Understanding the human health effects of chemical mixtures

Exploring the reproductive exposure risks of phthalates and organophosphates in atmospheric particulate matter based on quantitative structure-activity relationships and network toxicology models

Minimal study focused on the association between mixed pollutants in atmospheric particulate matter (PM2.5) and their reproductive health risks. Utilizing a novel quantitative structure-activity relationship (QSAR) integrated machine learning algorithms, we evaluated the mixed reproductive health risks associated with phthalates (PAEs) and organophosphates (OPEs) exposure by assessing the affinities of these compounds binding to estrogen receptors (ER) and androgen receptors (AR). The mixed toxicity equivalent factor (TEFmix) and mixed toxicity equivalent quantity (TEQmix) by the QSAR model were all smaller than the sum TEF and TEQ of individual PAEs and OPEs, which may be due to the antagonistic effect of PAEs and OPEs monomers on reproductive toxicity. Based on network toxicology approach, a total of 590 potential targets associated with PAEs and OPEs affecting sex hormones were initially identified, with an additional 50 core targets, including AR and ER. Di-2-ethylhexyl phthalate (DEHP), triphenyl phosphate (TPHP) and mono-(2-ethylhexyl) phthalate (MEHP) were key components to disrupt AR and ER signaling pathway, and was confirmed by molecular docking analysis. In addition to ER and AR, serine/threonine kinase 1 (AKT1) and heat shock protein 90α family A member 1 (HSP90AA1) might be key targets for reproductive toxicity, which have hardly mentioned before. Our study provided precious information on the mixed reproductive exposure risk of PAEs and OPEs in PM2.5, and innovatively explored the potential mechanisms of PAEs and OPEs affecting human reproductive health using network toxicology.

Elucidating the physicochemical interactions between fibrinogen and surfactant mixtures: Implications for pharmaceutical sciences

This study investigates the physicochemical interactions between fibrinogen (Fib), a key glycoprotein in blood clotting, and a mixture of two biologically active compounds: dicloxacillin (Diclox), an antibiotic; and cetyltrimethylammonium bromide (CTAB), a cationic surfactant. Understanding these interactions is crucial for enhancing drug delivery systems and optimizing pharmaceutical formulations. Molecular docking simulations and various spectroscopic techniques, including UV-Vis, fluorescence, and circular dichroism, were employed to explore how this mixture affects the structural and functional properties of fibrinogen. The docking results revealed that the binding affinity of the dicloxacillin-CTAB mixture with fibrinogen was stronger than either compound individually, suggesting a synergistic interaction. Spectroscopic analysis confirmed structural modifications in the fibrinogen molecule, notably in α-helix content and aromatic residues, indicating loosening or unfolding in protein conformation upon ligand binding. Thermodynamic analyses further supported that the binding process was driven by hydrophobic interactions and electrostatic forces, contributing to stable complex formation. This study advances the current understanding of protein-ligand interactions by exploring the synergistic effects of a dual-ligand system, a novel approach that has not been comprehensively explored in previous literature. These findings provide new insights into the design of drug delivery systems, offering potential applications for improving the efficacy and safety of pharmaceutical formulations targeting fibrinogen-related conditions.

Frequentist Grouped Weighted Quantile Sum Regression for Correlated Chemical Mixtures

As individuals are exposed to a myriad of potentially harmful pollutants every day, it is important to determine which actors have the greatest influence on health outcomes. However, jointly modeling the associations of multiple pollutant exposures is often hindered by the presence of highly correlated chemicals originating from a common source. A popular approach to analyzing associations between a disease outcome and several highly correlated exposures is Weighted Quantile Sum Regression (WQSR) modeling. WQSR provides increased stability in estimating model parameters but requires data splitting to estimate individual and group effects of chemicals, which reduces the power of the approach. A recent Bayesian implementation of WQSR regression provides a model fitting procedure that avoids data splitting at the cost of high computational expense on large data. In this paper, we introduce a Frequentist Grouped Weighted Quantile Sum Regression (FGWQSR) model that can be fitted efficiently to large datasets without requiring data splitting. FGWQSR produces estimates of the joint effect of mixture groups and of individual chemicals, and likelihood-ratio-based tests that account for FGWQSR's non-standard asymptotics. We demonstrate that FGWQSR is well calibrated for type-I errors while outperforming both Bayesian Grouped Weighted Quantile Sum Regression and Quantile Logistic Regression in terms of statistical power to detect the effects of mixture groups and individual chemicals. In addition, we show that FGWQSR is robust to model misspecification and can be fitted on large datasets in a fraction of the time required for BGWQSR. We apply FGWQSR to a dataset of 317 767 mother-child pairs with exposure profiles generated by chemical transport models to study the associations between several components found in particulate matter with an aerodynamic diameter smaller than 2.5μ m $$ \mu \mathrm{m} $$ (PM  2 . 5 $$ {}_{2.5} $$ ) and child Autism Spectrum Disorder (ASD) diagnosis before age 5. PM  2 . 5 $$ {}_{2.5} $$ copper and PM  2 . 5 $$ {}_{2.5} $$ crustal material are found to be statistically significantly associated with ASD diagnosis by five years of age.

Sex- and trimester-specific impact of gestational co-exposure to organophosphate esters and phthalates on insulin action among preschoolers: Findings from the Ma'anshan birth cohort

INTRODUCTION

Prenatal exposure to organophosphate esters (OPEs) and phthalic acid esters (PAEs) is ubiquitous among pregnant individuals. However, research exploring the relationship between prenatal co-exposure to OPEs and PAEs and childhood insulin function remains limited.

METHODS

In this study, utilizing data from 2,246 maternal-fetal dyads in the Ma'anshan Birth Cohort, associations between co-exposure to OPEs and PAEs and insulin action were analyzed. Repeated measures of tris (2-chloroethyl) phosphate, six OPE metabolites, and seven PAE metabolites were collected from maternal urine. Homeostasis model assessment of insulin resistance (HOMA-IR) and the insulin action index (IAI) served as outcome measures. After adjusting for potential confounders, the effects of repeated exposure on insulin action were evaluated using generalized estimating equations, while mixture effects were assessed through BayesianKernel Machine Regression and Quantile-Based G-Computation.

RESULTS

The average age of the children at the time of the study was 5.33 years. Repeated measures analysis revealed that prenatal exposure to MEP was positively associated with increased HOMA-IR (β, 0.027; 95 % CI: 0.002, 0.053), while IAI was inversely correlated with rising MEP levels (β, 0.025; 95 % CI: -0.046, -0.004) and MEHHP exposure (β, -0.128; 95 % CI: -0.218, -0.037). Mixed exposure modeling further indicated that co-exposure to OPEs and PAEs was positively linked to HOMA-IR (β, 0.058; 95 % CI: 0.001, 0.114) and negatively correlated with IAI (β, -0.054; 95 % CI: -0.097, -0.010), with stronger effects observed during the second trimester. Notably, the association was more pronounced in female children compared to males.

CONCLUSIONS

This study provides the first epidemiological evidence highlighting the pregnancy- and sex-specific links between prenatal co-exposure to OPEs and PAEs and childhood insulin action.

Generalized functional varying-index coefficient model for dynamic synergistic gene-environment interactions with binary longitudinal traits

The genetic basis of complex traits involves the function of many genes with small effects as well as complex gene-gene and gene-environment interactions. As one of the major players in complex diseases, the role of gene-environment interactions has been increasingly recognized. Motivated by epidemiology studies to evaluate the joint effect of environmental mixtures, we developed a functional varying-index coefficient model (FVICM) to assess the combined effect of environmental mixtures and their interactions with genes, under a longitudinal design with quantitative traits. Built upon the previous work, we extend the FVICM model to accommodate binary longitudinal traits through the development of a generalized functional varying-index coefficient model (gFVICM). This model examines how the genetic effects on a disease trait are nonlinearly influenced by a combination of environmental factors. We derive an estimation procedure for the varying-index coefficient functions using quadratic inference functions combined with penalized splines. A hypothesis testing procedure is proposed to evaluate the significance of the nonparametric index functions. Extensive Monte Carlo simulations are conducted to evaluate the performance of the method under finite samples. The utility of the method is further demonstrated through a case study with a pain sensitivity dataset. SNPs were found to have their effects on blood pressure nonlinearly influenced by a combination of environmental factors.

Assessing the role of selenium in Minamata disease through reanalysis of historical samples

Minamata disease, a severe neurological disorder identified in Japan in 1956, results from methylmercury (MeHg) intoxication in humans due to environmental contamination. Before MeHg was recognized as the cause, selenium (Se) was suspected of being the potential cause owing to elevated Se levels in patients' organs. Subsequent animal studies indicated that Se mitigates MeHg toxicity; however, its role in Minamata disease remains unexplored. We analyzed Hg and Se in historical samples of the industrial wastes (n = 4) on the factory site, sediments (n = 9), and fish/shellfish (n = 16) in Minamata Bay, and organs of patients with Minamata disease (n = 12). All samples showed elevated levels of both Hg and Se, providing the first evidence that Se was also discharged into Minamata Bay, entering the food chain and accumulating at high levels in patient organs. The Hg/Se molar ratio in contaminated shellfish (median > 3.0) indicated exceptionally high MeHg exposure, far exceeding the ordinary level (< 1.0). Patients exhibited significantly increased Se levels in the liver and kidney but lower amounts in the brain. Notably, median Hg/Se molar ratios exceeding 4.0 were observed, particularly in the cerebrum and cerebellum in acute cases, closely mirroring the molar ratios found in seafood. The elevated Hg/Se molar ratio in the brain helps explain the severe neurological damage in patients' central nervous systems, despite higher Hg levels in the liver and kidney compared to the brain. These findings provide important insight into the mechanism of MeHg intoxication and highlight the risks associated with MeHg-contaminated seafood, aiding efforts to protect consumers.

Prediction of toxicity and identification of key components for complex mixtures containing hormetic components

Mixtures containing hormetic components are likely to induce hormesis. However, due to the presence of stimulatory effects, predicting the toxicity of such mixtures and identifying their key components face challenges. This study investigated the complex relationship between the stimulatory effects of individual components and their mixtures, focusing on predicting mixture toxicity and identifying key components influencing this toxicity. Sixteen chemicals, commonly found in disinfectants and hand sanitizers, were selected to construct a complex mixture system containing hormetic components. Using Vibrio qinghaiensis sp.-Q67 as an indicator organism, the study employed microplate toxicity tests to collect toxicity data for individual chemicals and their mixtures. The independent action (IA) and back-propagation neural network (BPNN) methods were utilized to predict mixture toxicity, while global sensitivity analysis (GSA) identified key components affecting toxicity. Results revealed that six of the sixteen chemicals exhibited time-dependent hormesis. However, when combined into mixtures, the stimulatory effects observed in individual components tended to diminish or disappear, leading to higher overall toxicity, likely due to synergism. Traditional models like the IA significantly underestimated mixture toxicity, whereas the BPNN model demonstrated superior predictive performance. GSA identified five key components, and changes in the levels of some non-toxic components significantly altered the toxicity of the mixtures. Moreover, increasing the levels of certain key components could either increase or decrease the mixture's toxicity, making the strategy of reducing their concentration to control mixture toxicity ineffective. This study revealed the potential of neural networks in predicting the toxicity of mixtures containing hormetic components and the possible characteristics of the effects of key components on mixture toxicity.

Domestic groundwater wells in Appalachia show evidence of low-dose, complex mixtures of legacy pollutants

Lack of water quality data for private drinking water sources prevents robust evaluation of exposure risk for communities co-located with historically contaminated sites and ongoing industrial activity. Areas of the Appalachian region of the United States (i.e., Pennsylvania, Ohio and West Virginia) contain extensive hydraulic fracturing activity, as well as other extractive and industrial technologies, in close proximity to communities reliant on private drinking water sources, creating concern over potential groundwater contamination. In this study, we characterized volatile organic compound (VOC) occurrence at 307 private groundwater well sites within Pennsylvania, Ohio, and West Virginia. The majority (97%) of water samples contained at least one VOC, while the average number of VOCs detected at a given site was 5 ± 3. The majority of individual VOC concentrations fell below applicable U.S. Environmental Protection Agency (EPA) Maximum Contamination Levels (MCLs), except for chloroform (MCL of 80 μg L-1; n = 1 at 98 μg L-1), 1,2-dibromoethane (MCL of 0.05 μg L-1; n = 3 ranging from 0.05 to 0.35 μg L-1), and 1,2-dibromo-3-chloropropane (MCL of 0.2 μg L-1; n = 7 ranging from 0.20 to 0.58 μg L-1). To evaluate well susceptibility to VOCs from industrial activity, distance to hydraulic fracturing site was used to assess correlations with contaminant occurrences. Proximity to closest hydraulic fracturing well-site revealed no statistically significant linear relationships with either individual VOC concentrations, or frequency of VOC detections. Evaluation of other known industrial contamination sites (e.g., US EPA Superfund sites) revealed elevated levels of three VOCs (chloroform, toluene, benzene) in groundwaters within 10 km of those Superfund sites in West Virginia and Ohio, illuminating possible point source influence. Lack of correlation between VOC concentrations and proximity to specific point sources indicates complex geochemical processes governing trace VOC contamination of private drinking water sources. While individual concentrations of VOCs fell well below recommended human health levels, the low dose exposure to multiple VOCs occurring in drinking supplies for Appalachian communities was noted, highlighting the importance of groundwater well monitoring.

The Significance of Paying Attention to Medical Emergencies in Medical Diagnostic Laboratories in Iran

Background: Medical diagnostic laboratories as high-risk environments are often exposed to unpredictable situations such as patient fainting, blood pressure drops, chemical spills, and burns. These life-threatening events defined as medical emergencies and necessitate urgent actions. Hence, determining the most common medical emergencies in medical laboratories, so understanding and planning strategies to effective management seems to be crucial. Objective: This study aimed to investigate medical crises in Iranian medical laboratories. Methods: In this cross-sectional study, data collection was performed by a simple random sampling method through electronic and paper questionnaires filled by personnel in private and hospital laboratories in different provinces. Results: The most frequent medical emergencies were patient fainting, staff needle stick, and patient's blood pressure dropping. The occurrence of medical emergencies was 24% and 76% in men and women, respectively. Out of all, treatment was administered at the scene of the accident in 37.1% of cases, and 28.1% were discharged after sampling. Moreover, 51% of the medical diagnostic laboratories had a trolley code, with injection devices and angiocaths as available tools. In 81% of the laboratories, practicing for probable medical emergencies was not possible. A significant relationship was found between the type of client (laboratory personnel or the referring person) and the type of emergency event (p < 0.05). Conclusions: Considering the prevalence and importance of handling medical emergencies in a short time, it is necessary to design training courses for laboratory personnel and expert them to encountering with unpredictable threats in order to help affected individuals.

Exposure to Per- and Polyfluoroalkyl Substances and Risk of Psoriasis: A Population-Based Study

PFAS are a group of synthetic chemicals that have been reported to be associated with adverse health outcomes. However, the relationship of PFAS exposure with psoriasis risk has not been reported. Utilizing data from the 2003-2018 NHANES, we explored the relationship of PFAS exposure with psoriasis risk. Our study included 5370 participants and examined serum levels of five PFAS compounds: PFOA, PFOS, PFHxS, PFNA, and PFDA, along with self-reported psoriasis status. Generalized linear regression, quantile g-computation, repeated hold out WQS regression, and BKMR models were employed to assess individual and combined effects of PFAS on psoriasis risk. We found each doubling the PFOS concentration was associated with a 19% increased risk of psoriasis (OR: 1.19; 95% CI: 1.01, 1.41) in the overall population. Sex-stratified analyses indicated significant associations between PFOA and PFNA exposure and psoriasis risk in females. Mixture analyses using WQS regression indicated that PFAS mixtures were associated with an 11% increased risk of psoriasis (OR: 1.11, 95% CI: 1.01, 1.22) in females in both the negative and positive direction. BKMR analyses also indicated a positive trend of PFAS mixtures with psoriasis risk in females. Our findings indicate a possible association between PFAS exposure and psoriasis risk, particularly in females.

Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland

Background/Objectives: Poisonings among children are a major cause of morbidity and mortality worldwide and present a significant challenge for emergency medical services (EMS). The aim of this study was to analyze the types of substances causing poisonings and the intention of poisonings in children, providing detailed information on the most common causes of poisonings in different age groups. Methods: A retrospective study was conducted analyzing medical records of pediatric patients under the care of emergency medical services (EMS) in Wroclaw, Poland, between 2015 and 2017. The study included all patients under 18 years old diagnosed with poisoning. Data collected included age, sex, cause of poisoning, location of the incident, neurological status (GCS), and the type of healthcare facility. Results: The study included 484 patients, with a mean age of 13 years. The largest age group was 16-18 years (44%), and the majority were female (58%). The most common causes of poisonings were alcohol (29.3%), medications (26%), and intoxicants (24.8%). Over half of the incidents occurred at home (52.5%). Intentional poisonings constituted 75% of cases, particularly involving alcohol (38.6%), intoxicants (32%), and medications (26.7%). Accidental poisonings were mainly due to household chemicals (28.7%) and carbon monoxide (27%). The differences in causes and locations of poisonings were statistically significant (p < 0.001). Conclusions: Our study showed that the most common causes of poisonings among children were alcohol, medications, and intoxicants. Poisonings most frequently occurred at home, especially with medications, while outside the home, alcohol and intoxicants were predominant. This study was not registered.

Associations between prenatal metal and metalloid mixtures in teeth and reductions in childhood lung function

BACKGROUND

Metal(oid)s have been cross-sectionally associated with lung function outcomes in childhood but there is limited data on their combined effects starting in utero. Child sex may further modify these effects.

OBJECTIVE

Examine associations between in utero and early life exposure to metals assessed via novel dentine biomarkers and childhood lung function and explore effect modification by child sex.

METHODS

Analyses included 291 children enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study, a longitudinal birth cohort study in Mexico City. Weekly dentine levels of arsenic (As), cadmium (Cd), cobalt (Co), copper (Cu), manganese (Mn), nickel (Ni), and lead (Pb) were measured from 15 weeks pre-birth to 15 weeks post birth in deciduous children's teeth. Lung function was tested at ages 8-14 years and then modeled as age, height and sex adjusted z-scores. Associations were modeled using lagged weighted quantile sum (LWQS) regression to evaluate the potential for a time-varying mixture effect adjusting for maternal age and education at enrollment and exposure to environmental tobacco smoke in pregnancy. Models were also stratified by sex.

RESULTS

We identified a window of susceptibility at 12-15 weeks pre-birth in which the metal mixture was associated with lower FVC z-scores in children aged 8-14 years. Cd and Mn were the largest contributors to the mixture effect (70 %). There was also some evidence of effect modification by sex, in which the mean weights and weighted correlations over the identified window was more evident in males when compared to females. In the male stratum, Cd, Mn and additionally Pb also dominated the mixture association.

CONCLUSIONS

Prenatal metal(oid) exposure was associated with lower lung function in childhood. These findings underscore the need to consider both mixtures and windows of susceptibility to fully elucidate effects of prenatal metal(oid) exposure on childhood lung function.

Metabolomics in human SGBS cells as new approach method for studying adipogenic effects: Analysis of the effects of DINCH and MINCH on central carbon metabolism

Growing evidence suggests that exposure to certain metabolism-disrupting chemicals (MDCs), such as the phthalate plasticizer DEHP, might promote obesity in humans, contributing to the spread of this global health problem. Due to the restriction on the use of phthalates, there has been a shift to safer declared substitutes, including the plasticizer diisononyl-cyclohexane-1,2-dicarboxylate (DINCH). Notwithstanding, recent studies suggest that the primary metabolite monoisononyl-cyclohexane-1,2-dicarboxylic acid ester (MINCH), induces differentiation of human adipocytes and affects enzyme levels of key metabolic pathways. Given the lack of methods for assessing metabolism-disrupting effects of chemicals on adipose tissue, we used metabolomics to analyze human SGSB cells exposed to DINCH or MINCH. Concentration analysis of DINCH and MINCH revealed that uptake of MINCH in preadipocytes was associated with increased lipid accumulation during adipogenesis. Although we also observed intracellular uptake for DINCH, the solubility of DINCH in cell culture medium was limited, hampering the analysis of possible effects in the μM concentration range. Metabolomics revealed that MINCH induces lipid accumulation similar to peroxisome proliferator-activated receptor gamma (PPARG)-agonist rosiglitazone through upregulation of the pyruvate cycle, which was recently identified as a key driver of de novo lipogenesis. Analysis of the metabolome in the presence of the PPARG-inhibitor GW9662 indicated that the effect of MINCH on metabolism was mediated at least partly by a PPARG-independent mechanism. However, all effects of MINCH were only observed at high concentrations of 10 μM, which are three orders of magnitudes higher than the current concentrations of plasticizers in human serum. Overall, the assessment of the effects of DINCH and MINCH on SGBS cells by metabolomics revealed no adipogenic potential at physiologically relevant concentrations. This finding aligns with previous in vivo studies and supports the potential of our method as a New Approach Method (NAM) for the assessment of adipogenic effects of environmental chemicals.

Associations between maternal exposure to multiple metals and metalloids and blood pressure in preschool children: A mixture-based approach

BACKGROUND

Exposure to metals during pregnancy can potentially influence blood pressure (BP) in children, but few studies have examined the mixed effects of prenatal metal exposure on childhood BP. We aimed to assess the individual and combined effects of prenatal metal and metalloid exposure on BP in preschool children.

METHODS

A total of 217 mother-child pairs were selected from the Zhuang Birth Cohort in Guangxi, China. The maternal plasma concentrations of 20 metals [e.g. lead (Pb), rubidium (Rb), cesium (Cs), and zinc (Zn)] in early pregnancy were measured by inductively coupled plasmamass spectrometry. Childhood BP was measured in August 2021. The effects of prenatal metal exposure on childhood BP were explored by generalized linear models, restricted cubic spline and Bayesian kernel machine regression (BKMR) models.

RESULTS

In total children, each unit increase in the log10-transformed maternal Rb concentration was associated with a 10.82-mmHg decrease (95% CI: -19.40, -2.24) in childhood diastolic BP (DBP), and each unit increase in the log10-transformed maternal Cs and Zn concentrations was associated with a 9.67-mmHg (95% CI: -16.72, -2.61) and 4.37-mmHg (95% CI: -8.68, -0.062) decrease in childhood pulse pressure (PP), respectively. The log10-transformed Rb and Cs concentrations were linearly related to DBP (P nonlinear=0.603) and PP (P nonlinear=0.962), respectively. Furthermore, an inverse association was observed between the log10-transformed Cs concentration and PP (β =-12.18; 95% CI: -22.82, -1.54) in girls, and between the log10-transformed Rb concentration and DBP (β =-12.54; 95% CI: -23.87, -1.21) in boys, while there was an increasing association between the log10-transformed Pb concentration and DBP there was an increasing in boys (β =6.06; 95% CI: 0.36, 11.77). Additionally, a U-shaped relationship was observed between the log10-transformed Pb concentration and SBP (P nonlinear=0.015) and DBP (P nonlinear=0.041) in boys. Although there was no statistically signiffcant difference, there was an inverse trend in the combined effect of maternal metal mixture exposure on childhood BP among both the total children and girls in BKMR.

CONCLUSIONS

Prenatal exposure to both individual and mixtures of metals and metalloids influences BP in preschool children, potentially leading to nonlinear and sex-specific effects.

The use of effect biomarkers in chemical mixtures risk assessment - Are they still important?

Human epidemiological studies with biomarkers of effect play an invaluable role in identifying health effects with chemical exposures and in disease prevention. Effect biomarkers that measure genetic damage are potent tools to address the carcinogenic and/or mutagenic potential of chemical exposures, increasing confidence in regulatory risk assessment decision-making processes. The micronucleus (MN) test is recognized as one of the most successful and reliable assays to assess genotoxic events, which are associated with exposures that may cause cancer. To move towards the next generation risk assessment is crucial to establish bridges between standard approaches, new approach methodologies (NAMs) and tools for increase the mechanistically-based biological plausibility in human studies, such as the adverse outcome pathways (AOPs) framework. This paper aims to highlight the still active role of MN as biomarker of effect in the evolution and applicability of new methods and approaches in human risk assessment, with the positive consequence, that the new methods provide a deeper knowledge of the mechanistically-based biology of these endpoints.

Are We Justified in Modeling Human Exposure to Chlorinated Paraffin Mixtures Using the Average Properties of Congeners and Homologues?

Concern over human exposure to chlorinated paraffin (CP) mixtures keeps increasing. The absence of a comprehensive understanding of how human exposure varies with the physicochemical properties of CP constituents has hindered the ability to determine at what level of aggregation exposure to CPs should be assessed. We answer this question by comparing exposure predicted with either a "complex" method that utilizes isomer-specific properties or "simplified" methods that rely on median properties of congener, homologue, or short-/medium-/long-chain CP groups. Our results demonstrate the wide range of physicochemical properties across CP mixtures and their dependence on molecular structures. Assuming unit emissions in the environment, these variances translate into an extensive disparity in whole-body concentrations predicted for different isomers, spanning ∼11 orders of magnitude. CPs with 13-19 carbons and 6-10 chlorines exhibit the highest human exposure potential, primarily owing to moderate to high hydrophobicity and slow environmental degradation and biotransformation. Far-field exposure is dominant for most CP constituents. Our study underscores that using average properties of congener, homologue, or S/M/LCCP groups yields results that are consistent with those derived from isomer-based modeling, thus offering an efficient and practical framework for future risk assessments and human exposure studies of CPs and other complex chemical mixtures.

Combined toxicity of oil-based PAH4 mixtures on HL-7702 cells

Polycyclic aromatic hydrocarbons (PAHs) as a group of prevalent persistent organic pollutants in the environment are always found as mixtures. The combined toxicity of oil-based PAH4 seems seldom to be mentioned. To evaluate the combined toxicity of oil-based PAH4 mixtures on HL-7702 cells, the effects of single, binary, ternary, and quaternary mixtures on cell viability were examined, and the concentration addition model and combination index (CI)-isobologram model were selected to predict the toxicological interactions of the mixtures. The results showed that the PAH4 mixtures had a concentration-dependent effect on cell viability. The CI model was more suitable for elucidating the toxicity interactions of mixtures. In addition, the combined toxicity of BaA + BaP and BaA + Chr + BbF + BaP was antagonistic, BaA + Chr, BaA + BbF, Chr + BbF, and BaA + Chr + BbF was synergistic, and the remaining mixtures shifted from antagonistic to synergistic. Antagonistic effects were observed in all mixtures containing BaP, indicating that oil-based PAH4 mixtures containing BaP had a mitigating effect on cytotoxicity. Furthermore, BbF was identified as playing a key role in the synergistic effects in binary and ternary mixtures. This study provided a new acknowledgment to assess the interactions of PAH4 mixtures which is helpful for further study of the toxicity risks in the environment.

Association between prenatal exposure to alkylphenols and intelligence quotient among preschool children: sex-specific effects

BACKGROUND

While prenatal exposure to alkylphenols (APs) has been demonstrated to be associated with neurodevelopmental impairments in animals, the evidence from epidemiological studies remains limited and inconclusive. This study aimed to explore the link between AP exposure during pregnancy and the intelligence quotient (IQ) of preschool children.

METHODS

A total of 221 mother-child pairs from the Guangxi Zhuang Birth Cohort were recruited. Nonylphenol (NP), 4-tert-octylphenol (4-T-OP), 4-n-nonylphenol (4-N-NP), and 4-n-octylphenol were measured in maternal serum in early pregnancy. Childhood IQ was evaluated by the Fourth Edition of Wechsler Preschool and Primary Scale of the Intelligence at 3 to 6 years of age. The impact of APs on childhood IQ were evaluated by generalized linear models (GLMs), restricted cubic spline (RCS), and Bayesian kernel machine regression (BKMR).

RESULTS

In GLMs, prenatal exposure to NP and the second tertile of 4-T-OP exhibited an inverse association with full-scale IQ (FSIQ) (β = -2.38; 95% CI: -4.59, -0.16) and working memory index (WMI) (β = -5.24; 95% CI: -9.58, -0.89), respectively. Prenatal exposure to the third tertile of 4-N-NP showed a positive association with the fluid reasoning index (β = 4.95; 95% CI: 1.14, 8.77) in total children, as well as in girls when stratified by sex. A U-shaped relationship between maternal 4-T-OP and WMI was noted in total children and girls by RCS (all P nonlinear < 0.05). The combined effect primarily driven by NP, of maternal AP mixtures at concentrations above the 50th percentile exhibited an inverse trend on FSIQ in total children and girls in BKMR.

CONCLUSIONS

Prenatal exposure to various APs affects IQ in preschool children, and there may be nonmonotonic and sex-specific effects. Further investigation across the population is required to elucidate the potential neurotoxic effects of APs.

Exposure to a Mixture of Endocrine-Disrupting Chemicals and Metabolic Outcomes in Belgian Adolescents

Childhood exposure to endocrine-disrupting chemicals (EDCs), either alone or in mixtures, may affect metabolic outcomes, yet existing evidence remains inconclusive. In our study of 372 adolescents from the Flemish Environment and Health Study (FLEHS IV, 2017-2018), we measured 40 known and suspected EDCs and assessed metabolic outcomes, including body mass index z-score (zBMI), abdominal obesity (AO), total cholesterol (TC), and triglycerides (TG). We applied Bayesian kernel machine regression (BKMR) and Bayesian penalized horseshoe regression for variable selection and then built multivariate generalized propensity score (mvGPS) models to provide an overview of the effects of selected EDCs on metabolic outcomes. As a result, BKMR and horseshoe together identified five EDCs associated with zBMI, three with AO, three with TC, and five with TG. Through mvGPS analysis, monoiso-butyl phthalate (MIBP), polychlorinated biphenyl (PCB-170), and hexachlorobenzene (HCB) each showed an inverse association with zBMI, as did PCB-170 with AO. Copper (Cu) was associated with higher TC and TG, except in boys where it was linked to lower TG. Additionally, monoethyl phthalate (MEP) and monobenzyl phthalate (MBzP) were associated with higher TG. To conclude, our findings support the association between certain chemicals (Cu, MEP, and MBzP) and elevated lipid levels, aligning with prior studies. Further investigation is needed for sex-specific effects.

Preterm Birth and Metal Mixture Exposure among Pregnant Women from the Navajo Birth Cohort Study

BACKGROUND

Preterm birth (PTB), defined as birth before 37 wk gestation, is associated with hypertension, diabetes, inadequate prenatal care, unemployment or poverty, and metal exposure. Indigenous individuals are more likely to have maternal risk factors associated with PTB compared with other populations in the United States; however, the role of environmental metals on PTB among pregnant Indigenous women remains uncertain. Previous research identified associations between PTB and individual metals, but there is limited investigation on metal mixtures and this birth outcome.

OBJECTIVES

We used a mixtures analysis framework to investigate the association between metal mixtures and PTB among pregnant Indigenous women from the Navajo Birth Cohort Study (NBCS).

METHODS

Maternal urine and blood samples were collected at the time of study enrollment and analyzed for metals by inductively coupled plasma dynamic reaction cell mass spectrometry. Bayesian Profile Regression was used to identify subgroups (clusters) of individuals with similar patterns of coexposure and to model association with PTB.

RESULTS

Results indicated six subgroups of maternal participants with distinct exposure profiles, including one group with low exposure to all metals and one group with total arsenic, cadmium, lead, and uranium concentrations exceeding representative concentrations calculated from the National Health and Nutrition Examination Survey (NHANES). Compared with the reference group (i.e., the lowest exposure subgroup), the subgroup with the highest overall exposure had a relative risk of PTB of 2.9 times (95% credible interval: 1.1, 6.1). Exposures in this subgroup were also higher overall than NHANES median values for women 14-45 years of age.

DISCUSSION

Given the wide range of exposures and elevated PTB risk for the most exposed subgroups in a relatively small study, follow-up investigation is recommended to evaluate associations between metal mixture profiles and other birth outcomes and to test hypothesized mechanisms of action for PTB and oxidative stress caused by environmental metals. https://doi.org/10.1289/EHP10361.

Adding open spectral data to MassBank and PubChem using open source tools to support non-targeted exposomics of mixtures

The term "exposome" is defined as a comprehensive study of life-course environmental exposures and the associated biological responses. Humans are exposed to many different chemicals, which can pose a major threat to the well-being of humanity. Targeted or non-targeted mass spectrometry techniques are widely used to identify and characterize various environmental stressors when linking exposures to human health. However, identification remains challenging due to the huge chemical space applicable to exposomics, combined with the lack of sufficient relevant entries in spectral libraries. Addressing these challenges requires cheminformatics tools and database resources to share curated open spectral data on chemicals to improve the identification of chemicals in exposomics studies. This article describes efforts to contribute spectra relevant for exposomics to the open mass spectral library MassBank (https://www.massbank.eu) using various open source software efforts, including the R packages RMassBank and Shinyscreen. The experimental spectra were obtained from ten mixtures containing toxicologically relevant chemicals from the US Environmental Protection Agency (EPA) Non-Targeted Analysis Collaborative Trial (ENTACT). Following processing and curation, 5582 spectra from 783 of the 1268 ENTACT compounds were added to MassBank, and through this to other open spectral libraries (e.g., MoNA, GNPS) for community benefit. Additionally, an automated deposition and annotation workflow was developed with PubChem to enable the display of all MassBank mass spectra in PubChem, which is rerun with each MassBank release. The new spectral records have already been used in several studies to increase the confidence in identification in non-target small molecule identification workflows applied to environmental and exposomics research.

Synergistic impact of co-exposures to whole blood metals on chronic kidney disease in general US adults: a cross‑sectional study of the National Health and Nutrition Examination Survey 2011-2020

The impact of exposure to metals on chronic kidney disease (CKD) has only been investigated in two-way or single metal interactions in previous studies. We investigated the associations between five single metals in blood and their mixed exposure and CKD by using the machine learning approach. Relevant data were extracted from the National Health and Nutrition Examination Survey (NHANES 2011-2020), and the level of five metals in blood detected by inductively coupled plasma mass spectrometry was considered as exposures, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se). The correlations between individual metal and metal mixtures and CKD were then evaluated by survey-multivariable logistic regression (SMLR), generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR). Altogether, our study included 12,412 participants representing 572.6 million non-institutionalized US adults. Several single metals with the high quartile of exposure showed a positive association with the CKD ratio including Cd [(AOR = 1.873, 95% CI: 1.537, 2.284), Q4], Pb [(AOR = 1.559, 95% CI: 1.295, 1.880), Q4], and total Hg [(AOR = 1.169, 95% CI: 1.018, 1.343), Q2], while Mn [(AOR = 0.796, 95% CI: 0.684, 0.927), Q2] and Se [(AOR = 0.805, 95% CI: 0.664, 0.976), Q4] were negatively associated with the CKD ratio. In light of the positive fit of the WQS regression model, a significantly positive correlation was found between mixed metals and CKD (AOR = 1.373, 95% CI: 1.224, 1.539) after full covariate adjustment, and a similar finding was also detected in the BKMR model. Our study revealed that each single metal including Cd, Pb, and total Hg might have a positive association with CKD while this association was negative for both Mn and Se. The five metals might have a positive joint effect on CKD.

Potential roles of gut microbiota in metal mixture and bone mineral density and osteoporosis risk association: an epidemiologic study in Wuhan

Few studies have focused on the effects of multiple metal mixtures on bone health and the underlying mechanisms related to alterations in the gut microbiota. This study aimed to examine the potential roles of gut microbiota alterations in metal mixtures and their association with osteoporosis traits. Adults aged ≥ 55 years were recruited from two community healthcare centers in Wuhan City during 2016-2019. The plasma concentrations of six metals (zinc, iron, selenium, lead, cadmium, and arsenic) were measured using an inductively coupled plasma mass spectrometer. The k-means clustering method was employed to explore the exposure profiles of metal mixtures for all participants. 16S rRNA gene sequencing was used to profile the gut microbiota of participants. Combining these results with those of our previous study, we identified overlapping taxa and evaluated their potential roles. A total of 806 participants (516 females), with an average age of 67.36 years were included. The participants were grouped into three clusters using k-means clustering: Cluster 1 (n = 458), Cluster 2 (n = 199), and Cluster 3 (n = 149). The high-exposure group for iron, zinc, lead, and cadmium (Cluster 3) showed a negative association with lumbar spine 1-4 bone mineral density (BMD). A total of 201 individuals (121 females) underwent sequencing of the gut microbiota. Both alpha and beta diversities were statistically different among the three groups. Bacteroidaceae, Lachnospiraceae, Bifidobacteriaceae, Bacteroides, and Lachnospiraceae_incertae_sedis were identified as overlapping taxa associated with the metal mixtures and BMD. Interaction analysis revealed that Cluster 3 interacted with Bacteroidaceae/Bacteroides, resulting in a positive effect on LS1-4 BMD (β = 0.358 g/cm2, 95% CI: 0.047 to 0.669, P = 0.025). Our findings indicate associations between multiple metal mixtures and BMD as well as gut microbiota alterations. Exploring the interaction between metal mixtures and the gut microbiota provides new perspectives for the precise prevention and treatment of osteoporosis.

Blood Levels of Environmental Heavy Metals are Associated with Poorer Iron Status in Ugandan Children: A Cross-Sectional Study

BACKGROUND

Iron deficiency (ID) and environmental exposure to metals frequently co-occur among Ugandan children, but little is known about their associations, although iron and other divalent metals share the same intestinal absorption transporter, divalent metal transporter 1 (DMT1).

OBJECTIVES

We examined associations between iron status and blood concentrations of lead, manganese (Mn), cobalt (Co), and cadmium, both singly and as a mixture.

METHODS

We used data on sociodemographic status, iron biomarkers, and blood concentrations of heavy metals collected from a cross-sectional survey of 100 children aged 6-59 mo in Kampala, Uganda. We compared blood concentrations of metals in ID with iron-sufficient children. We examined associations between a metal mixture and iron biomarkers using multiple linear regression and weighted quintile sum regression.

RESULTS

The median (interquartile range) blood Mn (μg/L) was higher in ID children defined by soluble transferrin receptor (sTfR) and ferritin (ID compared with iron-sufficient children): (sTfR [21.3 {15.1, 28.8}, 11.2 {8.6, 18.5}], ferritin [19.5 {15.0, 27.2}, 11.2 {8.8, 19.6}]; P < 0.001 for both). Similarly, the median (interquartile range) blood Co (μg/L) was higher in ID children by ferritin ([0.5 {0.4, 0.9}, 0.4 {0.3, 0.5}], P = 0.05). Based on the multiple linear regression results, higher blood Co and Mn were associated with poorer iron status (defined by all 4 iron indicators for Co and by sTfR for Mn). The weighted quintile sum regression result showed that higher blood concentrations of a metal mixture were associated with poorer iron status represented by sTfR, ferritin, and hepcidin, mainly driven by Co and Mn.

CONCLUSIONS

Our study findings suggest that poorer iron status is associated with overall heavy metal burden, predominantly Co and Mn, among Ugandan children. Further prospective studies should confirm our primary findings and investigate the combined effects of coexposures to neurotoxicants on the neurodevelopment of young children.

Association between mediterranean diet and metal(loid) exposure in 4-5-year-old children living in Spain

Even relatively low levels of metals exposure may impact health, particularly among vulnerable populations such as infants and young children. However, little is known about the interplay between simultaneous metal exposures, common in real-life scenarios, and their association with specific dietary patterns. In this study, we have evaluated the association between adherence to Mediterranean diet (MD) and urinary metal concentrations individually and as an exposure mixture in 713 children aged 4-5-years from the INMA cohort study. We used a validated food frequency questionnaire to calculate two MD indexes scores: aMED and rMED. These indexes gather information on various food groups within the MD and score differently. To measure urinary concentrations of cobalt, copper, zinc, molybdenum, selenium, lead, and cadmium as exposure biomarkers, we used inductively coupled plasma mass spectrometry (ICP-MS), coupled with an ion chromatography (IC) equipment for arsenic speciation analysis. We applied linear regression and quantile g-computation, adjusted for confounders, to analyse the association between MD adherence and exposure to the metal mixture. High adherence to MD such as the quintile (Q) 5 MD was associated with higher urinary arsenobetaine (AsB) levels than Q1, with β values of 0.55 (confidence interval - CI 95% 0.01; 1.09) for aMED and 0.73 (CI 95% 0.13; 1.33) for rMED. Consumption of fish was associated with increased urinary AsB but reduced inorganic arsenic concentrations. In contrast, the aMED vegetables consumption increased urinary inorganic arsenic content. A moderate level of adherence to MD (Q2 and Q3) was associated with lower copper urinary concentrations than Q1, with β values of -0.42 (CI 95% -0.72; -0.11) for Q2 and -0.33 (CI 95% -0.63; -0.02) for Q3, but only with aMED. Our study, conducted in Spain, revealed that adhering to the MD reduces exposure to certain metals while increasing exposure to others. Specifically, we observed increase in exposure to non-toxic AsB, highlighting the significance of consuming fish/seafood. However, it is crucial to emphasize the necessity for additional efforts in reducing early-life exposure to toxic metals, even when adhering to certain food components of the MD.

A weighted quantile sum regression with penalized weights and two indices

Background

New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect.

Objectives

In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term.

Methods

To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data.

Results

The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively.

Discussion

Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.

Evaluation of the cancer risk from PAHs by inhalation: Are current methods fit for purpose?

There is ample evidence from occupational studies that exposure to a mixture of Polycyclic Aromatic Hydrocarbons (PAHs) is causally associated with an increased incidence of lung cancers. In both occupational atmospheres and ambient air, PAHs are present as a mixture of many compounds, but the composition of the mixture in ambient air differs from that in the occupational atmosphere, and varies in time and space in ambient air. Estimates of cancer risk for PAH mixtures are based upon unit risks which derive from extrapolation of occupational exposure data or animal model data, and in the case of the WHO use one compound, benzo[a]pyrene as a marker for the entire mixture, irrespective of composition. The U.S. EPA has used an animal exposure study to derive a unit risk for inhalation exposure to benzo[a]pyrene alone, and there have been a number of rankings of relative carcinogenic potency for other PAHs which many studies have used to calculate a cancer risk from the PAHs mixture, frequently incorrectly by adding the estimated relative risks of individual compounds, and applying the total "B[a]P equivalent" to the WHO unit risk, which already applies to the entire mixture. Such studies are often based upon data solely for the historic US EPA group of 16 compounds which do not include many of the apparently more potent carcinogens. There are no data for human cancer risk of individual PAHs, and conflicting evidence of additivity of PAH carcinogenicity in mixtures. This paper finds large divergences between risk estimates deriving from the WHO and U.S. EPA methods, as well as considerable sensitivity to the mixture composition, and assumed PAH relative potencies. Of the two methods, the WHO approach appears more likely to provide reliable risk estimates, but recently proposed mixture-based approaches using in vitro toxicity data may offer some advantages.

In Vitro Genotoxicity Evaluation of PAHs in Mixtures Using Experimental Design

Settled dusts are sinks for environmental pollutants, including Polycyclic Aromatic Hydrocarbons (PAHs) that are ubiquitous, persistent, and carcinogenic. To assess their toxicity in mixtures, Toxic Equivalent Factors (TEFs) are routinely used and based on the hypothesis of additive effects, although PAH interactions may occur and remain an open issue. This study investigated genotoxic binary interaction effects for six PAHs in mixtures using two in vitro assays and estimated Genotoxic Equivalent Factors (GEFs) to roughly predict the genotoxicity of PAH in mixtures. The Design of the Experiment approach was used with the micronucleus assay for cytostasis and micronuclei frequency and the alkaline comet assay for DNA damage. GEFs were determined for each PAH independently and in a mixture. For the cytostasis endpoint, no PAHs interaction was noted. BbF and BaP had a synergistic effect on DNA damage. All the PAH interacted between them regarding chromosomal damage. Although the calculated GEFs were similar to the TEFs, the latter may underestimate the genotoxic potential of a PAH mixture. GEFs calculated for PAH alone were lower than GEFs for PAHs in mixtures; thus, mixtures induce greater DNA/chromosomal damage than expected. This research helps to advance the challenging issue of contaminant mixtures' effects on human health.

Human Exposure to Bisphenols, Parabens, and Benzophenones, and Its Relationship with the Inflammatory Response: A Systematic Review

Bisphenols, parabens (PBs), and benzophenones (BPs) are widely used environmental chemicals that have been linked to several adverse health effects due to their endocrine disrupting properties. However, the cellular pathways through which these chemicals lead to adverse outcomes in humans are still unclear, suggesting some evidence that inflammation might play a key role. Thus, the aim of this study was to summarize the current evidence on the relationship between human exposure to these chemicals and levels of inflammatory biomarkers. A systematic review of peer-reviewed original research studies published up to February 2023 was conducted using the MEDLINE, Web of Science, and Scopus databases. A total of 20 articles met the inclusion/exclusion criteria. Most of the reviewed studies reported significant associations between any of the selected chemicals (mainly bisphenol A) and some pro-inflammatory biomarkers (including C-reactive protein and interleukin 6, among others). Taken together, this systematic review has identified consistent positive associations between human exposure to some chemicals and levels of pro-inflammatory biomarkers, with very few studies exploring the associations between PBs and/or BPs and inflammation. Therefore, a larger number of studies are required to get a better understanding on the mechanisms of action underlying bisphenols, PBs, and BPs and the critical role that inflammation could play.

Exposure to Cadmium, Lead, Mercury, and Arsenic and Uric Acid Levels: Results from NHANES 2007-2016

Mechanisms underlying abnormal uric acid (UA) levels from exposure to toxic metals/metalloids have not been not fully elucidated, especially in the context of mixtures. The aim was to identify major toxic metals/metalloids that affected UA levels with a mixture exposure concept in the association model. From 2007-2016 National Health and Nutrition Examination Survey (NHANES), 4794 adults were involved. Serum UA (SUA) and SUA to serum creatinine ratio (SUA/SCr) were used to estimate the UA levels, and cadmium (Cd), lead (Pb), mercury (Hg), and arsenic (As) in the blood and/or urine were evaluated in the study. We assessed the associations between toxic metals and UA levels using linear regression and Bayesian kernel machine regression (BKMR). The median [P₂₅, P₇₅] SUA/SCr and SUA level were 6.22 [5.27, 7.32] and 0.83 [0.72, 0.98], respectively. There was no difference for SUA/SCr by gender (men, 6.25 [5.39, 7.29]; women, 6.17 [5.17, 7.36], P = 0.162), but men had higher SUA than women (men, 0.95 [0.85, 1.05]; women, 0.72 [0.64, 0.82], P < 0.001). Blood Pb (β_men = 0.651 and β_women = 1.014) and urinary Cd (β_men = 0.252 and β_women = 0.613) were positively associated with SUA/SCr, and urinary Pb (β_men =  - 0.462 and β_women =  - 0.838) was inversely associated with SUA/SCr in multivariate linear regression analysis. However, urinary As (β_men = 0.351) was positively associated with SUA/SCr only in men. BKMR showed that higher concentrations of exposure to a mixture of toxic metals were positively associated with higher UA levels, where Cd, Pb, and urinary As contributed most to the overall mixture effect in men, while Pb and urinary Cd in women. Our study provided the first evidence that mixtures of metals are associated with the UA levels. Increased concentrations of metals, mainly blood Pb, urinary Cd, and As (only in men) may increase the level of UA.

Co-exposure to perfluoroalkyl acids and heavy metals mixtures associated with impaired kidney function in adults: A community-based population study in China

BACKGROUND

Previous studies have separately linked either perfluoroalkyl acid (PFAA) or heavy metal exposure with kidney dysfunction. However, the relationships of co-exposure to PFAAs and heavy metals with kidney function are still unclear.

OBJECTIVES

To explore the associations between exposure to PFAAs and heavy metals mixtures and kidney function in adults.

METHODS

We conducted a cross-sectional community-based population study in Guangzhou, China, enrolling 1312 adults from November 2018 to August 2019. We quantified 13 PFAAs in serum and 14 heavy metals in plasma. We chose estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) as outcomes of interest. Distributed lag non-linear models (DLNMs) were used to check nonlinearity of individual pollutant with kidney function. Joint associations of pollutant mixtures on kidney function were assessed by Bayesian Kernel Machine Regression (BKMR) models. We further explored modification effects of gender.

RESULTS

Most individual PFAA and heavy metal were associated with declined kidney function in single-pollutant models. We also observed significant dose-response relationships of pollutant mixtures with reduced eGFR levels and increased odds of CKD in BKMR models. Perfluoroheptanesulfonic acid (PFHpS), arsenic (As) and strontium (Sr) were the predominant contributors among pollutant mixtures. A change in log PFHpS, As and Sr concentrations from the 25th to the 75th percentile were associated with a decrease in eGFR of -5.42 (95% confidence interval (CI): -6.86, -3.98), -2.14 (95% CI: -3.70, -0.58) and -1.87 (95% CI: -3.03, -0.72) mL/min/1.73 m², respectively, when other pollutants were at their median values. In addition, the observed associations were more obvious in females.

CONCLUSIONS

We provided new evidence that co-exposure to PFAAs and heavy metals mixtures was associated with reduced kidney function in adults and PFHpS, As and Sr appeared to be the major contributors. Further studies are warranted to confirm our findings and elucidate the underlying mechanisms.

Associations of maternal urinary bisphenol and phthalate concentrations with offspring reproductive development

Fetal exposure to bisphenols and phthalates may influence development of the reproductive system. In a population-based, prospective cohort study of 1059 mother-child pairs, we examined the associations of maternal gestational urinary bisphenols and phthalates concentrations with offspring reproductive development from infancy until 13 years. We measured urinary bisphenol and phthalate concentrations in each trimester. We obtained information on cryptorchidism or hypospadias after birth from medical records. At 9.7 years, we measured testicular and ovarian volume by MRI. At 13.5 years, we measured child Tanner stages and menstruation through questionnaire. We performed linear or logistic regression models for boys and girls to assess the associations of maternal urinary average and trimester-specific bisphenols and phthalates with child reproductive outcomes. Next, to further explore potential synergistic or additive effects of exposures together, we performed mixed exposure models using a quantile g computation approach. Models were adjusted for maternal age, ethnicity, body-mass index, education, parity, energy intake, smoking and alcohol use, and child's gestational age at birth, birthweight and body-mass index. In boys, no associations of maternal gestational phthalate or bisphenol with offspring cryptorchidism and hypospadias were found. Higher maternal high-molecular-weight phthalate and total bisphenol, but not phthalic acid or low-molecular-weight phthalate, were associated with larger child testicular volume at 10 years. Higher maternal phthalic acid and total bisphenol were associated with earlier genital and pubic hair development at 13 years, respectively (p-values<0.05). In girls, we found no associations of maternal urinary bisphenol and phthalate with ovarian volume or menstrual age. Only higher maternal urinary high-molecular-weight phthalate was associated with earlier pubic hair development at 13 years (p-values <0.05). Higher mixture exposure was associated with earlier pubic hair development in both sexes. In conclusion, higher maternal gestational urinary bisphenol and phthalate concentrations were associated with alterations in offspring reproductive development, mainly in boys.

Maternal Serum and Placental Metabolomes in Association with Prenatal Phthalate Exposure and Neurodevelopmental Outcomes in the MARBLES Cohort

Prenatal exposure to phthalates, a family of endocrine-disrupting plasticizers, is associated with disruption of maternal metabolism and impaired neurodevelopment. We investigated associations between prenatal phthalate exposure and alterations of both the maternal third trimester serum metabolome and the placental metabolome at birth, and associations of these with child neurodevelopmental outcomes using data and samples from the Markers of Autism Risk in Babies Learning Early Signs (MARBLES) cohort. The third trimester serum (n = 106) and placental (n = 132) metabolomes were investigated using 1H nuclear magnetic resonance spectroscopy. Children were assessed clinically for autism spectrum disorder (ASD) and cognitive development. Although none of the urinary phthalate metabolite concentrations were associated with maternal serum metabolites after adjustment for covariates, mixture analysis using quantile g-computation revealed alterations in placental metabolites with increasing concentrations of phthalate metabolites that included reduced concentrations of 2-hydoxybutyrate, carnitine, O-acetylcarnitine, glucitol, and N-acetylneuraminate. Child neurodevelopmental outcome was not associated with the third trimester serum metabolome, but it was correlated with the placental metabolome in male children only. Maternal phthalate exposure during pregnancy is associated with differences in the placental metabolome at delivery, and the placental metabolome is associated with neurodevelopmental outcomes in males in a cohort with high familial ASD risk.

Non-targeted metabolomics and associations with per- and polyfluoroalkyl substances (PFAS) exposure in humans: A scoping review

OBJECTIVE

To summarize the application of non-targeted metabolomics in epidemiological studies that assessed metabolite and metabolic pathway alterations associated with per- and polyfluoroalkyl substances (PFAS) exposure.

RECENT FINDINGS

Eleven human studies published before April 1st, 2021 were identified through database searches (PubMed, Dimensions, Web of Science Core Collection, Embase, Scopus), and citation chaining (Citationchaser). The sample sizes of these studies ranged from 40 to 965, involving children and adolescents (n = 3), non-pregnant adults (n = 5), or pregnant women (n = 3). High-resolution liquid chromatography-mass spectrometry was the primary analytical platform to measure both PFAS and metabolome. PFAS were measured in either plasma (n = 6) or serum (n = 5), while metabolomic profiles were assessed using plasma (n = 6), serum (n = 4), or urine (n = 1). Four types of PFAS (perfluorooctane sulfonate(n = 11), perfluorooctanoic acid (n = 10), perfluorohexane sulfonate (n = 9), perfluorononanoic acid (n = 5)) and PFAS mixtures (n = 7) were the most studied. We found that alterations to tryptophan metabolism and the urea cycle were most reported PFAS-associated metabolomic signatures. Numerous lipid metabolites were also suggested to be associated with PFAS exposure, especially key metabolites in glycerophospholipid metabolism which is critical for biological membrane functions, and fatty acids and carnitines which are relevant to the energy supply pathway of fatty acid oxidation. Other important metabolome changes reported included the tricarboxylic acid (TCA) cycle regarding energy generation, and purine and pyrimidine metabolism in cellular energy systems.

CONCLUSIONS

There is growing interest in using non-targeted metabolomics to study the human physiological changes associated with PFAS exposure. Multiple PFAS were reported to be associated with alterations in amino acid and lipid metabolism, but these results are driven by one predominant type of pathway analysis thus require further confirmation. Standardizing research methods and reporting are recommended to facilitate result comparison. Future studies should consider potential differences in study methodology, use of prospective design, and influence from confounding bias and measurement errors.

Association of Metals and Metalloids With Urinary Albumin/Creatinine Ratio: Evidence From a Cross-Sectional Study Among Elderly in Beijing

Background

Environmental exposure to toxic elements contributes to the pathogenesis of chronic kidney disease (CKD). Few studies focus on the association of urinary metals and metalloids concentrations with the urinary albumin/creatinine ratio (UACR) among elderly, especially in areas and seasons with severe air pollution.

Objective

We aimed to evaluate the associations of urinary metals and metalloids concentration with UACR, which is an early and sensitive indicator of CKD.

Method

We conducted a cross-sectional study among 275 elderly people in Beijing from November to December 2016, which has experienced the most severe air pollution in China. We measured 15 urinary metals and metalloids concentration and estimated their association with UACR using a generalized linear model (GLM). Bayesian kernel machine regression (BKMR) and quantile g-computation (qgcomp) models were also conducted to evaluate the combined effect of metal and metalloid mixtures concentration.

Results

Of the 275 elderly people included in the analysis, we found that higher urinary Cu concentration was positively associated with UACR using GLM (β = 0.36, 95% CI: 0.25, 0.46). Using the BKMR model, we found that the change in UACR was positively associated with a change in urinary Cu concentration from its 25th to 75th percentile value with all other metals and metalloids concentration fixed at their 25th, 50th, or 75th percentile levels. Urinary Cu concentration had the most significant positive contribution (59.15%) in the qgcomp model. Our finding was largely robust in three mixture modeling approaches: GLM, qgcomp, and BKMR.

Conclusion

This finding suggests that urinary Cu concentration was strongly positively associated with UACR. Further analyses in cohort studies are required to corroborate this finding.

Profiling of seasonal variation in and cancer risk assessment of benzo(a)pyrene and heavy metals in drinking water from Kirkuk city, Iraq

Water samples at 13 sites were analyzed to evaluate heavy metals (cobalt, lead, manganese, copper) and benzo(a)pyrene using 2 methods of analysis (high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) kits). The Lesser Zap River is the main tributary of the Tigris and is used as a main source of drinking water in Kirkuk city through the General Kirkuk project. Risk evaluation for benzo(a)pyrene and lead in water samples was accomplished by Monte Carlo simulation. The highest concentrations of B(a)P were recorded at sites S7 and S5, with levels of 0.192 and 0.122 µg L^-1 detected by HPLC and ELISA, respectively. The WHO guidelines for benzo[a]pyrene in drinking water recommend 0.7 µg L ^-1, and none of the samples surpassed this level; moreover, B(a)P levels exceeded EPA standards in 2014 (0.01 µg L^-1), particularly when the liquid-liquid extraction method with HPLC was used. Carcinogenic risks for human adults and children exist and are highest during the rainy season as compared with the carcinogenic risk during the dry season and risks for children exceed those of adults. This indicates that the 2^nd round of sampling (winter season) harbors more carcinogenic risk than the 1^st round of sampling (dry season).

Traffic-generated air pollution - Exposure mediated expression of factors associated with demyelination in a female apolipoprotein E-/- mouse model

Epidemiology studies suggest that exposure to ambient air pollution is associated with demyelinating diseases in the central nervous system (CNS), including multiple sclerosis (MS). The pathophysiology of MS results from an autoimmune response involving increased inflammation and demyelination in the CNS, which is higher in young (adult) females. Exposure to traffic-generated air pollution is associated with neuroinflammation and other detrimental outcomes in the CNS; however, its role in the progression of pathologies associated with demyelinating diseases has not yet been fully characterized in a female model. Thus, we investigated the effects of inhalation exposure to mixed vehicle emissions (MVE) in the brains of both ovary-intact (ov+) and ovariectomized (ov-) female Apolipoprotein (ApoE^-/-) mice. Ov + and ov- ApoE^-/- mice were exposed via whole-body inhalation to either filtered air (FA, controls) or mixed gasoline and diesel vehicle emissions (MVE: 200 PM μg/m³) for 6 h/d, 7 d/wk., for 30 d. We then analyzed MVE-exposure mediated alterations in myelination, the presence of CD4+ and CD8+ T cells, reactive oxygen species (ROS), myelin oligodendrocyte protein (MOG), and expression of estrogen (ERα and ERβ) and progesterone (PROA/B) receptors in the CNS. MVE-exposure mediated significant alterations in myelination across multiple regions in the cerebrum, as well as increased CD4+ and CD8+ staining. There was also an increase in ROS production in the CNS of MVE-exposed ov- and ov + ApoE^-/- mice. Ov- mice displayed a reduction in cerebral ERα mRNA expression, compared to ov + mice; however, MVE exposure resulted in an even further decrease in ERα expression, while ERβ and PRO A/B were unchanged across groups. These findings collectively suggest that inhaled MVE-exposure may mediate estrogen receptor expression alterations associated with increased CD4+/CD8+ infiltration, regional demyelination, and ROS production in the CNS of female ApoE^-/- mice.

Prenatal Exposure to Nonpersistent Chemical Mixtures and Offspring IQ and Emotional and Behavioral Problems

Prenatal exposure to nonpersistent chemicals such as phthalates, bisphenols, and organophosphate (OP) pesticides is ubiquitous and occurs in mixtures. So far, epidemiological studies investigating neurodevelopmental consequences of these exposures have mainly been restricted to single-pollutant models. Thus, we studied the association between prenatal exposure to nonpersistent chemical mixtures and child IQ and emotional and behavioral problems. Data came from 782 mother-child pairs. Eleven phthalate, one bisphenol, and five OP pesticide urinary exposure biomarkers were measured three times during pregnancy and averaged. Nonverbal IQ, internalizing and attention problems, aggressive behavior, and autistic traits were assessed at child age 6 years. We used quantile g-computation to estimate the change in each outcome per quartile increase in all chemicals within the mixture. Higher exposure to the mixture was associated with lower nonverbal IQ (-4.0 points (95%CI = -7.0, -1.0), -5.5 points (95%CI = -10.2, -0.9), and -4.6 points (95%CI = -10.8, 1.5) for the second, third, and fourth quartile, respectively, compared to the first quartile). These results were mainly driven by the phthalate mixture. No association was observed with emotional and behavioral problems. Prenatal exposure to nonpersistent chemical mixtures was associated with lower nonverbal IQ in children. Exposure to chemical mixtures during gestation is universal and may impact neurodevelopment.

Prenatal Exposure to Chemical Mixtures and Cognitive Flexibility among Adolescents

Cognitive flexibility, the ability to smoothly adapt to changing circumstances, is a skill that is vital to higher-level executive functions such as problem-solving, planning, and reasoning. As it undergoes substantial development during adolescence, decrements in cognitive flexibility may not become apparent until this time. There is evidence that prenatal exposure to individual chemicals may adversely impact executive functions in children, but few studies have explored the association of co-exposure to multiple chemicals with cognitive flexibility specifically among adolescents. We investigated this association among a diverse group of adolescents living near a Superfund site in New Bedford, Massachusetts. Specifically, using Bayesian kernel machine regression (BKMR) and multivariable regression analyses, we investigated the association of biomarkers of prenatal exposure to organochlorines (DDE, HCB, PCBs) and metals (lead, manganese) with cognitive flexibility, measured with four subtests of the Delis-Kaplan Executive Function System. In BKMR models, we observed adverse joint associations of the chemical mixture with two of the four cognitive flexibility subtests. In covariate-adjusted linear regression models, a two-fold increase in cord blood Mn was associated with poorer performance on two of the subtests: Trail-Making (scaled score difference = −0.60; 95% CI: −1.16, −0.05 points) and Color-Word Interference (scaled score difference = −0.53; 95% CI: −1.08, 0.01 points). These adverse Mn-cognitive flexibility associations were supported by the results of the BKMR. There was little evidence of effect modification by sex and some evidence of effect modification by a measure of social disadvantage, particularly for the associations between HCB and cognitive flexibility. This study is among the first to provide evidence of an adverse association of prenatal exposure to a chemical mixture with cognitive flexibility in adolescence.

Prenatal Exposure to Chemical Mixtures and Inhibition among Adolescents

Inhibition, one of the building blocks of executive function, is the ability to focus one's attention despite interference from external stimuli. It undergoes substantial development during adolescence and may be susceptible to adverse impacts of prenatal exposure to chemical mixtures, yet few studies have explored this association. The New Bedford Cohort (NBC) is a birth cohort of residents living near the New Bedford Harbor Superfund site in Massachusetts. Among adolescents from the NBC, we investigated the association of biomarkers of prenatal exposure to organochlorines (DDE, HCB, PCBs) and metals (Pb, Mn) with inhibition, assessed with the Delis-Kaplan Executive Function System Design Fluency (non-verbal task) and Color-Word Interference (verbal task) subtests. An exploratory mixtures analysis using Bayesian kernel machine regression (BKMR) informed a traditional multivariable regression approach. NBC adolescents are diverse with 29% non-white and 31% in a low-income household at birth. Cord serum organochlorine concentrations and cord blood metals concentrations were generally similar to other birth cohorts. In BKMR models, we observed a suggestive adverse association of the chemical mixture with Color-Word Interference but not Design Fluency. In covariate-adjusted linear regression models including all five chemical exposure measures, a doubling of cord blood Mn was associated with poorer Color-Word Interference completion time scaled scores (difference = -0.74; 95% CI: -1.34, -0.14). This study provided evidence of an adverse joint association between prenatal exposure to a five-chemical mixture and verbal inhibition in adolescence with exposure to Mn potentially driving this overall association.

Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio

Exposure to metal mixtures may lead to health impacts greater than the effects associated with singular exposures. Two common childhood environmental exposures, manganese (Mn) and lead (Pb), are associated with similar adverse neurodevelopmental effects; however, the effects surrounding concurrent exposure to both metals remain unclear. We study the impact of joint exposure to Mn and Pb on cognitive performance in school-aged children participating in the Communities Actively Researching Exposure Study (CARES) based in East Liverpool, Ohio. Blood Pb levels were measured for each child (geometric mean (GM) = 1.13 μg/dL, range 0.30 μg/dL - 6.64 μg/dL). Mn was measured in participant blood, hair, and toenails with GMs of 10.1 μg/L, 360 ng/g, 0.974 μg/g, respectively. Trained team members administered the Wechsler Intelligence Scale for Children-IV (WISC-IV) to assess intelligence quotient (IQ). The WISC-IV provides scores for Full Scale IQ, Perceptual Reasoning, Processing Speed, Working Memory, and Verbal Comprehension. Interactions between blood Pb and all Mn biomarkers were tested in linear models adjusted for child sex, household income, and serum cotinine. Separate regression models were run for each of the Mn biomarkers. The cohort was comprised of 106 children with a mean age of 8.4 years. Interactions between blood Pb and hair Mn were significant (p < 0.05) for four out of the five IQ domains. The effect of blood Pb on IQ was more pronounced at higher levels of hair and toenail Mn. No significant associations were observed when characterizing the main effect of Mn using blood. Uncovering the health impacts associated with exposure mixtures is critical to understanding the impact of real-life conditions. Our findings suggest that joint exposure to Mn and Pb may produce heightened neurocognitive impacts even at blood Pb levels below the CDC reference concentration of 5 μg/dL.

Prenatal Exposure to Nonpersistent Chemical Mixtures and Fetal Growth: A Population-Based Study

BACKGROUND

Prenatal exposure to mixtures of nonpersistent chemicals is universal. Most studies examining these chemicals in association with fetal growth have been restricted to single exposure models, ignoring their potentially cumulative impact.

OBJECTIVE

We aimed to assess the association between prenatal exposure to a mixture of phthalates, bisphenols, and organophosphate (OP) pesticides and fetal measures of head circumference, femur length, and weight.

METHODS

Within the Generation R Study, a population-based cohort in Netherlands (n=776), urinary concentrations of 11 phthalate metabolites, 3 bisphenols, and 5 dialkylphosphate (DAP) metabolites were measured at <18, 18-25, and >25 weeks of gestation and averaged. Ultrasound measures of head circumference, femur length, and estimated fetal weight (EFW) were taken at 18-25 and >25 weeks of gestation, and measurements of head circumference, length, and weight were performed at delivery. We estimated the difference in each fetal measurement per quartile increase in all exposures within the mixture with quantile g-computation.

RESULTS

The average EFW at 18-25 wk and >25wk was 369 and 1,626g, respectively, and the average birth weight was 3,451g. Higher exposure was associated with smaller fetal and newborn growth parameters in a nonlinear fashion. At 18-25 wk, fetuses in the second, third, and fourth quartiles of exposure (Q2-Q4) had 26g [95% confidence intervals (CI):-38, -13], 35g (95% CI: -55, -15), and 27g (95% CI: -54, 1) lower EFW compared with those in the first quartile (Q1). A similar dose-response pattern was observed at >25wk, but all effect sizes were smaller, and no association was observed comparing Q4 to Q1. At birth, we observed no differences in weight between Q1-Q2 or Q1-Q3. However, fetuses in Q4 had 91g (95% CI: -258, 76) lower birth weight in comparison with those in Q1. Results observed at 18-25 and >25wk were similar for femur length; however, no differences were observed at birth. No associations were observed for head circumference.

DISCUSSION

Higher exposure to a mixture of phthalates, bisphenols, and OP pesticides was associated with lower EFW in the midpregnancy period. In late pregnancy, these differences were similar but less pronounced. At birth, the only associations observed appeared when comparing individuals from Q1 and Q4. This finding suggests that even low levels of exposure may be sufficient to influence growth in early pregnancy, whereas higher levels may be necessary to affect birth weight. Joint exposure to nonpersistent chemicals may adversely impact fetal growth, and because these exposures are widespread, this impact could be substantial. https://doi.org/10.1289/EHP9178.

Chemical pollution: A growing peril and potential catastrophic risk to humanity

Anthropogenic chemical pollution has the potential to pose one of the largest environmental threats to humanity, but global understanding of the issue remains fragmented. This article presents a comprehensive perspective of the threat of chemical pollution to humanity, emphasising male fertility, cognitive health and food security. There are serious gaps in our understanding of the scale of the threat and the risks posed by the dispersal, mixture and recombination of chemicals in the wider environment. Although some pollution control measures exist they are often not being adopted at the rate needed to avoid chronic and acute effects on human health now and in coming decades. There is an urgent need for enhanced global awareness and scientific scrutiny of the overall scale of risk posed by chemical usage, dispersal and disposal.

Bioavailability for organic chemical bioaccumulation follows the power law

Despite the importance of bioavailability for organic chemical bioaccumulation by terrestrial and benthic invertebrates, the principles of bioavailability for organic chemical bioaccumulation remain poorly understood. Here we use large-scale databases with contrasting geographic, compound and organism coverage (from 925 sites, 446 compounds and 184 invertebrate species), and report that bioavailability for organic chemical bioaccumulation follows the power law. It represents that the internal concentration of organic chemicals is the composite power function of the lipid fraction of invertebrates, bulk site concentration of compounds, and organic carbon content of soils/sediments. This law directly links environmental exposures and body burdens of organic chemicals in contaminated sites, and provides a method for enabling case-specific risk assessments of a vast number of organic chemicals and contaminated sites. Our findings may pave the way for translating bioavailability knowledge into risk-oriented regulation of organic chemicals and contaminated sites.

Investigation of Antioxidant and Cytotoxicity Effects of Silver Nanoparticles Produced by Biosynthesis Using Lactobacillus gasseri

The biosynthesis of silver nanoparticles (AgNPs) is a new approach in nanotechnology which was optimistically implemented in medicine, food control, and pharmacology. The present study aimed to investigate the antioxidant and cytotoxicity effects of AgNPs produced by Lactobacillus gasseri filtrate. Also, changing color from yellow to brown confirmed the production of AgNPs. AgNPs were characterized using ultraviolet-visible spectroscopy, FE-SEM, and Fourier Transform Infrared Spectroscopy (FTIR). The antioxidant activity of AgNPs was tested using the DPPH assay. The scavenging test for DPPH showed 19.3%, 32.6%, 47.6%, 72%, 85.3% at concentrations (6.25, 12.5, 25, 52, 100) µg/ml, respectively, which proved that the scavenging percentage increased with increasing concentration. The effect of AgNPs on the chromosomal pattern was also studied. The results of the experiment of AgNPs against SK-GT-4 cancer cells showed the toxic activity of the used particles against the strains of these human esophageal cancer cells and failed to affect normal cells.

Classification of Human Failure in Chemical Plants: Case Study of Various Types of Chemical Accidents in South Korea from 2010 to 2017

The increasing use and distribution of chemicals are causing serious chemical accidents such as fires, explosions, and leaks during manufacturing and handling. In most cases, all risks caused by chemicals are classified as accidents due to defects in process facilities, human errors, and multi-cause accidents. Among chemical accidents caused by human errors, accurate analysis of accidents caused by the complex action of various types of human failures is required. Based on the accident investigation reports that occurred in South Korea from 2010 to 2017, chemical accidents caused by human failure were analyzed, and the fundamental causes were derived by classifying them into human error and violation. Human failure was analyzed according to the classification criteria for human failure of health and safety executive (HSE). As a result of the analysis, several types of human failure acted in combination to be a more significant cause of chemical accidents; incorrect application of process rules and procedures, inappropriate chemical information, lack of education, and defects in the current safety regulation were analyzed as the main causes. In addition, the cause of human errors was presented through case studies of chemical accidents in South Korea.