Early exposure to dichlorodiphenyldichloroethylene, breastfeeding and asthma at age six

[Pesticide exposure and chronic respiratory diseases]

INTRODUCTION

Pesticides are used worldwide, mainly in agriculture as a means of controlling pests and protecting crops. That said, the entire world population is ultimately subject to pesticide exposure (consumption of fruits and vegetables, living near treated fields…), with varying degrees of toxicity involved.

STATE OF THE ART

In recent decades, epidemiological studies have contributed to the identification of chemical pesticide families with detrimental effects on human health: cognitive disorders, Parkinson's disease, prostate cancer… and impairment in respiratory functioning. Current scientific evidence points to the implication of the active substances in insecticides, herbicides and fungicides in chronic respiratory diseases, two examples being chronic obstructive pulmonary disease (COPD) in exposed workers, and asthmatic wheezing in children during prenatal or postnatal exposure.

PERSPECTIVES

The safety of individuals exposed to pesticides is of key importance in public health. Further epidemiological investigations are needed to identify the chemical families affecting certain populations.

CONCLUSIONS

The scientific literature suggests strong links between pesticide exposure and respiratory health. Whether it be environmental or occupational, pesticide exposure can lead to respiratory disorders and symptoms of varying severity.

Dichlorodiphenyltrichloroethane for Malaria and Agricultural Uses and Its Impacts on Human Health

Pesticides are widely used in agriculture and disease control, and dichlorodiphenyltrichloroethane (DDT) is one of the most used pesticides in human history. Besides its significant contributions in pest control in agriculture, DDT was credited as having saved millions of human lives for controlling malaria and other deadly insect-transmitted diseases. Even today, the use of DDT in some countries for malaria control cannot be replaced without endangering people who live there. The recent COVID-19 pandemic has changed our lives and reminded us of the challenges in dealing with infectious diseases, especially deadly ones including malaria. However, DDT and its metabolites are stable, persist long, are found in almost every corner of the world, and their persistent effects on humans, animals, and the environment must be seriously considered. This review will focus on the history of DDT use for agriculture and malaria control, the pathways for the spread of DDT, benefits and risks of DDT use, DDT exposure to animals, humans, and the environment, and the associated human health risks. These knowledge and findings of DDT will benefit the selection and management of pesticides worldwide.

The Association Between Urinary Concentrations of Organophosphate Metabolites and Asthma-Related Outcomes Among Schoolchildren From Informal Settlements

Objectives: There is inconsistent evidence on the relationship between pesticide exposure and childhood respiratory outcomes in non-agricultural settings. This study investigated the association between organophosphate (OP) pesticide exposure and asthma-related outcomes in children residing in four informal settlements. Methods: The study was a longitudinal study of 590 schoolchildren, with a 12 months follow-up period. A standardised questionnaire adopted from the International Study of Asthma and Allergies in Childhood was administered to caregivers for child's respiratory symptoms and household characteristics. Spirometry and fractional-exhaled nitric oxide, including a phadiatop test (atopy status) and urinary dialkyl phosphate (DAP) metabolites were measured at baseline and follow-up. DAP metabolites included diethylphosphate (DEP) and dimethyl phosphate (DMP) measured at baseline and follow-up and dimethylthiophosphate (DMTP) measured only at baseline. Results: The mean ages of schoolchildren were 9.9 ± 0.91 years and the overal incidence proportions of new doctor diagnosed asthma was 2.2%. No consistent patterns of increased risk of asthma outcomes with increasing DAP concentrations was found in multivariate analysis. Conclusion: Future studies with longer follow-up periods and repeated OP biomonitoring are recommended.

Systematic Review: Association of Pesticide Exposure and Child Wheeze and Asthma

BACKGROUND

The prevalence of wheeze and asthma has risen over recent decades for all age groups, especially children. These disorders can lead to decreased quality of life, missed school, urgent care and emergency department visits, hospitalizations, and increased health care costs. Environmental exposures, including pesticide exposure, are likely a contributing factor to this increased prevalence.

OBJECTIVE

To evaluate the association of pesticide exposure with childhood wheeze and asthma.

METHODS

We conducted a systematic review evaluating studies of pesticide exposure (measured objectively) and child respiratory outcomes. We searched PubMed, Embase (Elsevier), CINAHL (EBSCO), Scopus (Elsevier), Cochrane Database of Systematic Reviews (Wiley), and ClinicalTrials. gov from 1988 - 2021. Main search keywords included "pesticides", "insecticides", "herbicides", "respiratory", "asthma" and "wheeze".

RESULTS

Out of 5767 studies, 25 met the inclusion criteria; eight evaluated prenatal pesticide exposure (n=8407), twelve evaluated postnatal exposures (n= 50,488), and five evaluated pre-and postnatal exposures (n=20,919). Main pesticides investigated were dichlorodiphenyldichloroethylene (DDE) (14 studies) followed by organophosphates (7 studies). Primary methods of outcome assessment were questionnaire-based (84%), followed by spirometry (16%), registry data, and blood measures. Studies varied in the strength of evidence relating to study design and measures. Most studies (84%) reported a positive association of exposure with adverse child respiratory health.

CONCLUSION

The studies suggest an association of pesticide exposure and childhood wheeze and asthma. The varying results and methods reinforce the need for more research and standardized approaches to these studies to confirm the suggested association of pesticide exposure and childhood wheeze and asthma.

Effect of Gestational Pesticide Exposure on the Child's Respiratory System: A Narrative Review

BACKGROUND

In recent years, concern has arisen worldwide about the potential adverse effects that could result from early-life exposure to pesticides. Asthma, bronchitis, and persistent cough in children have been linked to gestational exposure to pesticides. The respiratory effects of gestational exposure to pesticides are controversial. The aim of this study was to determine the relationship between pesticide exposure in pregnant women and its effect on the respiratory system of their children.

METHODS

A narrative review was carried out by means of a search in the main databases.

RESULTS

Findings of studies confirmed the effects of pesticides on the child's health. These substances cross the placenta and become transmitters of exposure to the individual at the most sensitive stage of her development.

CONCLUSIONS

Chronic exposure to pesticides in fetuses is associated with chronic respiratory symptoms and disease.

Association between exposure to pesticides and allergic diseases in children and adolescents: a systematic review with meta-analysis

OBJECTIVE

The study aimed to conduct a systematic review of the literature to verify the association between exposure to pesticides and allergic diseases (asthma, allergic rhinitis, and atopic dermatitis) in children and adolescents.

METHOD

A systematic review and meta-analysis were performed using the PRISMA method with the question "What is the association between exposure to pesticides and allergic diseases in children (asthma, allergic rhinitis, and atopic dermatitis)?" MEDLINE, EMBASE, SciELO, and Cochrane electronic databases were searched throughout the period in the literature up to September 2020. A total of 1296 studies were found, and 24 were selected.

RESULTS

Exposure to pesticides showed a two-fold greater risk of developing or exacerbating asthma in children and adolescents (odds ratio [OR] = 2.14 95% confidence interval [CI] 1.26-3.64, p < 0.01). There was no association between exposure to pesticides and the development of allergic rhinitis (OR = 2.73, 95% CI 0.13-57.8, p = 0.52) and atopic dermatitis (OR = 2.19, 95% CI 0.51-9.36, p = 0.29).

CONCLUSIONS

Exposure to pesticides increases the risk of developing or exacerbating asthma in children and adolescents. There was no evidence of an association between exposure to pesticides and the development of allergic rhinitis and atopic dermatitis in children and adolescents, possibly due to the low number of studies found in this review.

Influence of gestational weight gain on the organochlorine pollution content of breast milk

BACKGROUND

Transplacental transfer and breastfeeding are the main transport routes of organic pollutants into children at the beginning of life. Although pollutant transmission through these mechanisms primarily depends on the maternal pollution burden, its impact may be modulated by physiological effects.

OBJECTIVES

We have examined whether gestational weight gain (GWG) exerts an influence on the content of lipophilic low volatile pollutants in breast milk.

RESULTS

Colostrum from mothers from the INMA cohorts of Sabadell and Gipuzkoa (n = 256 and 119, respectively) with low GWG as defined by the Institute of Medicine (IOM) from the US National Academies of Sciences, Engineering and Medicine had significantly higher concentrations of polychlorobiphenyls (PCBs) and 4,4'-DDE than colostrum in mothers who gained weight within IOM recommendations or in those who exceeded this threshold. Statistically significant differences were also found in the colostrum:maternal serum ratios of these compounds. Women with low GWG retained higher pollutant amounts in colostrum. These observations are consistent with previously described higher concentrations of these pollutants in infant cord blood from mothers with low GWG by IOM standards. They indicate that mobilization of lipophilic organic pollutants by metabolic pregnant changes not only leads to higher fetal transfer but to higher accumulation into the mammary system upon low GWG.

CONCLUSIONS

The present results show that insufficient GWG, besides increasing in utero exposure, also enhances pollutant transfer to infants during breastfeeding which considerably extends the significance of this physiological change for the pollutant children intake in early life.

Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis

Objective

To investigate the relationship between breastfeeding and the development of paediatric asthma.

Methods

A systematic review and meta-analysis was conducted with MEDLINE, Embase, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children aged <18 years with breastfeeding exposure reported were included. The primary outcome was a diagnosis of asthma by a physician or using a guideline-based criterion. A secondary outcome was asthma severity.

Results

42 studies met inclusion criteria. 37 studies reported the primary outcome of physician-/guideline-diagnosed asthma, and five studies reported effects on asthma severity. Children with longer duration/more breastfeeding compared to shorter duration/less breastfeeding have a lower risk of asthma (OR 0.84, 95% CI 0.75–0.93; I² = 62.4%). Similarly, a lower risk of asthma was found in children who had more exclusive breastfeeding versus less exclusive breastfeeding (OR 0.81, 95% CI 0.72–0.91; I²=44%). Further stratified analysis of different age groups demonstrated a lower risk of asthma in the 0–2-years age group (OR 0.73, 95% CI 0.63–0.83) and the 3–6-years age group (OR 0.69, 95% CI 0.55–0.87); there was no statistically significant effect on the ≥7-years age group.

Conclusion

The findings suggest that the duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years.

The findings of this systematic review and meta-analysis of cohort studies suggest that duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 yearshttps://bit.ly/3p804PG

Sex specific associations between in utero exposure to persistent organic pollutants and allergy-related outcomes in childhood: The Rhea Mother-Child Cohort (Crete, Greece)

Accumulating evidence suggests that in utero exposures can influence the development of the immune system. Few studies have investigated whether prenatal exposure to persistent organic pollutants (POPs) is associated with allergy-related phenotypes in childhood, nor explored sex differences. We examined the association between prenatal exposure to POPs and offspring allergic outcomes in early and mid-childhood. We included 682 mother-child pairs from the prospective birth cohort Rhea. We measured dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB) and 6 polychlorinated biphenyl (PCB) congeners in maternal first trimester serum. Parents completed the questionnaires adapted from the International Study on Asthma and Allergy in Childhood (ISAAC) for allergy-related phenotypes when their children were 4 and 6 years old. We used Poisson regression models to estimate Risk Ratios. Prenatal HCB was associated with increased risk for rhinoconjunctivitis at 6 years (RR (95% CI): 2.5; (1.3, 4.8) for a doubling in the exposure). Among girls, prenatal DDE was associated with increased risk for current wheeze, current asthma and current rhinoconjunctivitis at 4 years (RR (95%CI): 1.4 (0.8, 2.6), 1.6 (1.1, 2.4) and 1.8 (1.0, 3.3) and p-interaction = 0.035, 0.027 and 0.059, respectively), with increased risk for current rhinoconjunctivitis at 6 years (RR (95%CI): 1.7 (0.7, 3.8) and p-interaction = 0.028) and total PCBs were associated with increased risk for current eczema at 4 years (RR (95%CI): 2.1 (1.1, 4.2) and p-interaction = 0.028). In boys, prenatal DDE was associated with decreased risk for current wheeze and current asthma at 4 years. Our findings suggest that even low levels of exposure to POPs prenatally may affect the development of childhood allergy-related outcomes in a sex and age-specific manner.

Tracking pesticide exposure to operating workers for risk assessment in seed coating with tebuconazole and carbofuran

BACKGROUND

Coating seed with pesticides is an effective way to control plant pests, however, factory-based coating processes may carry a potential risk to operational workers of chemical exposure. To study the risk, carbofuran and tebuconazole were used to coat corn seed and their subsequent distribution on the bodies of workers was measured at manufacturers XFS and LS (Shanxi, China). Clothing was collected from workers during operations and analyzed using high-performance liquid chromatography.

RESULTS

At XFS, dermal exposure to carbofuran was 4.83, 3.31 and 1.48 mg kg^-1 , and exposure to tebuconazole was 6.88, 5.16 and 1.72 mg kg^-1 for coating, packing and transport workers, respectively. At LS, dermal exposure to carbofuran was 2.32, 0.46 and 0.55 mg kg^-1 , and exposure to tebuconazole was 1.69, 0.46 and 0.70 mg kg^-1 , for coating, packing and transport workers, respectively. The level of pesticide exposure was significantly higher for seed-coating workers than for packing and transport workers. The main area of exposure was the hands for all workers and the lower limbs for packers; exposure was relatively uniform for pesticide handlers. Occupational risk was assessed based on margin of exposure (MOE). In seed-coating, the MOE was greater than 100 for tebuconazole, indicating no potential risk, but ranged from 0.25 to 2.88 for carbofuran, indicating the risk of a health impact.

CONCLUSION

The level of exposure varied depending on type of operation undertaken and body parts of workers' body, but the risk of a health impact was highly associated with pesticide toxicity. This provides a guideline for workers in pesticide manufacturing to ensure safe operation of the seed-coating process. © 2021 Society of Chemical Industry.

Associations between prenatal exposure to DDT and DDE and allergy symptoms and diagnoses in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), South Africa

Dichlorodiphenyl trichloroethane (DDT) is an organochlorine insecticide that is banned internationally except for use as part of Indoor Residual Spraying (IRS) programs to control malaria. Although animal studies show that DDT and its breakdown product dichlorodiphenyl dichloroethylene (DDE) affect the immune system and may cause allergies, no studies have examined this question in populations where IRS is conducted. The aim of our study was to investigate whether prenatal exposure to DDT and DDE is associated with allergy symptoms and diagnose among South African children living in an area where IRS is conducted. To accomplish this aim, we used data from the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), an ongoing birth cohort study of 752 children born between 2012 and 2013 in the rural Vhembe district of Limpopo, South Africa. We measured maternal peripartum serum concentrations of DDT and DDE, and administered a questionnaire to the caregivers of 658 children aged 3.5 years to collect information on allergy symptoms and diagnoses as well as potential confounders using validated instruments. Using multiple logistic regression models, we found positive associations between DDT and DDE serum concentrations and most of the allergy symptoms and diagnoses. Maternal DDT (Odds Ratio [OR] = 1.5 per 10-fold increase, 95% Confidence interval, CI = 1.0, 2.3) and DDE (OR = 1.4, 95% CI = 0.8, 2.4) serum concentrations were most strongly associated with caregiver report of wheezing or whistling in the chest. Concentrations of DDT and/or DDE were also associated with increased odds of children's chests sounding wheezy during or after exercise, itchy rashes coming and going for at least six months, diagnosis of food allergy, and diagnosis of dust or dust mites allergy but confidence intervals crossed the null. Results suggest that prenatal exposure to DDT, and possibly DDE, is associated with elevated odds of wheezing among children from an IRS area.

Organic Air Quality Markers of Indoor and Outdoor PM2.5 Aerosols in Primary Schools from Barcelona

Airborne particulate matter with an aerodynamic diameter smaller than 2.5 µg, PM2.5 was regularly sampled in classrooms (indoor) and playgrounds (outdoor) of primary schools from Barcelona. Three of these schools were located downtown and three in the periphery, representing areas with high and low traffic intensities. These aerosols were analyzed for organic molecular tracers and polycyclic aromatic hydrocarbons (PAHs) to identify the main sources of these airborne particles and evaluate the air quality in the urban location of the schools. Traffic emissions were the main contributors of PAHs to the atmospheres in all schools, with higher average concentrations in those located downtown (1800-2700 pg/m3) than in the periphery (760-1000 pg/m3). The similarity of the indoor and outdoor concentrations of the PAH is consistent with a transfer of outdoor traffic emissions to the indoor classrooms. This observation was supported by the hopane and elemental carbon concentrations in PM2.5, markers of motorized vehicles, that were correlated with PAHs. The concentrations of food-related markers, such as glucoses, sucrose, malic, azelaic and fatty acids, were correlated and were higher in the indoor atmospheres. These compounds were also correlated with plastic additives, such as phthalic acid and diisobutyl, dibutyl and dicyclohexyl phthalates. Clothing constituents, e.g., adipic acid, and fragrances, galaxolide and methyl dihydrojasmonate were also correlated with these indoor air compounds. All these organic tracers were correlated with the organic carbon of PM2.5, which was present in higher concentrations in the indoor than in the outdoor atmospheres.

Prenatal exposure to organochlorine compounds and lung function during childhood

INTRODUCTION

Prenatal exposure to organochlorine compounds (OCs) can increase the risk of reported respiratory symptoms in children. It remains unclear whether these compounds can also impact on lung function. We assessed the association between prenatal exposure to OCs and lung function during childhood.

METHODS

We included 1308 mother-child pairs enrolled in a prospective cohort study. Prenatal concentrations of p,p'-dichlorodiphenyltrichloroethane [p,p'-DDT], p,p'-dichlorodiphenyldichloroethylene [p,p'-DDE], hexachlorobenzene [HCB], and seven polychlorinated biphenyls [PCBs] were measured in cord blood. Spirometry was performed in the offspring at ages 4 (n = 636) and 7 years (n = 1192).

RESULTS

More than 80% of samples presented quantifiable levels of p,p'-DDE, HCB, PCB-138, PCB-153, and PCB-180; p,p'-DDE was the compound with the highest median concentrations. At 4 years, prenatal p,p'-DDE exposure was associated with a decrease in forced expiratory volume in 1 s (FEV₁) in all quartiles of exposure (e.g., third quartile [0.23-0.34 ng/mL]: β for FEV₁ -53.61 mL, 95% CI -89.87, -17.35, vs. the lowest). Prenatal p,p'-DDE levels also decreased forced vital capacity (FVC) and FEV₁/FVC, but associations did not reach statistical significance in most exposure quartiles. At 7 years, p,p'-DDE was associated with a decrease in FVC and FEV₁ in only the second quartile of exposure (e.g. β for FEV₁ -36.96 mL, 95% CI -66.22, -7.70, vs. the lowest). Prenatal exposure to HCB was associated with decreased FVC and FEV₁, but in only the second quartile and at 7 years (e.g. [0.07-0.14 ng/mL]: β for FEV₁ -25.79 mL, 95% CI -55.98, 4.39, vs. the lowest). PCBs were not consistently associated with lung function.

CONCLUSION

Prenatal exposure to p,p'-DDE may decrease lung function during childhood, especially FEV₁ and at medium levels of exposure. Further and deeper knowledge on the impact of environmental chemicals during pregnancy on lung development is needed.

Infant milk-feeding practices and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the life span: a systematic review

BACKGROUND

During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these populations.

OBJECTIVES

The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding prior to infant formula introduction, 4) feeding a lower versus higher intensity of human milk to mixed-fed infants, and 5) feeding a higher intensity of human milk by bottle versus breast with food allergies, allergic rhinitis, atopic dermatitis, and asthma.

METHODS

The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published between January 1980 and March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.

RESULTS

The systematic reviews numbered 1-5 above included 44, 35, 1, 0, and 0 articles, respectively. Moderate, mostly observational, evidence suggests that 1) never versus ever being fed human milk is associated with higher risk of childhood asthma, and 2) among children and adolescents who were fed human milk as infants, shorter versus longer durations of any human milk feeding are associated with higher risk of asthma. Limited evidence does not suggest associations between 1) never versus ever being fed human milk and atopic dermatitis in childhood or 2) the duration of any human milk feeding and allergic rhinitis and atopic dermatitis in childhood.

CONCLUSIONS

Moderate evidence suggests that feeding human milk for short durations or not at all is associated with higher childhood asthma risk. Evidence on food allergies, allergic rhinitis, and atopic dermatitis is limited.

Associations of residential exposure to agricultural pesticides with asthma prevalence in adolescence: The PIAMA birth cohort

BACKGROUND

It has been suggested that children who are exposed to agricultural pesticides have an increased risk of asthma, but evidence for associations betweeen residential pesticide exposure and childhood asthma is inconsistent.

OBJECTIVES

To investigate the associations of residential pesticide exposure with the prevalence of asthma and related symptoms within a Dutch birth cohort study.

METHODS

In this cross-sectional analysis, we included participants of the PIAMA birth cohort study with data on residential pesticide exposure and asthma from parent-completed questionnaires at age 14, collected in 2012 (N = 1473). We used spatial data on the presence of individual crops (cereals, open field vegetables, commercial crops, open field floriculture/bulbs, corn and potatoes) and pesticide application on these crops to estimate residential exposure to pesticides with known irritant properties for the respiratory system within distances of 100, 500, and 1000 m of the participants' homes. Logistic regression was used to estimate associations between exposure and outcomes, adjusting for potential confounders.

RESULTS

No associations were found between living within 100, 500 and 1000 m of agricultural fields likely treated with pesticides and symptoms of asthma. For instance, for participants living within 100 m of fields with any crops likely treated with pesticides, the adjusted odds ratios (95% confidence interval) for the prevalence of asthma, shortness of breath and dry night cough at age 14 were 0.31 (0.07, 1.32), 0.61 (0.23, 1.57) and 1.26 (0.56, 2.80), respectively. No associations were found between estimated exposure to pesticides with known irritant properties for the respiratory system and asthma or related symptoms.

CONCLUSIONS

There was no association between living near agricultural fields likely treated with pesticides and asthma and related respiratory symptoms, among our study participants.

Hazardous effects of chemical pesticides on human health-Cancer and other associated disorders

Poisoning from pesticides is a global public health problem and accounts for nearly 300,000 deaths worldwide every year. Exposure to pesticides is inevitable; there are different modes through which humans get exposed to pesticides. The mode of exposure is an important factor as it also signifies the concentration of pesticides exposure. Pesticides are used extensively in agricultural and domestic settings. These chemicals are believed to cause many disorders in humans and wildlife. Research from past few decades has tried to answer the associated mechanism of action of pesticides in conjunction with their harmful effects. This perspective considers the past and present research in the field of pesticides and associated disorders. We have reviewed the most common diseases including cancer which are associated with pesticides. Pesticides have shown to be involved in the pathogenesis of Parkinson's and Alzheimer's diseases as well as various disorders of the respiratory and reproductive tracts. Oxidative stress caused by pesticides is an important mechanism through which many of the pesticides exert their harmful effects. Oxidative stress is known to cause DNA damage which in turn may cause malignancies and other disorders. Many pesticides have shown to modulate the gene expression at the level of non-coding RNAs, histone deacetylases, DNA methylation patterns suggesting their role in epigenetics.

Drivers of the accumulation of mercury and organochlorine pollutants in Mediterranean lean fish and dietary significance

An integrated assessment of lean fish of commercial value as Hg and organochlorine compound source into the population of the Balearic Islands were reported. Dependences between pollutant concentrations, trophic level, fish species, specimen weight and physical-chemical properties were evaluated. Hg and total DDTs showed highest variability between fish species whereas PCBs and HCB displayed more constant median values. The organochlorine compounds found in highest concentrations were those with highest hydrophobicity, consistently with their higher bioaccumulation potential. These pollutant concentrations were higher in Mediterranean than Atlantic fish. Higher median total DDT and PCBs concentrations were also observed in the third than the second trophic level species. The observed concentrations were below the threshold recommended by the EU for human consumption (75ng/g wet weight). The Hg concentrations were higher in Mediterranean than Atlantic fish, with average values of 1.5μg/g ww and 0.43μg/g ww, respectively. Forty-one percent of the specimens from the Mediterranean and 25% of dusky grouper specimens from the Atlantic Ocean showed Hg concentrations above the EU recommended limits for human consumption, either 0.5μg/g ww or 1μg/g ww. In the third trophic level, a significant dependence between median Hg concentrations and weight of each studied species was observed, which remained significant in specimen weight correlations. Independent species correlations of Hg concentrations vs individual weight generally showed higher concentrations at higher weight. Weight/size of the individuals was therefore an important factor for Hg accumulation but the trend was modulated by a species effect. Extrapolation of the observed Hg concentrations in Mediterranean fish to Provisional Tolerable Weekly Intakes (PTWIs) showed higher intakes than the thresholds recommended by EFSA for adults and children, 110% and 140%, respectively. The estimated PTWIs for MeHg corresponded to 310% and 400% of the recommended threshold values. The PTWI values for organochlorine compounds were lower than those recommended.

Association between Organochlorine Pesticide Levels in Breast Milk and Their Effects on Female Reproduction in a Taiwanese Population

Only few studies have focused on organochlorine pesticides (OCPs) in breast milk and the related health risks for women in Taiwan. Our goal is to examine breast milk OCPs and their associations with female reproductive function (infertility, gynecological diseases, and menstruation characteristics) as well as their correlation with sociodemographic parameters (age, pre-pregnant body mass index (BMI), annual incomes, population, birth year, and parity) and dietary habit. The breast milk samples were collected in southern Taiwan (n = 68) from 2013 to 2016 and the OCP residues were analyzed using high resolution gas chromatography with low resolution mass spectrometry (HRGC/LRMS). The results show that the most abundant OCP residues in the breast milk was ΣDDT with the geometric mean ± standard deviation of 9.81 ± 7.52 ng⁻¹ lipid⁻¹ followed by ΣHCH (0.539 ± 0.557 ng⁻¹·lipid⁻¹). In the principal component analysis, cis-chlordane (cis-CHL) and γ-HCH were found to be related to participants who received medical treatment for infertility, and 4,4′-DDT was associated with those who received gynecological surgery. The logistic regression showed that the odds ratio (OR) of log γ-hexachlorocyclohexane (γ-HCH) was higher for mothers who had received medical treatment for infertility than for the normal group (OR = 25.6, p = 0.035) after adjustments for age, pre-pregnant BMI, annual income, population (i.e., native-born Taiwanese), birth year, and parity. Cow milk and beef consumption as well as menstruation characteristics such as average menstrual period (>5 days), shortest menstrual period (<3 days), and women who had taken hormonal drugs were significantly associated to several OCP residues in the breast milk. In addition, ΣHCH including β-HCH and γ-HCH was correlated with annual family income and gravidity as well as cow milk and beef consumptions. Overall, γ-HCH exhibited a probable association with the infertility diseases of Taiwanese women, and dietary habit might play an important role in the female Taiwanese exposure to OCPs.

Body Burden of Dichlorodiphenyl Dichloroethene (DDE) and Childhood Pulmonary Function

Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE) can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1) were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE) and FEV1 (n = 328; −0.17 L per μg/L of DDE), mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in human breast milk and associated health risks to nursing infants in Northern Tanzania

This is the first study to report organochlorines (OCs), including chlorinated pesticides (OCPs) and polychlorinated biphenyls (PCBs) in human milk from Tanzania. The main aims of this study were to assess the level of contamination and the possible health risks related to OC exposure in nursing infants from the Northern parts of Tanzania. Ninety-five healthy mother-infant couples attending Mount Meru Regional Referral Hospital (MMRRH), Arusha, Tanzania, were assessed for associations between maternal/infant characteristics, i.e. mother's age, BMI, gestational weight gain, occupation, residence and fetal growth parameters and breast milk levels of OCPs, such as dichlorodiphenyltrichloroethane (DDT) and its metabolites, dieldrin and PCBs. p,p'-DDE and p,p'-DDT were detected in 100% and 75% of the breast milk samples, respectively, and ranged between 24 and 2400ng/g lipid weight (lw) and <LOD and 133ng/g lw, respectively. Dieldrin was detected in 66% of the samples in levels up to 937ng/g lw. ∑7PCBs ranged between <LOD and 157ng/g lw. Other OCPs were detected in low levels. For assessment of health risks, the Hazard Quotient (HQ) was calculated by comparing estimated daily intakes of OCPs and PCBs with health based guidance values. The estimated daily intake (ng/kg body weight/day) of ∑DDTs, dieldrin and nondioxin-like PCBs (∑6PCBs) exceeded the provisional tolerable daily intake (PTDI) in two, six and forty-eight of the nursing infants, respectively, suggesting potential health risks. In addition, head circumference were negatively associated with p,p´-DDE in female infants, suggesting that OC exposure during pregnancy may influence fetal growth.

Pesticide exposures and respiratory health in general populations

Human exposures to pesticides can occur in the workplace, in the household and through the ambient environment. While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings, to the best of our knowledge, this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations. In this article, we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations. This article also highlighted questions arising from these studies, including our recent analyses using the data from the Canadian Health Measures Survey (CHMS), for future research. We found few studies have addressed the impact of environmental pesticide exposures on respiratory health, especially on lung function, in general populations. In the studies using the data from CHMS Cycle 1, exposures to OP insecticides, pyrethroid insecticides, and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population, but no significant associations were observed for the herbicide 2,4-D. Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population, and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures. Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems, and thereafter providing greater benefit to the general population.

Prenatal exposure to persistent organic pollutants and offspring allergic sensitization and lung function at 20 years of age

BACKGROUND

Prenatal exposures to persistent organic pollutants (POPs) have been associated with asthma medication use and self-reported symptoms, but associations with lung function and allergic sensitization have been minimally explored. The aim of the study was to examine the associations between prenatal exposures to POPs and allergic sensitization and lung function in 20-year-old offspring.

METHODS

In a Danish cohort of 965 pregnant women established in 1988-1989, six polychlorinated biphenyl (PCB) congeners, hexachlorobenzene (HCB), and dichlorodiphenyldichloroethylene (p,p'-DDE) were quantified in archived maternal serum drawn in gestational week 30 (n = 872). Among those with available maternal exposure information, at age 20, 421 offspring attended attended a clinical examination including measurements of allergic sensitization (serum-specific IgE ≥ 0.35 kUA /L) (n = 418) and lung function [forced expiratory volume in one second (FEV1 ) and forced vital capacity (FVC)] (n = 414).

RESULTS

There were no associations between maternal concentrations of POPs and offspring allergic sensitization at 20 years of age. Maternal concentrations of POPs were, however, positively associated with offspring airway obstruction (FEV1 /FVC < 75%). Compared to offspring in the first tertile of exposure, offspring in the third tertile of dioxin-like PCB exposure had an OR of 2.96 (95% CI: 1.14-7.70). Similar associations for non-dioxin-like PCBs, HCB, and p,p'-DDE were 2.68 (1.06-6.81), 2.63 (1.07, 6.46), and 2.87 (1.09, 7.57), respectively. No associations were observed with reduced lung function (FEV1 % of predicted value < 90%).

CONCLUSION AND CLINICAL RELEVANCE

Our data indicate that prenatal exposure to POPs appears to be associated with airway obstruction but not allergic sensitization at 20 years of age. The findings support that chronic obstructive lung diseases may have at least part of their origins in early life.

Pesticides: an update of human exposure and toxicity

Pesticides are a family of compounds which have brought many benefits to mankind in the agricultural, industrial, and health areas, but their toxicities in both humans and animals have always been a concern. Regardless of acute poisonings which are common for some classes of pesticides like organophosphoruses, the association of chronic and sub-lethal exposure to pesticides with a prevalence of some persistent diseases is going to be a phenomenon to which global attention has been attracted. In this review, incidence of various malignant, neurodegenerative, respiratory, reproductive, developmental, and metabolic diseases in relation to different routes of human exposure to pesticides such as occupational, environmental, residential, parental, maternal, and paternal has been systematically criticized in different categories of pesticide toxicities like carcinogenicity, neurotoxicity, pulmonotoxicity, reproductive toxicity, developmental toxicity, and metabolic toxicity. A huge body of evidence exists on the possible role of pesticide exposures in the elevated incidence of human diseases such as cancers, Alzheimer, Parkinson, amyotrophic lateral sclerosis, asthma, bronchitis, infertility, birth defects, attention deficit hyperactivity disorder, autism, diabetes, and obesity. Most of the disorders are induced by insecticides and herbicides most notably organophosphorus, organochlorines, phenoxyacetic acids, and triazine compounds.

Environmental exposure to pesticides and respiratory health

Respiratory effects of environmental exposure to pesticides are debated. Here we aimed to review epidemiological studies published up until 2013, using the PubMed database. 20 studies dealing with respiratory health and non-occupational pesticide exposure were identified, 14 carried out on children and six on adults. In four out of nine studies in children with biological measurements, mothers' dichlorodiphenyldichloroethylene (DDE) blood levels during pregnancy were associated with asthma and wheezing in young children. An association was also found between permethrin in indoor air during pregnancy and wheezing in children. A significant association between asthma and DDE measured in children's blood (aged 7-10 years) was observed in one study. However, in three studies, no association was found between asthma or respiratory infections in children and pesticide levels in breast milk and/or infant blood. Lastly, in three out of four studies where post-natal pesticide exposure of children was assessed by parental questionnaire an association with respiratory symptoms was found. Results of the fewer studies on pesticide environmental exposure and respiratory health of adults were much less conclusive: indeed, the associations observed were weak and often not significant. In conclusion, further studies are needed to confirm whether there is a respiratory risk associated with environmental exposure to pesticides.

A comprehensive review of pesticides and the immune dysregulation: mechanisms, evidence and consequences

Nowadays, in many communities, there is a growing concern about possible adverse effects of pesticides on human health. Reports indicate that during environmental or occupational exposure, pesticides can exert some intense adverse effects on human health through transient or permanent alteration of the immune system. There is evidence on the relation between pesticide-induced immune alteration and prevalence of diseases associated with alterations of the immune response. In the present study, direct immunotoxicity, endocrine disruption and antigenicity have been introduced as the main mechanisms working with pesticides-induced immune dysregulation. Moreover, the evidence on the relationship between pesticide exposure, dysregulation of the immune system and predisposition to different types of psychiatric disorders, cancers, allergies, autoimmune and infectious diseases are criticized.

Prenatal exposure to environmental chemical contaminants and asthma and eczema in school-age children

BACKGROUND

Emerging evidence suggests that prenatal or early-life exposures to environmental contaminants may contribute to an increased risk of asthma and allergies in children. We aimed to the explore associations of prenatal exposures to a large set of environmental chemical contaminants with asthma and eczema in school-age children.

METHODS

We studied 1024 mother-child pairs from Greenland and Ukraine from the INUENDO birth cohort. Data were collected by means of an interview-based questionnaire when the children were 5-9 years of age. Questions from the ISAAC study were used to define asthma, eczema, and wheeze. We applied principal components analysis (PCA) to sixteen contaminants in maternal serum sampled during pregnancy, including perfluoroalkyl substances (PFASs), metabolites of diethylhexyl (DEHP) and diisononyl (DiNP) phthalates, PCB-153, and p,p'-DDE. Scores of five principal components (PCs) explaining 70% of the variance were included in multiple logistic regression models.

RESULTS

In a meta-analysis that included both populations, the PC2 score, reflecting exposure to DiNP, was negatively associated with current eczema (OR 0.71, 95% CI 0.52-0.96). Other associations were not consistent between the two populations. In Ukrainian children, the PC3 score (DEHP) was positively associated with current wheeze (adjusted OR 1.56, 95% CI 1.03-2.37), whereas the PC5 score, dominated by perfluorooctanoic acid (PFOA), was inversely associated with current wheeze (OR 0.64, 0.41-0.99). In Greenlandic children, a negative association of PC4 (organochlorines) with ever eczema (OR 0.78, 0.61-0.99) was found.

CONCLUSIONS

We found limited evidence to support a link between prenatal exposure to environmental chemical contaminants and childhood asthma and eczema.

Association between lung function in adults and plasma DDT and DDE levels: results from the Canadian Health Measures Survey

BACKGROUND

Although DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] has been banned in many countries since the 1970s, it may still pose a risk to human respiratory health. In agriculture, DDT exposures have been associated with asthma and chronic bronchitis. However, little is known about the effect of DDT on lung function.

METHODS

We used data on 1,696 participants 20-79 years of age from the Canadian Health Measures Survey (CHMS) and conducted multiple regression analysis to estimate associations between plasma p,p´-DDT/DDE and lung function.

RESULTS

Almost all participants (> 99.0%) had detectable concentrations of plasma p,p´-DDE, but only 10.0% had detectable p,p´-DDT. Participants with detectable p,p´-DDT had significantly lower mean FVC (difference = 311 mL; 95% CI: -492, -130; p = 0.003) and FEV1 (difference = 232 mL; 95% CI: -408, -55; p = 0.015) than those without. A 100-ng/g lipid increase in plasma p,p´-DDE was associated with an 18.8-mL decrease in mean FVC (95% CI: -29, -9) and an 11.8-mL decrease in mean FEV1 (95% CI: -21, -3). Neither exposure was associated with FEV1/FVC ratio or FEF25%-75%.

CONCLUSIONS

DDT exposures, which may have occurred decades ago, were still detectable among Canadians. Plasma DDT and DDE were negatively associated with lung function parameters. Additional research on the potential effects of DDT use on lung function is warranted.

Prenatal exposure to DDE and PCB 153 and respiratory health in early childhood: a meta-analysis

BACKGROUND

Persistent organic pollutants may affect the immune and respiratory systems, but available evidence is based on small study populations. We studied the association between prenatal exposure to dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyl 153 (PCB 153) and children's respiratory health in European birth cohorts.

METHODS

We included 4608 mothers and children enrolled in 10 birth cohort studies from 7 European countries. Outcomes were parent-reported bronchitis and wheeze in the first 4 years of life. For each cohort, we performed Poisson regression analyses, modeling occurrences of the outcomes on the estimates of cord-serum concentrations of PCB 153 and DDE as continuous variables (per doubling exposure) and as cohort-specific tertiles. Summary estimates were obtained through random-effects meta-analyses.

RESULTS

The risk of bronchitis or wheeze (combined variable) assessed before 18 months of age increased with increasing DDE exposure (relative risk [RR] per doubling exposure = 1.03 [95% confidence interval = 1.00-1.07]). When these outcomes were analyzed separately, associations appeared stronger for bronchitis. We also found an association between increasing PCB 153 exposure and bronchitis in this period (RR per doubling exposure = 1.06 [1.01-1.12]) but not between PCB 153 and wheeze. No associations were found between either DDE or PCB 153 and ever-wheeze assessed after 18 months. Inclusion of both compounds in the models attenuated risk estimates for PCB 153 tertiles of exposure, whereas DDE associations were more robust.

CONCLUSION

This large meta-analysis suggests that prenatal DDE exposure may be associated with respiratory health symptoms in young children (below 18 months), whereas prenatal PCB 153 levels were not associated with such symptoms.

Concentrations of persistent organic pollutants (POPs) and heavy metals in soil from San Luis Potosí, México

The aim of this study was to assess the levels of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethylene (DDE), and four heavy metals (arsenic, cadmium, lead, and mercury) in soil from the city of San Luis Potosí in Mexico. In order to confirm the presence of the previously mentioned compounds, outdoor surface soil samples were collected and analyzed by gas chromatography/mass spectrometer for PBDEs, PCBs, DDT, and DDE. Meanwhile, heavy metals were quantified using the atomic absorption spectrophotometry technique. The total PBDEs levels ranged from 5.0 to 134 μg/kg dry weight (dw), with a total mean PBDEs level of 22.0 ± 32.5 μg/kg dw (geometric mean ± standard deviation). For PCBs, the total mean level in the studied soil was 21.6 ± 24.7 μg/kg dw (range, <LOD to 80.5). An important finding in our study was that all soil samples (100 %) had detectable levels of the metabolite DDE. Moreover, the total mean DDT level (∑ DDT and DDE) was approximately 5.50 ± 4.50 μg/kg dw. The mean levels for arsenic, mercury, cadmium, and lead in soil samples were 7.20 ± 10.7 (range, 15.0 to 265 mg/kg dw), 0.45 ± 0.48 (range, <LOD to 2.50 mg/kg dw), 3.00 ± 3.00 (range, 1.00-13.0 mg/kg dw), and 108 ± 105 (range, 25.0 to 435 mg/kg dw), respectively. This screening study provides us with concentration data for the occurrence of persistent organic pollutants (POPs) and four heavy metals in soil samples from the city of San Luis Potosí, Mexico, and considering that soil is an important pathway of exposure for people, a biomonitoring program for the surveillance of the general population in the city of San Luis Potosi is necessary.

Biomarkers of Insecticide Exposure and Asthma in Children: A National Health and Nutrition Examination Survey (NHANES) 1999-2008 Analysis

Pesticide exposure is a potential risk factor for increased asthma prevalence among children. The authors used National Health and Nutrition Examination Survey (1999-2008) biomarker data to evaluate dialkylphosphate (DAP) urinary concentrations, serum dichlorodiphenyldichloroethylene (DDE), and asthma among school-aged children (Mexican American, Non-Hispanic Black, Non-Hispanic White). Poisson logistic regression included age, sex, nativity, poverty index ratio, tobacco smoke exposure, and body mass index covariates. No association was found between DAP (N=2,777) and asthma outcomes; adverse effect of DDE (N=940) was suggested for Current Wheeze. Subgroup analyses identified positive associations with some asthma outcomes among Non-Hispanic Blacks, whereas inverse associations were identified among Mexican Americans. Results support previous associations observed among children's DDE exposure and wheeze. Characterization of risk factors for pesticide exposure and disease recognition among Mexican Americans is needed.

Persistent organic pollutants and children's respiratory health: the role of cytokines and inflammatory biomarkers

Evidence of adverse effects of persistent organic pollutants (POPs) on the developmental respiratory and immune systems in children is still limited, and the biological mechanisms behind such effects are not fully understood. The aim of the present study is to evaluate the effects of prenatal DDE, HCB and ΣPCB exposure on children's respiratory health from birth to 14 years and to evaluate the role of immune biomarkers in these associations. We measured prenatal DDE, HCB and ΣPCB levels in 405 participants of the INMA-Menorca birth cohort (Spain) and collected information on wheeze, chest infections, atopy and asthma from birth until the age of 14 years. At age 4 years, 275 children provided serum samples and IL6, IL8, IL10, TNFα and C-reactive protein were measured. We applied linear and logistic regression models and generalized estimating equations. Prenatal DDE was associated with wheeze at age 4 years [RR (95% CI) per doubling of concentration=1.35 (1.07, 1.71)], but not thereafter. Prenatal HCB was associated with wheeze [1.58 (1.04, 2.41)] and chest infections [1.89 (1.10, 3.25)] at age 10years. No associations were found with ΣPCBs. IL10 levels increased with increasing POP concentration, with HCB showing the strongest association [β (95% CI)=0.22 (0.02, 0.41)]. IL8, IL10 and TNFα were associated with wheeze and/or chest infections and IL10 was associated with asthma. Prenatal DDE and HCB exposure was associated with respiratory health of children at different ages. This study further suggests a possible role of IL10, but not of the other immune biomarkers examined, as an early marker of chronic immune-related health effects of POPs.

Breastfeeding and childhood asthma: systematic review and meta-analysis

Asthma and wheezing disorders are common chronic health problems in childhood. Breastfeeding provides health benefits, but it is not known whether or how breastfeeding decreases the risk of developing asthma. We performed a systematic review and meta-analysis of studies published between 1983 and 2012 on breastfeeding and asthma in children from the general population. We searched the PubMed and Embase databases for cohort, cross-sectional, and case-control studies. We grouped the outcomes into asthma ever, recent asthma, or recent wheezing illness (recent asthma or recent wheeze). Using random-effects meta-analyses, we estimated pooled odds ratios of the association of breastfeeding with the risk for each of these outcomes. We performed meta-regression and stratified meta-analyses. We included 117 of 1,464 titles identified by our search. The pooled odds ratios were 0.78 (95% confidence interval: 0.74, 0.84) for 75 studies analyzing "asthma ever," 0.76 (95% confidence interval: 0.67, 0.86) for 46 studies analyzing "recent asthma," and 0.81 (95% confidence interval: 0.76, 0.87) for 94 studies analyzing recent wheezing illness. After stratification by age, the strong protective association found at ages 0-2 years diminished over time. We found no evidence for differences by study design or study quality or between studies in Western and non-Western countries. A positive association of breastfeeding with reduced asthma/wheezing is supported by the combined evidence of existing studies.

Occupational pesticide exposures and respiratory health

Pesticides have been widely used to control pest and pest-related diseases in agriculture, fishery, forestry and the food industry. In this review, we identify a number of respiratory symptoms and diseases that have been associated with occupational pesticide exposures. Impaired lung function has also been observed among people occupationally exposed to pesticides. There was strong evidence for an association between occupational pesticide exposure and asthma, especially in agricultural occupations. In addition, we found suggestive evidence for a link between occupational pesticide exposure and chronic bronchitis or COPD. There was inconclusive evidence for the association between occupational pesticide exposure and lung cancer. Better control of pesticide uses and enforcement of safety behaviors, such as using personal protection equipment (PPE) in the workplace, are critical for reducing the risk of developing pesticide-related symptoms and diseases. Educational training programs focusing on basic safety precautions and proper uses of personal protection equipment (PPE) are possible interventions that could be used to control the respiratory diseases associated with pesticide exposure in occupational setting.

Effects of persistent organic pollutants on the developing respiratory and immune systems: a systematic review

BACKGROUND

Disruption of developing immune and respiratory systems by early-life exposure to persistent organic pollutants (POPs) could result into reduced capacity to fight infections and increased risk to develop allergic manifestations later in life.

OBJECTIVES

To systematically review the epidemiologic literature on the adverse effects of early-life exposure to POPs on respiratory health, allergy and the immune system in infancy, childhood and adolescence.

METHODS

Based on published guidelines for systematic reviews, two independent researchers searched for published articles in MEDLINE and SCOPUS using defined keywords on POPs and respiratory health, immune function and allergy. Study eligibility criteria were defined to select the articles.

RESULTS

This review of 41 studies finds limited evidence for prenatal exposure to DDE, PCBs and dioxins and risk of respiratory infections. Evidence was limited also for postnatal exposure to PCBs, specifically ndl-PCBs, and reduced immune response after vaccination in childhood. The review indicates lack of association between postnatal exposure to PCBs/ndl-PCBs and risk of asthma-related symptoms. For the other exposure-outcome associations reviewed evidence was inadequate.

DISCUSSION AND CONCLUSION

Current epidemiological evidence suggests that early-life exposure to POPs can adversely influence immune and respiratory systems development. Heterogeneity between studies in exposure and outcome assessment and the small number of studies for any given exposure-outcome relationship currently make comparisons difficult and meta-analyses impossible. Also, mechanisms remain largely unexplored. Recommendations for significantly improving our understanding thus include harmonization of exposure and outcome assessment between studies, conduct of larger studies, long-term assessment of respiratory infections and asthma symptoms in order to identify critical periods of susceptibility, integration of the potential immunotoxic mechanisms of POPs, and use of new statistical tools to detangle the role of multiple exposures on multiple outcomes.

Assessment of the levels of DDT and DDE in soil and blood samples from Tabasco, Mexico

In Mexico, 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) was used until the year 2000, principally in agriculture and anti-paludal program health campaigns. The southeastern region of Mexico was an important area of malaria, and from 1957 DDT was applied indoors every 6 months, with a coverage of 2 g/m(2). The current study was performed in Tabasco, a Mexican state located in the southeastern region of Mexico. DDT and 1,1-dichloro-2,2-bis(4-chlorophenyl)ethene (DDE) were analyzed by gas chromatography/mass spectrometry. In general, low levels were found in household outdoor samples; the levels of DDT ranged from not detectable to 0.048 mg/kg, and of DDE from 0.001 to 0.068 mg/kg. An important finding was that, in all communities where DDT in blood was analyzed, exposure to DDT was found, indicating both past and present exposure. Although the levels found in this study were lower than other studies in Mexico, there is a need to evaluate whether the people living in the study area are at risk.

Pesticide induced immunotoxicity in humans: a comprehensive review of the existing evidence

The immune system can be the target of many chemicals, with potentially severe adverse effects on the host's health. In Western countries pesticides, together with new and modified patterns of exposure to chemicals, have been implicated in the increasing prevalence of diseases associated with alterations of the immune response, such as hypersensitivity reactions, certain autoimmune diseases and cancers. Xenobiotics may initiate, facilitate or exacerbate pathological immune processes, resulting in immunotoxicity by induction of mutations in genes coding for immunoregulatory factors, modifying immune tolerance and activation pathways. The purpose of this article is to update the evidence of pesticide immunotoxicity. Even if experimental data as well as sporadic human studies indicate that some pesticides can affect the immune system, overall, existing epidemiological studies are inadequate to raise conclusions on the immunotoxic risk associated to pesticide exposure. The available studies on the effects of pesticides on human immune system have several limitations including poor indication on exposure levels, multiple chemical exposures, heterogeneity of the approach, and difficulty in giving a prognostic significance to the slight changes often observed. Further studies are necessary, and they should be preferably carried out through comparison of pre and post-exposure findings in the same group of subjects with a matched control group. Attempt should be made to define the prognostic significance of slight changes often observed. Animal and in vitro studies are also important and necessary to scientifically support epidemiological evidences on pesticide-induced immunotoxicity.

Assessment of DDT and DDE levels in soil, dust, and blood samples from Chihuahua, Mexico

The aim of this study was to assess levels of DDT and DDE in two environmental matrices (soil and dust) and to investigate the blood levels of these insecticides in exposed children living in a north Mexican state (Chihuahua) where DDT was sprayed several years ago during (1) health campaigns for the control of malaria and (2) agricultural activities. DDT and DDE were analyzed by gas chromatography/mass spectrometry. In general, lower levels were found in household outdoor samples. The levels in outdoor samples ranged from 0.001 to 0.788 mg/kg for DDT and from 0.001 to 0.642 mg/kg for DDE. The levels in indoor samples ranged from 0.001 to 15.47 mg/kg for DDT and from 0.001 to 1.063 mg/kg for DDE. Similar results to those found in indoor soil were found in dust, in which the levels ranged from 0.001 to 95.87 mg/kg for DDT and from 0.001 to 0.797 mg/kg for DDE. Moreover, blood levels showed that all of the communities studied had been exposed to DDT and/or DDE, indicating a general past or present exposure to DDT. It is important to note that the quotient DDT/DDE in all matrices was always >1. Whether the people living in our study area are at risk is an issue that deserves further analysis. However, applying precautionary principles, it is important to initiate a risk-reduction program to decrease exposure to DDT and its metabolites in people living in this area.

Application of computational systems biology to explore environmental toxicity hazards

BACKGROUND

Computer-based modeling is part of a new approach to predictive toxicology.

OBJECTIVES

We investigated the usefulness of an integrated computational systems biology approach in a case study involving the isomers and metabolites of the pesticide dichlorodiphenyltrichloroethane (DDT) to ascertain their possible links to relevant adverse effects.

METHODS

We extracted chemical-protein association networks for each DDT isomer and its metabolites using ChemProt, a disease chemical biology database that includes both binding and gene expression data, and we explored protein-protein interactions using a human interactome network. To identify associated dysfunctions and diseases, we integrated protein-disease annotations into the protein complexes using the Online Mendelian Inheritance in Man database and the Comparative Toxicogenomics Database.

RESULTS

We found 175 human proteins linked to p,p'-DDT, and 187 to o,p'-DDT.Dichlorodiphenyldichloroethylene (p,p'-DDE) was the metabolite with the highest number of links, with 52. We grouped proteins for each compound based on their disease annotations. Although the two data sources differed in linkage to diseases, integrated results predicted that most diseases were linked to the two DDT isomers. Asthma was uniquely linked with p,p'-DDT, and autism with o,p'-DDT. Several reproductive and neurobehavioral outcomes and cancer types were linked to all three compounds.

CONCLUSIONS

Computer-based modeling relies on available information. Although differences in linkages to proteins may be due to incomplete data, our results appear meaningful and suggest that the parent DDT compounds may be responsible for more disease connections than the metabolites. The findings illustrate the potential use of computational approaches to toxicology.

Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness

There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whether there is any association between breast feeding and wheezing in children aged over 5 years and to discover possible sources of heterogeneity. An electronic search of MEDLINE and EMBASE databases was conducted from January 2000 to June 2010. In addition, reference lists from relevant publications were searched. Birth cohort, cross-sectional and case-control studies were included if they measured any breast feeding or exclusive breast feeding for 3 or 4 months. Wheezing illness, including asthma, was identified based on symptoms, reported diagnosis or objective criteria. Thirty-one publications were identified for meta-analysis. There was no association found between any or exclusive breast feeding and wheezing illness, although there was a high level of heterogeneity between the studies. Subgroup analysis revealed that any breast feeding slightly lowers the odds of wheeze (pooled odds ratio 0.92 [0.86, 0.98]) but slightly increases the odds of asthma defined by specific criteria (pooled odds ratio 1.10 [1.00, 1.22]). This meta-analysis does not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over. The difference in the effects of breast feeding according to the nature of the wheezing illness highlights the importance of the heterogeneity of illness phenotypes.

Concentration of DDT compounds in breast milk from African women (Manhiça, Mozambique) at the early stages of domestic indoor spraying with this insecticide

Breast milk concentrations of 4,4'-DDT and its related compounds were studied in samples collected in 2002 and 2006 from two populations of mothers in Manhiça, Mozambique. The 2006 samples were obtained several months after implementation of indoor residual spraying (IRS) with DDT for malaria vector control in dwellings and those from 2002 were taken as reference prior to DDT use. A significant increase in 4,4'-DDT and its main metabolite, 4,4'-DDE, was observed between the 2002 (median values 2.4 and 0.9 ng/ml, respectively) and the 2006 samples (7.3 and 2.6 ng/ml, respectively, p<0.001 and 0.019, respectively). This observation identifies higher body burden intakes of these compounds in pregnant women already in these initial stages of the IRS program. The increase in both 4,4'-DDT and 4,4'-DDE suggest a rapid transformation of DDT into DDE after incorporation of the insecticide residues. The median baseline concentrations in breast milk in 2002 were low, and the median concentrations in 2006 (280 ng/g lipid) were still lower than in other world populations. However, the observed increases were not uniform and in some individuals high values (5100 ng/g lipid) were determined. Significant differences were found between the concentrations of DDT and related compounds in breast milk according to parity, with higher concentrations in primiparae than multiparae women. These differences overcome the age effect in DDT accumulation between the two groups and evidence that women transfer a significant proportion of their body burden of DDT and its metabolites to their infants.

Organochlorine concentrations in breast milk and prevalence of allergic disorders in Japanese women

Persistent organic pollutants have been shown to have immunomodulating effects in humans. However, epidemiological evidence regarding the relationships between organochlorine compound exposure and allergic disorders coming from studies of children has been limited and inconsistent. The current cross-sectional study examined the associations between the concentrations of β-hexachlorocyclohexane (HCH), hexachlorobenzene (HCB), p,p'-dichlorodiphenyldichloroethylene (DDE), and trans-nonachlordane in breast milk and the prevalence of allergic disorders in 124 adult Japanese women. The definition of wheeze and asthma was based on criteria from the European Community Respiratory Health Survey whereas that of eczema and rhinoconjunctivitis was based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, smoking, family history of allergic disorders, and education. The prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 9.7%, 4.8%, 13.7%, and 29.8%, respectively. The median concentrations of β-HCH, HCB, p,p'-DDE, and trans-nonachlordane in breast milk were 28.3, 7.0, 71.6, and 23.9 ng g(-1) lipid, respectively (range, 4.5-253, 2.1-14.5, 7.5-362, and 1.8-130 ng g(-1) lipid, respectively). When the exposures were treated as continuous variables, no significant associations were found between concentrations of HCB, β-HCH, p,p'-DDE, or trans-nonachlordane and the prevalence of wheeze, asthma, eczema, or rhinoconjunctivitis. Our results suggest that concentrations of β-HCH, HCB, p,p'-DDE, and trans-nonachlordane in breast milk are not evidently associated with the prevalence of wheeze, asthma, eczema, or rhinoconjunctivitis in young female Japanese adults.

Sibling number and prevalence of allergic disorders in pregnant Japanese women: baseline data from the Kyushu Okinawa Maternal and Child Health Study

BACKGROUND

Although an inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified. There is no epidemiological research regarding the sibling effect on allergic disorders in Japanese adults. The current cross-sectional study examined the relationship between number of siblings and prevalence of allergic disorders among adult women in Japan.

METHODS

Subjects were 1745 pregnant women. This study was based on questionnaire data. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, region of residence, pack-years of smoking, secondhand smoke exposure at home and at work, family history of asthma, atopic eczema, and allergic rhinitis, household income, and education.

RESULTS

The prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 10.4%, 5.5%, 13.0%, and 25.9%, respectively. A significant inverse exposure-response relationship was observed between the number of older siblings and rhinoconjunctivitis, but not wheeze, asthma, or eczema (P for trend=0.03); however, the adjusted odds ratio (OR) for having 2 or more older siblings was not significant although the adjusted OR for having 1 older sibling was statistically significant (adjusted OR=0.71 [95% CI: 0.56-0.91]). Number of total siblings and number of younger siblings were not related to wheeze, asthma, eczema, or rhinoconjunctivitis.

CONCLUSIONS

This study found a significant inverse relationship between the number of older siblings and the prevalence of rhinoconjunctivitis among pregnant Japanese women. Our findings are likely to support the intrauterine programming hypothesis; however, we could not rule out the hygiene hypothesis.

Maternal and childhood asthma: risk factors, interactions, and ramifications

Asthma is emerging as a premier example of a health risk that can largely be molded by the status of the mother and the environmental conditions encountered during sensitive windows of prenatal and early childhood development. While genetic background, allergic status of parents, and predisposition for atopy and inflammation play a role, early-life environmental conditions can completely alter the course of immune and respiratory system development. Environmentally induced alterations that (1) maintain the Th2 bias seen during gestation, (2) block the maturation of innate immune cells and (3) create inflammatory dysfunction in the infant provide the foundation for childhood asthma. No single risk factor can fully explain the increased prevalence of asthma in recent decades but it is assumed that the rapid increase is due to environmental and/or epigenetic changes. Well-established and suspected environmental risk factors cover all categories of early life interactions from diet, exposure to environmental contaminants and drugs, maternal and neonatal infections, hygiene, timing of vaccinations and even the mode of birth delivery. Because asthma is connected to the risk of several comorbid chronic conditions, the benefit of asthma risk reduction and prevention is greater than initially may be apparent. This review discusses strategies to optimize preventative and therapeutic options across life stages.