), scented candles (methyl paraben: 2.6, 95%CI 1.1-6.1), and scented carpet powder (2,5-dichlorophenol: 2.8, 95%CI 1.2-6.3). Additionally, consuming canned food was associated with some increased biomarker concentrations (ratios: BPA: 1.7, 95%CI 1.2-2.4; BPS: 2.1, 95% CI: 1.2-3.6).

SIGNIFICANCE

These findings add to the body of evidence suggesting that recent use of select consumer products in Black children contributes to exposure of chemicals of concern and could potentially inform exposure mitigation interventions. Findings have broad potential health implications for pediatric populations and Black children who may face exposure and health disparities.

IMPACT

Little is known about how children's personal care product use and consumer behaviors affect their exposures to endocrine disrupting chemicals (EDCs). This is particularly true for Black children who often experience a disparate exposure burden to many EDCs. This is a significant knowledge gap among children that are uniquely vulnerable to EDCs as they undergo critical windows of growth and development. Our findings show associations between consumer products and EDC exposures in predominantly Black children in low-income settings. Identifying EDC exposure determinants has broad health implications as many of these chemicals have been associated with adverse health risks.

Hair Dye and Relaxer Use among Cisgender Women in Embu and Nakuru Counties, Kenya: Associations with Perceived Risk of Breast Cancer and Other Health Effects

Despite widespread use of hair products globally, little is known about the prevalence and patterns of use in populations outside the United States. As some hair products contain endocrine-disrupting chemicals (EDCs) and EDCs have been linked to breast cancer, which is increasing globally, in this study, we addressed key knowledge gaps about hair product use and practices, and perceptions of use among women in two counties in Kenya. Using community-engaged approaches in Embu and Nakuru, Kenya, we recruited women aged 15-50 years to complete a questionnaire that ascertained hair product use in the last 7-14 days, ever using hair dyes and chemical relaxers, and participants' perceptions or harm around hair product use. In multivariable-adjusted regression models, we evaluated associations between participants' sociodemographic characteristics and perceptions of hair product use in relation to if they have ever used hair dyes and relaxers. In our sample of 746 women (mean age, 30.4 ± 8.1 years), approximately one-third of participants reported ever using permanent and/or semi-permanent hair dyes, with approximately one-fifth reporting current use. Almost 60% reported ever using chemical relaxers, with a little over one-third reporting current use. Increasing age and having an occupation in the sales and service industry were statistically significant predictors of hair dye use (OR 1.04, 95% CI: 1.02-1.06 and OR 2.05, 95% CI: 1.38-3.03, respectively) and relaxer use (OR 1.03, 95% CI: 1.01-1.06 and OR 1.93, 95% CI: 1.30-2.87). On average, participants reported moderate-to-high levels of concern about exposures and general health effects from using hair products, and relatively high levels of perceived risk of breast cancer related to hair product use. However, in contrast to our hypotheses, we observed mixed evidence regarding whether higher levels of perceived risk were associated with lower odds of ever using hair dyes and relaxers. These findings add new knowledge to the extant literature on hair product use among women in Kenya, where breast cancer incidence rates are increasing. Improving the understanding of patterns of use of specific products and their chemical ingredients-which may be hormone disruptors or carcinogens-and exploring the role of environmental health literacy are critical for developing interventions to reduce potentially harmful exposures found in these products.

Risk perception and use of personal care products by race and ethnicity among a diverse population

Personal care products can contain phthalates, parabens and other endocrine-disrupting chemicals. However, information on perception of risks from personal care product use and how use varies by race and ethnicity is limited. We evaluated differences in personal care product use and risk perception in a diverse sample of participants recruited from a US college campus and online. A self-administered questionnaire captured information on sociodemographic factors, personal care product use trends and perception of risk associated with them. Pearson's chi-square and Fisher's exact tests were used to determine differences in personal care product use and risk perception by race and ethnicity. Ordered logistic regressions were performed to measure associations between personal care product use frequency across racial/ethnic categories. Participant (n = 770) mean age was 22.8 years [standard deviation ± 6.0]. Daily use of make-up (eye = 29.3%; other = 38.0%; all = 33.7%) and skincare products (55%) was most frequently reported among Middle Eastern and North African participants. Non-Hispanic Black participants reported the highest daily use of hairstyling products (52%) and lotion (78%). Daily make-up use was more frequently reported among females (41%) than males (24.6%). Levels of agreement were similar across racial and ethnic groups, that personal care product manufacturers should be required to list all ingredients (≥87%). There were significant associations between the frequency of use of some personal care products and racial/ethnic categories when the use frequencies of participants from other racial/ethnic categories were compared to the use frequency of non-Hispanic White participants. There were significant differences in daily use frequency, levels of trust, perception of safety and health risks associated with personal care products by race and ethnicity, underscoring that there may be different sources of exposure to chemicals in personal care products by race and ethnicity.

The hair tales of women of color in Northern Manhattan: a qualitative analysis

Introduction

Exposure to endocrine disrupting chemicals (EDCs), such as phthalates, can negatively impact maternal and child health, contributing to impaired fetal growth, preterm birth, and pregnancy complications, as well as increased downstream risks of cardiometabolic disease and breast cancer. Notably, women of color (WOC) are the largest consumers of personal care products, which are a common source of EDC exposure.

Methods

The Let's Reclaim Our Ancestral Roots (Let's R.O.A.R) Pilot Study developed an educational intervention delivered during pregnancy to promote reduced use of phthalate-containing hair care products (HCPs). This mixed-methods study included: (1) a quantitative analysis and (2) a qualitative analysis of the educational sessions and the semi-structured focus groups to evaluate the factors that influenced the hair care practices and product choices of WOC at various stages of life, including their current pregnancy (hereafter referred to as the hair journey). During the sessions, participants learned about EDCs (with a focus on phthalates), the unequal burden of exposure for WOC, adverse implications of exposure, and exposure reduction strategies. Focus group sessions provided insight into participants' hair journeys from childhood to the current pregnancy and explored factors during their hair product selection process. All sessions were transcribed and imported into NVivo Version 12 for coding and thematic analysis.

Results

A total of 46 individuals were enrolled in the study, and 31 participated in an educational session. This current work synthesizes the qualitative analysis of this study. We identified two important life stages (before and after gaining agency over hair care practices and product choices) and three dominant themes related to HCP use: (1) products that impacted the hair journey, which involved all mentions of hair products, (2) factors that influenced the hair journey, which included individuals or entities that shaped participants' hair experiences, and (3) the relationship between hair and sense of self, where sense of self was defined as the alignment of one's inner and outer beauty.

Conclusion

The themes intersected and impacted the participants' hair journey. Cultural integration was a sub-theme that overlapped within the dominant themes and participants discussed the effect of traditions on their hair experiences.

Personal Care Products, Socioeconomic Status, and Endocrine-Disrupting Chemical Mixtures in Black Women

Personal care products (PCPs) are sources of exposure to endocrine-disrupting chemicals (EDCs) among women, and socioeconomic status (SES) may influence these exposures. Black women have inequitable exposure to EDCs from PCP use, but no study has investigated how exposure to EDCs through PCPs may vary by SES, independent of race. Using data from the Study of Environment, Lifestyle, and Fibroids, a cohort of reproductive-aged Black women (n = 751), we quantified associations between PCPs and urinary biomarker concentrations of EDC mixtures (i.e., phthalates, phenols, parabens) within SES groups, defined using k-modes clustering based on education, income, marital status, and employment. Information about PCP use and SES was collected through questionnaires and interviews. We used principal component analysis to characterize the EDC mixture profiles. Stratified linear regression models were fit to assess associations between PCP use and EDC mixture profiles, quantified as mean differences in PC scores, by SES group. Associations between PCP use and EDC mixture profiles varied by SES group; e.g., vaginal powder use was associated with a mixture of phenols among lower SES women, whereas this association was null for higher SES women. Findings suggest that SES influences PCP EDC exposure in Black women, which has implications for public health interventions.

Personal Care Product Use during Puberty and Incident Breast Cancer among Black, Hispanic/Latina, and White Women in a Prospective US-Wide Cohort

BACKGROUND

Some personal care products (PCPs) contain endocrine-disrupting chemicals that may affect breast cancer (BC) risk. Patterns of use vary by race and ethnicity. Use often starts in adolescence, when rapidly developing breast tissue may be more susceptible to environmental carcinogens. Few studies have examined associations of BC with PCP use during this susceptible window.

OBJECTIVES

We characterized race and ethnicity-specific patterns of PCP use at 10-13 years of age and estimated associations of use with incident BC.

METHODS

At enrollment (2003-2009), Sister Study participants (n = 4,049 Black, 2,104 Latina, and 39,312 White women) 35-74 years of age reported use of 37 "everyday" PCPs during the ages of 10-13 y (did not use, sometimes, or frequently used). We conducted race and ethnicity-specific latent class analyses to separately identify groups of women with similar patterns of beauty, hair, and skincare/hygiene product use. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of identified PCP classes and single products with incident BC using Cox proportional hazards regression.

RESULTS

During a mean follow-up time of 10.8 y, 280 Black, 128 Latina, and 3,137 White women were diagnosed with BC. Classes of adolescent PCP use were not clearly associated with BC diagnosis among Black, Latina, or White women. HRs were elevated but imprecise for frequent nail product and perfume use in Black women (HR = 1.34; 95% CI: 0.85, 2.12) and greater hair product use in Black (HR = 1.28; 95% CI: 0.91, 1.80) and Latina (HR = 1.42; 95% CI: 0.81, 2.48) women compared with lighter use. In single-product models, we observed higher BC incidence associated with frequent use of lipstick, nail products, pomade, perfume, makeup remover, and acne/blemish products in at least one group.

DISCUSSION

This work provides some support for the hypothesis that PCP use during puberty is associated with BC risk. More research is needed to confirm these novel findings. https://doi.org/10.1289/EHP13882.

Racial and Ethnic Disparities in Phthalate Exposure and Preterm Birth: A Pooled Study of Sixteen U.S. Cohorts

BACKGROUND

Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth.

OBJECTIVES

We investigated race and ethnicity in the relationship between biomarkers of phthalate exposure and preterm birth by examining: a) how hypothetical reductions in racial and ethnic disparities in phthalate metabolites might reduce the probability of preterm birth; and b) exposure-response models stratified by race and ethnicity.

METHODS

We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate-adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity-stratified logistic regression to characterize associations between phthalate metabolites and preterm birth.

RESULTS

In comparison with concentrations among White participants, adjusted mean phthalate metabolite concentrations were consistently higher among Black and Hispanic/Latina participants by 23%-148% and 4%-94%, respectively. Asian/Pacific Islander participants had metabolite levels that were similar to those of White participants. Hypothetical interventions to reduce disparities in metabolite mixtures were associated with lower probabilities of preterm birth for Black [13% relative reduction; 95% confidence interval (CI): - 34 % , 8.6%] and Hispanic/Latina (9% relative reduction; 95% CI: - 19 % , 0.8%) participants. Odds ratios for preterm birth in association with phthalate metabolites demonstrated heterogeneity by race and ethnicity for two individual metabolites (mono-n-butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants.

CONCLUSIONS

Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831.

Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

PURPOSE OF REVIEW

The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods.

RECENT FINDINGS

We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.

Use of Chemical Hair Straighteners and Fecundability in a North American Preconception Cohort

Chemical hair straighteners ("relaxers") are used by millions of North Americans, particularly women of color. Hair relaxers may contain endocrine-disrupting compounds, which can harm fertility. We evaluated the association between hair relaxer use and fecundability among 11,274 participants from Pregnancy Study Online (PRESTO), a North American preconception cohort study. During 2014-2022, participants completed a baseline questionnaire in which they reported their history of relaxer use and completed follow-up questionnaires every 8 weeks for 12 months or until pregnancy, whichever came first. We used multivariable-adjusted proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs). Relative to never use, fecundability was lower among current (FR = 0.81, 95% CI: 0.64, 1.03) and former (FR = 0.89, 95% CI: 0.81, 0.98) users of hair relaxers. FRs for first use of hair relaxers at ages <10, 10-19, and ≥20 years were 0.73 (95% CI: 0.55, 0.96), 0.93 (95% CI: 0.83, 1.04), and 0.85 (95% CI: 0.74, 0.98), respectively. Fecundability was lowest among those with longer durations of use (≥10 years vs. never: FR = 0.71, 95% CI: 0.54, 0.91) and more frequent use (≥5 times/year vs. never: FR = 0.82, 95% CI: 0.60, 1.11), but associations were nonmonotonic. In this preconception cohort study, use of chemical hair straighteners was associated with slightly reduced fecundability.

Allergic Contact Dermatitis and Patch Testing in Skin of Color Patients

Objective: Skin of color patients face important health issues relevant to dermatologists, such as allergic contact dermatitis; however, there is a lack of information surrounding common allergens causing contact dermatitis that disproportionately affect skin of color patients, as well as interpreting patch testing in this population. Methods: Covidence, Embase, MEDLINE, PubMed, Web of Science, and Google Scholar were searched to identify relevant articles studying allergic and irritant contact dermatitis in skin of color patients. Results: The most common positive reactions in African American patients included PPD, balsam of Peru, bacitracin, fragrance mix, and nickel. The most common positive reactions in Hispanic patients included Carba mix, nickel sulfate, and thiuram mix. The most common positive reactions in Asian patients included nickel sulfate, fragrance mix, and potassium dichromate. When interpreting patch test results in patients with higher Fitzpatrick skin types, positive patch tests presented with lichenification and hyperpigmentation, rather than erythema and vesicles. Furthermore, characteristic bright red or pink hues for positive results may appear violaceous or faint pink. Conclusions: Awareness of the common allergens associated with allergic contact dermatitis in patients of skin of color can help guide patch testing as an important diagnostic tool. Further research must be conducted regarding contact dermatitis in this patient population, especially given the relative lack of data surrounding Hispanic, Asian and Pacific Islander, and Native American patients.

Chemicals of concern in personal care products used by women of color in three communities of California

BACKGROUND

Personal care products (PCPs) may contain chemicals associated with adverse health effects. Prior studies found differences in product use by race/ethnicity and suggest some women are disproportionately exposed to chemicals of concern (CoCs).

OBJECTIVE

We quantified chemicals linked to cancer, reproductive or developmental harm, or endocrine disruption in PCPs used by women of color.

METHODS

We documented PCPs in stores frequented by Black, Latina, and Vietnamese women in their communities in California and CoCs on ingredient labels of 546 unique hair, skin, makeup, nail, deodorant/perfume, and intimate care products. Community partners chose 31 products for a combined targeted and suspect screen (National Institute of Standards and Technology mass spectral library search) two-dimensional gas chromatography time-of-flight mass spectrometry (GCxGC-TOFMS) analysis to detect chemicals not on ingredient labels.

RESULTS

We found that 65% of labels included CoCs, and 74% of labels had undisclosed ingredients listed as "fragrance." The most prevalent chemicals were parabens, cyclosiloxanes, and formaldehyde releasers. GCxGC-TOFMS found additional CoCs, including fragrances, solvents, preservatives, ultraviolet filters, and contaminants.

SIGNIFICANCE

These findings contribute to awareness of potentially hazardous chemicals in PCPs, can help estimate disparities in chemical exposure, and complement research on health inequities due to chemical exposures from various contributors.

IMPACT STATEMENT

This study is one of the first detailed assessments of chemicals of concern found in various types of PCPs used by several racial/ethnic groups. We found that over half of the 546 products selected by community partners as marketed to and/or used by them contained ingredients linked to cancer, reproductive or developmental harm, or endocrine disruption. Laboratory analysis identified additional chemicals in a subset of products, including unlabeled fragrance chemicals and contaminants. Elucidating exposures to chemicals in PCPs is important for risk assessment and health inequity research.