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Balalian AA, Stingone JA, Kahn LG, Herbstman JB, Graeve RI, Stellman SD, Factor-Litvak P. Perinatal exposure to polychlorinated biphenyls (PCBs) and child neurodevelopment: A comprehensive systematic review of outcomes and methodological approaches. ENVIRONMENTAL RESEARCH 2024; 252:118912. [PMID: 38615789 DOI: 10.1016/j.envres.2024.118912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs), extensively used in various products, prompt ongoing concern despite reduced exposure since the 1970s. This systematic review explores prenatal PCB and hydroxylated metabolites (OH-PCBs) exposure's association with child neurodevelopment. Encompassing cognitive, motor development, behavior, attention, ADHD, and ASD risks, it also evaluates diverse methodological approaches in studies. METHODS PubMed, Embase, PsycINFO, and Web of Science databases were searched through August 23, 2023, by predefined search strings. Peer-reviewed studies published in English were included. The inclusion criteria were: (i) PCBs/OH-PCBs measured directly in maternal and cord blood, placenta or breast milk collected in the perinatal period; (ii) outcomes of cognitive development, motor development, attention, behavior, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) among children≤18 years old. Quality assessment followed the National Heart, Lung, and Blood Institute's tool. RESULTS Overall, 87 studies were included in this review. We found evidence for the association between perinatal PCB exposure and adverse cognitive development and attention issues in middle childhood. There appeared to be no or negligible link between perinatal PCB exposure and early childhood motor development or the risk of ADHD/ASD. There was an indication of a sex-specific association with worse cognition and attention scores among boys. Some individual studies suggested a possible association between prenatal exposure to OH-PCBs and neurodevelopmental outcomes. There was significant heterogeneity between the studies in exposure markers, exposure assessment timing, outcome assessment, and statistical analysis. CONCLUSIONS Significant methodological, clinical and statistical heterogeneity existed in the included studies. Adverse effects on cognitive development and attention were observed in middle childhood. Little or no apparent link on both motor development and risk of ADHD/ASD was observed in early childhood. Inconclusive evidence prevailed regarding other neurodevelopmental aspects due to limited studies. Future research could further explore sex-specific associations and evaluate associations at lower exposure levels post-PCB ban in the US. It should also consider OH-PCB metabolites, co-pollutants, mixtures, and their potential interactions.
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Affiliation(s)
- Arin A Balalian
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Question Driven Design and Analysis Group (QD-DAG), New York, NY, USA.
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Julie B Herbstman
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard I Graeve
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Halle Saale, Germany
| | - Steven D Stellman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Guo HJ, Ye YL, Gao YF, Liu ZH. Age at first birth is associated with the likelihood of frailty in middle-aged and older women: A population-based analysis from NHANES 1999-2018. Maturitas 2024; 181:107904. [PMID: 38157686 DOI: 10.1016/j.maturitas.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES This study examined whether age at first birth (AFB) is associated with the prevalence of frailty in middle-aged and older women. METHODS The study included 10,828 women (age ≥ 45 years) from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) in the United States. AFB data were collected using a standardized reproductive health questionnaire. Frailty was measured using a 53-item frailty index and was diagnosed if the score on that index was over 0.21. Survey-weighted logistic regression models were used to assess the association between AFB and the prevalence of frailty. A survey-weighted restricted cubic spline (RCS) model was used to determine the dose-response relationship between AFB and frailty. Mediation analyses were performed to estimate the mediated effects of education levels, family poverty income ratio, and parity on the association between AFB and the likelihood of frailty. Finally, sensitivity and subgroup analyses were conducted to validate the robustness of our findings. RESULTS Among the 10,828 women, 3828 (35.4 %) had frailty. The RCS depicted a U-shaped association between AFB and frailty. Compared with the women in the reference group (AFB: 33-35 years), women in the other groups (AFB: < 18, 18-20, 21-23, and 24-26 years) had a higher likelihood of frailty, with respective odds ratios (95 % confidence intervals) of 3.02 (1.89-4.83), 2.32 (1.54-3.50), 1.83 (1.19-2.81), and 1.64 (1.07-2.53). However, no statistically significant differences were detected for women with AFB of 27-29, 30-32, or > 35 years compared with the reference group. Education levels, family poverty income ratio, and parity significantly mediated the approximately linear negative association between AFB and frailty in the subset of women with AFB of ≤32 years and the mediation proportions were 23.4 %, 32.4 %, and 18.3 %, respectively (all p < 0.001). CONCLUSIONS Based on our results, we conclude that early AFB is associated with a higher likelihood of frailty in middle-aged and older women.
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Affiliation(s)
- Hui-Jie Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong 511400, China
| | - Yi-Lu Ye
- Department of Rehabilitation Medicine, Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510700, China
| | - Yun-Fei Gao
- Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510080, China; Department of Gynecology and Obstetrics, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 511300, China.
| | - Zhi-Hua Liu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510080, China.
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Sonne C, Desforges JP, Gustavson K, Bossi R, Bonefeld-Jørgensen EC, Long M, Rigét FF, Dietz R. Assessment of exposure to perfluorinated industrial substances and risk of immune suppression in Greenland and its global context: a mixed-methods study. Lancet Planet Health 2023; 7:e570-e579. [PMID: 37437998 DOI: 10.1016/s2542-5196(23)00106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/25/2022] [Accepted: 05/03/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are ubiquitous global contaminants that do not readily biodegrade and are therefore routinely found worldwide in wildlife, humans, and the environment. There is a paucity of global assessments to understand regional and continental differences in exposure to PFASs and the associated health risks, including those for Indigenous Arctic communities who consume high trophic marine diets. We aimed to estimate the long-term exposure of dietary PFASs from consumption of polar bear and ringed seal meat and establish its association with blood serum concentrations of PFASs in Inuit in Ittoqoortoormiit (Scoresby Sound), East Greenland. We also aimed to assess the risk of immune suppression on the basis of European Food Safety Authority (EFSA) thresholds for weekly intake and blood serum concentrations of PFASs. Last, we conducted a worldwide risk assessment based on blood concentrations of PFASs emphasising Arctic exposure in a global context. METHODS In this mixed-methods study, we conducted interviews to compare dietary exposure of PFASs in anonymous, non-pregnant, Inuit adults (aged ≥18 years) from full-time or part-time hunter families in Ittoqoortoormiit, East Greenland with ESFA toxic threshold values for tolerable weekly intake of the four most immunotoxic PFASs (∑4PFAS; perfluorooctanoic acid, perfluorononanoic acid, perfluorohexanesulfonic acid, and perfluorooctane sulfonate). Independent hospital staff from the local hospital randomly selected participants using simple randomisation using a telephone directory. Blood serum concentrations were then compared with EFSA risk categories: low (0·7-9·5 ng/mL), moderate (>9·5-17·5 ng/mL), high (>17·5-31·9 ng/mL), and severe (>31·9 ng/mL). We also reviewed the available scientific literature of ∑4PFAS concentrations in human blood to place the Inuit dataset in a broader global context. FINDINGS Between Sept 21, and Oct 2, 2015, 22 participants were enrolled in the study, of which 12 were male and ten were female. Sex data were obtained from personal social security numbers and options were male or female. As a result of a subsistence diet high in marine mammal muscle, 322 (92%) of 350 people in the Ittoqoortoormiit cohort exceeded the established immunotoxic thresholds of ∑4PFASs set by EFSA's tolerable weekly intake of 4·4 ng/kg, and 301 (86%) were in the most severe risk category (>31·9 ng/mL) based on blood serum concentrations. This Inuit cohort had the highest non-occupational long-term exposure to PFASs worldwide despite their remote location relative to industrial sources. Using country-wide average values across global studies, we found that blood serum concentrations of PFASs in populations from European countries, North America, the Arctic, and Australia were generally higher than those in South America, Africa, and mainland Asia, with the highest concentrations found in people from USA, Canada, Greenland, Faroe Islands, Denmark, Iceland, Norway, Sweden, the UK, Spain, Poland, and Australia. These high exposure countries all fall within the EFSA moderate-risk and high-risk categories. INTERPRETATION PFAS contamination of the environment and human populations occurs worldwide. This pollution not only poses substantial risks for immune system adverse events but also cardiovascular, cancerous, and reproductive endpoints. Data on such PFAS exposure is scarce in numerous countries. Therefore, it is important to also map out the exposure in these countries to enable a thorough global assessment of exposure and risks. FUNDING Danish Cooperation for Environment in the Arctic.
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Affiliation(s)
- Christian Sonne
- Department of Ecoscience, Arctic Research Centre, Aarhus University, Roskilde, Denmark; Henan Agricultural University, Zhengzhou, China.
| | - Jean-Pierre Desforges
- Department of Environmental Studies and Science, University of Winnipeg, Winnipeg, MB, Canada
| | - Kim Gustavson
- Department of Ecoscience, Arctic Research Centre, Aarhus University, Roskilde, Denmark
| | - Rossana Bossi
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Eva C Bonefeld-Jørgensen
- Department of Public Health, Centre for Arctic Health and Molecular Epidemiology, Aarhus University, Aarhus, Denmark; Greenland Centre for Health Research, Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | - Manhai Long
- Department of Public Health, Centre for Arctic Health and Molecular Epidemiology, Aarhus University, Aarhus, Denmark
| | - Frank F Rigét
- Department of Ecoscience, Arctic Research Centre, Aarhus University, Roskilde, Denmark
| | - Rune Dietz
- Department of Ecoscience, Arctic Research Centre, Aarhus University, Roskilde, Denmark
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Houd S, Sørensen HCF, Clausen JA, Maimburg RD. Giving birth in rural Arctic Greenland results from an Eastern Greenlandic birth cohort. Int J Circumpolar Health 2022; 81:2091214. [PMID: 35723230 PMCID: PMC9225745 DOI: 10.1080/22423982.2022.2091214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Eastern Greenland is one of the most remote areas in the world. Approximately 3,500 people lives in two small towns and five villages. There is limited information on birth outcomes in Eastern Greenland. A cohort of all birthing women from Eastern Greenland from 2000 to 2017 was established and pregnancy, birth, and neonatal outcomes were described. A total of 1,344 women and 1,355 children were included in the cohort where 14.5% of the women were 18 years or younger, and 36.2% were single parents. Most women, 84.8% gave birth in East Greenland and 92.9%, experienced a vaginal, non-instrumental birth. The overall caesarean section rate was 6.5%. The rate of premature births was 10.1% and 2.2% of the children were born with malformations. The rate of premature births was high, preventive initiatives such as midwifery-led continuity of care including a stronger focus on the pregnant woman’s social and mental life situation may be recommended. Organisation of maternity services in East Greenland may benefit from a strong focus on public health, culture, and setting specific challenges, including the birth traditions of the society.
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Affiliation(s)
- Susanne Houd
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Rikke Damkjær Maimburg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.,School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
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Rink E, Anastario M, Reimer GA, Peterson M. An ecological approach to understanding Women's reproductive health and pregnancy decision making in Greenland. Health Place 2022; 77:102868. [PMID: 35932597 DOI: 10.1016/j.healthplace.2022.102868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 12/27/2022]
Abstract
Using a community based participatory research framework and ecological systems theory we explored the experiences of reproductive health among Inuit women living in a remote Northwestern settlement in Greenland to understand the multiple diverse factors that influence their pregnancy outcomes. We conducted 15 in depth interviews with Inuit women between the ages of 19 and 45. Key factors influencing women's pregnancy decision making were: 1) precursors to pregnancy; 2) birth control use; 3) adoption and abortion; and 4) access to reproductive health care. Our results highlight the need to identify pathways through research, policy, health promotion, and health care practice that can support Inuit women in Greenland to be reproductively healthy and make informed decisions about pregnancy that resonate with their cultural beliefs as well as the realities of their everyday lives. We recommend the integration of cultural messaging into interdisciplinary approaches for preventive reproductive health care with women living in remote Arctic communities.
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Affiliation(s)
- Elizabeth Rink
- Montana State University, Department of Health and Human Development, 312 Herrick Hall, Bozeman, MT, 59719, USA.
| | - Mike Anastario
- Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
| | - Gitte Adler Reimer
- Ilisimatusarfik, University of Greenland, Postboks 1061, Nuuk, 3900, Greenland.
| | - Malory Peterson
- Montana State University, Department of Health and Human Development, 312 Herrick Hall, Bozeman, MT, 59719, USA.
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Wielsøe M, Long M, Bossi R, Vorkamp K, Bonefeld-Jørgensen EC. Persistent organic pollutant exposures among Greenlandic adults in relation to lifestyle and diet: New data from the ACCEPT cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 827:154270. [PMID: 35245549 DOI: 10.1016/j.scitotenv.2022.154270] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/20/2022] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
High concentrations of persistent organic pollutants (POPs) in blood of the Greenlandic population are well known. The exposure is mainly through traditional food intake, including marine mammals and seabirds. The present study aimed to follow up on POP concentrations (organochlorine pesticides, polychlorinated biphenyls, per- and polyfluoroalkyl substances, and halogenated flame retardants (HFRs)) and relations to lifestyle and diet of the mothers included in the Greenlandic ACCEPT cohort (3-5 years after inclusion in 2013-15) and to include the children's fathers. This new data collection in 2019-20 included blood samples for measurement of POP concentrations and lifestyle and food frequency questionnaires from 101 mothers and 76 fathers aged 24-55 years living in Nuuk, Sisimiut, and Ilulissat, Greenland. The mothers' intra-individual median percentage decrease in POP concentrations from inclusion to this follow-up (3-5 years later) was 16-58%, except for mirex (0% change). Median concentrations of POPs were 1.4-4.6 times higher in fathers than in mothers. The POPs differed by residential town with generally higher concentrations in Ilulissat compared to Sisimiut and Nuuk. We report, for the first time, novel HFRs in human samples from Greenland. However, concentrations were low and only dechlorane plus (with its anti-isomer) was detected in >50% of the samples. Most POPs correlated positively with age and n-3/n-6 fatty acid ratio. The lipophilic POPs correlated positively with the percentage of life lived in Greenland, whereas few POPs correlated positively with BMI, income (personal and household), education, and alcohol intake. The POPs generally associated positively with the intake of marine mammals, seabirds, and dried fish, while few POPs associated positively with Greenlandic fish intake. In contrast, POPs generally associated negatively with imported meat products intake. The study findings may be of interest for future dietary recommendations in Greenland. We discuss the potential explanations for the findings and suggestions for future research.
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Affiliation(s)
- Maria Wielsøe
- Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark.
| | - Manhai Long
- Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Rossana Bossi
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Katrin Vorkamp
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Eva Cecilie Bonefeld-Jørgensen
- Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark; Greenland Centre for Health Research, University of Greenland, Manutooq 1, 3905 Nuussuaq, Greenland.
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Dioxin-like Activity in Pregnant Women and Indices of Fetal Growth: The ACCEPT Birth Cohort. TOXICS 2022; 10:toxics10010026. [PMID: 35051068 PMCID: PMC8781564 DOI: 10.3390/toxics10010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/28/2021] [Indexed: 02/01/2023]
Abstract
Exposure to lipophilic persistent organic pollutants (lipPOPs) elicits a number of species- and tissue-specific toxic responses, many of which involve the aryl hydrocarbon receptor (AhR). This study aims to measure the combined serum dioxin-like activity of lipPOPs in Greenlandic Inuit pregnant women and the associations with fetal growth indices. The combined dioxin-like activity of serum lipPOPs extracts was determined using the AhR reporter gene bioassay and expressed as pico-gram (pg) TCDD equivalent (TEQ) per gram serum lipid [AhR-TEQ (pg/g lipid)]. Significant AhR-TEQ was found in >87% of serum samples with the median level of 86.2 pg TEQ/g lipid. The AhR-TEQ level positively correlated with the marine food intake biomarker n-3/n-6 polyunsaturated fatty acids ratio, while negatively correlated with body mass index and parity. Women giving birth to infants with low birth weight (<2500 g) and length (<50 cm) had higher AhR-TEQ level compared to those with normal weight and length infants. For previous smokers, we found significant inverse associations between maternal AhR-TEQ level and fetal growth indices. In conclusion, exposure of Greenlandic Inuit pregnant women to dioxin-like compounds through traditional marine food can adversely influence the fetal growth via induced AhR activity. Smoking might have modifying effects.
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Prenatal exposure to persistent organic pollutants and metals and problematic child behavior at 3-5 years of age: a Greenlandic cohort study. Sci Rep 2021; 11:22182. [PMID: 34772976 PMCID: PMC8589846 DOI: 10.1038/s41598-021-01580-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022] Open
Abstract
High levels of persistent organic pollutants (POPs) and heavy metals are found in Arctic populations. POP and heavy metals are linked to impaired cognitive development. This study examined associations between prenatal POP and metals exposure and problematic child behavior using the Strength and Difficulties Questionnaire (SDQ). POPs and metals were measured in 102 pregnant Greenlandic women. During follow-up at 3–5 years, parents answered an assisted questionnaire including children’s SDQ scores. Associations were analyzed using linear and logistic regression analyses and adjusted for maternal plasma cotinine, educational level and age at delivery. In the adjusted analyses, the medium tertile of hexachlorobenzene (β = 3.06, p = 0.010), β-hexachlorocyclohexane (β = 3.58, p = 0.004) and trans-nonachlor (β = 2.06, p = 0.082) were positively associated with SDQ scores. The continuous cis-nonachlor (OR = 1.09, p = 0.079), dichloro-diphenyl-dichloroethylene (OR = 1.01, p = 0.077), trans-nonachlor (OR = 1.01, p = 0.091), and sum Organochlorine-Pesticides (OR = 1.00, p = 0.094) were positively associated with abnormal SDQ score and the continuous mirex (OR = 1.28, p = 0.096), oxychlordane (OR = 1.04, p = 0.066), and trans-nonachlor (OR = 1.02, p = 0.071) with abnormal hyperactivity score. We found no consistent evidence of associations between polychlorinated biphenyls, perfluoroalkylated substances and heavy metals and problematic behavior. Prenatal organochlorine pesticide exposure associated significantly with problematic behavior in 3–5 year old children.
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Kok Grouleff M, Wielsøe M, Berthelsen D, Mulvad G, Isidor S, Long M, Bonefeld-Jørgensen EC. Anthropometric measures and blood pressure of Greenlandic preschool children. Int J Circumpolar Health 2021; 80:1954382. [PMID: 34291707 PMCID: PMC8300929 DOI: 10.1080/22423982.2021.1954382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The study aims to describe anthropometric data of Greenlandic preschool children, blood pressure (BP) measures and effects of maternal smoking during pregnancy in a follow-up of the ACCEPT birth cohort. The study included 102 children (55 boys and 47 girls) aged 3.5–5.5 years. Anthropometric measures included weight, height, head circumference (HC), body mass index (BMI), waist and hip circumference, ratio for height/weight, waist/height, waist/hip and BP measurements. Overweight and obesity-prevalence was determined using the international obesity task force BMI references for children. Significant increases in anthropometrics from 3.5 to 5.5 years included weight, height, HC and hip circumference, whereas ratio for height/weight, waist/hip and waist/height decreased. Boys had significantly larger HC than girls. The prevalence of overweight and obesity was similar (35.1%) between genders. Mean systolic and diastolic BP were 104 and 68 mmHg, respectively. Children of mothers smoking during pregnancy had higher hip circumference, lower waist/hip ratio and higher diastolic BP. The study present updated anthropometric data and BP of Greenlandic preschool children and effects of maternal smoking during pregnancy. The prevalence of overweight and obesity was higher than previously reported and maternal smoking during pregnancy affected the child data. Abbreviations ACCEPT: Adaptation to Climate Change, Environmental Pollution and dietary Transition; BMI: Body Mass Index; BP: Blood Pressure; Circ: Circumference; DBP: Diastolic Blood Pressure; FFH: Fisher-Freeman-Halton exact test; HC: Head Circumference; H: Height; HDL: high-density lipoprotein; HiC: Hip Circumference; IOTF International Obesity Task Force, Max: maximum, Min: minimum, P25: 25th percentile, P75: 75th percentile, SBP: Systolic Blood Pressure, SD: Standard Deviation; VDLD: very-low-density lipoprotein; WaC: Waist Circumference, W: Weight, WHO: World Health Organization.
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Affiliation(s)
- Magnus Kok Grouleff
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Maria Wielsøe
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dina Berthelsen
- Department of Health Care, Queen Ingrid's Health Center, Nuuk, Greenland
| | - Gert Mulvad
- Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
| | - Silvia Isidor
- Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
| | - Manhai Long
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Eva Cecilie Bonefeld-Jørgensen
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.,Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
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10
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Wielsøe M, Berthelsen D, Mulvad G, Isidor S, Long M, Bonefeld-Jørgensen EC. Dietary habits among men and women in West Greenland: follow-up on the ACCEPT birth cohort. BMC Public Health 2021; 21:1426. [PMID: 34281541 PMCID: PMC8290613 DOI: 10.1186/s12889-021-11359-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/21/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In the past decades, the diet in Greenland has been in transition resulting in a lower intake of traditional food and a higher intake of imported western food. This diet transition can affect public health negatively, and thus, continued monitoring of dietary habits is important. The present study aimed to follow up on the dietary habits of pregnant women included in the Greenlandic ACCEPT birth cohort (2013-2015) and the children's father. METHODS The follow-up food intake was assessed in 2019-2020 using food frequency questionnaires for 101 mothers and 76 fathers aged 24-55 years living in Nuuk, Sisimiut, and Ilulissat. Non-parametric statistical methods were used (Mann-Whitney U test/Spearman correlation) to assess the dietary pattern and influencing factors. RESULTS The proportion of traditional and imported food was 14 and 86%, respectively. Intake frequency differed by gender (vegetables, fruits, fast food), the living town (terrestrial animals, vegetables, fruits), and age (fish, meat products, fruits, fast food). Socioeconomic and lifestyle factors significantly correlated with the intake frequency of several traditional and imported foods. Few changes in the mother's dietary habits from inclusion (during pregnancy) to follow-up (3-5 years later) were found, showing less frequent intake of seabirds and fruits and more frequent meat intake. CONCLUSION We identified several factors that could affect dietary habits, and the results may be used to target future food recommendation for relevant population groups.
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Affiliation(s)
- Maria Wielsøe
- Department of Public Health, Aarhus University, Centre for Arctic Health & Molecular Epidemiology, Aarhus, Denmark.
| | | | - Gert Mulvad
- Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Silvia Isidor
- Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Manhai Long
- Department of Public Health, Aarhus University, Centre for Arctic Health & Molecular Epidemiology, Aarhus, Denmark
| | - Eva Cecilie Bonefeld-Jørgensen
- Department of Public Health, Aarhus University, Centre for Arctic Health & Molecular Epidemiology, Aarhus, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
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11
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Adlard B, Lemire M, Bonefeld-Jørgensen EC, Long M, Ólafsdóttir K, Odland JO, Rautio A, Myllynen P, Sandanger TM, Dudarev AA, Bergdahl IA, Wennberg M, Berner J, Ayotte P. MercuNorth - monitoring mercury in pregnant women from the Arctic as a baseline to assess the effectiveness of the Minamata Convention. Int J Circumpolar Health 2021; 80:1881345. [PMID: 34080521 PMCID: PMC8183506 DOI: 10.1080/22423982.2021.1881345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Exposure to mercury (Hg) is a global concern, particularly among Arctic populations that rely on the consumption of marine mammals and fish which are the main route of Hg exposure for Arctic populations.The MercuNorth project was created to establish baseline Hg levels across several Arctic regions during the period preceding the Minamata Convention. Blood samples were collected from 669 pregnant women, aged 18-44 years, between 2010 and 2016 from sites across the circumpolar Arctic including Alaska (USA), Nunavik (Canada), Greenland, Iceland, Norway, Sweden, Northern Lapland (Finland) and Murmansk Oblast (Russia). Descriptive statistics were calculated, multiple pairwise comparisons were made between regions, and unadjusted linear trend analyses were performed.Geometric mean concentrations of total Hg were highest in Nunavik (5.20 µg/L) and Greenland (3.79 µg/L), followed by Alaska (2.13 µg/L), with much lower concentrations observed in the other regions (ranged between 0.48 and 1.29 µg/L). In Nunavik, Alaska and Greenland, blood Hg concentrations have decreased significantly since 1992, 2000 and 2010 respectively with % annual decreases of 4.7%, 7.5% and 2.7%, respectively.These circumpolar data combined with fish and marine mammal consumption data can be used for assessing long-term Hg trends and the effectiveness of the Minamata Convention.
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Affiliation(s)
- Bryan Adlard
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Mélanie Lemire
- Axe Santé Des Populations Et Pratiques Optimales En Santé, Centre De Recherche Du CHU De Québec, Québec, QC, Canada.,Département De Médecine Sociale Et Préventive, Université Laval, Québec, QC, Canada
| | - Eva C Bonefeld-Jørgensen
- Center for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark.,Greenland Center for Health Research, University of Greenland, Nuuk, Greenland
| | - Manhai Long
- Center for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Kristín Ólafsdóttir
- Department of Pharmacology and Toxicology, University of Iceland, Reykjavik, Iceland
| | - Jon O Odland
- Institute of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.,International Research Laboratory for Reproductive Ecotoxicology (IL RET), The National Research University Higher School of Economics, Moscow, Russia
| | - Arja Rautio
- Thule Institute and Faculty of Medicine, University of Oulu and University of Arctic, Oulu, Finland
| | - Päivi Myllynen
- Northern Finland Laboratory Centre Nordlab, Northern Finland Laboratory Centre Nordlab, Oulu University Hospital, Oulu, Finland
| | - Torkjel M Sandanger
- Environmental Chemistry Department, NILU-Norwegian Institute for Air Research, the Fram Centre, Tromsø, Norway.,Department of Community Medicine, UiT-The Arctic University of Norway, Tromso, Norway
| | - Alexey A Dudarev
- Department of Arctic Environmental Health, Northwest Public Health Research Center, St. Petersburg, Russia
| | - Ingvar A Bergdahl
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Maria Wennberg
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - James Berner
- Department of Environment and Health, Division of Community Health, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Pierre Ayotte
- Axe Santé Des Populations Et Pratiques Optimales En Santé, Centre De Recherche Du CHU De Québec, Québec, QC, Canada.,Département De Médecine Sociale Et Préventive, Université Laval, Québec, QC, Canada.,Centre De Toxicologie, Institut National De Santé Publique Du Québec, Québec, QC, Canada
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12
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Long M, Wielsøe M, Bonefeld-Jørgensen EC. Time Trend of Persistent Organic Pollutants and Metals in Greenlandic Inuit during 1994-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2774. [PMID: 33803338 PMCID: PMC7967253 DOI: 10.3390/ijerph18052774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/19/2021] [Accepted: 02/26/2021] [Indexed: 12/14/2022]
Abstract
Persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs), organchlorine pesticides and perfluoroalkylated substances (PFASs) and heavy metals bioaccumulate in the marine food chain in the Arctic regions, and thus, the Greenlandic population has a higher body burden due to relatively high intake of marine mammals. We assessed the temporal trend for POPs, including PCB 153; 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE); oxychlordane; six PFASs; mercury; lead and selenium in Inuit from Ilulissat, Nuuk, and across Greenland (including thirteen towns/districts), from 1994 to 2015. Data showed a significant annual decrease of 6.85-8.61% for PCB153, 6.67-8.61% for p,p'-DDE, 6.11-9.52% for oxychlordane, 5.92-6.76% for mercury and 6.48-9.43% for lead in Inuit women from Nuuk, Ilulissat, and across thirteen Greenlandic districts. The blood selenium level of all Greenlandic women increased 1.01% annually, while the trend direction was negative for Nuuk women. A similar pattern was seen for men across Greenland, with a yearly decrease of 11.3% for PCB 153, 8.61% for p,p'-DDE, 15.6% for oxychlordane, 13.1% for mercury and 12.2% for lead. Perfluorooctane sulfonate, perfluorohexane sulfonate and perfluorooctanoic acid significantly decreased 5.82-11.7% annually for both women and men across Greenland. For perfluorononanoic acid, perfluorodecanoic acid and perfluoroundecanoic acid, we observed an increasing trend for women across Greenland. In conclusion, there was a decreasing trend of the regulated POPs and metals but a potential increasing trend of the nonregulated PFASs in the Greenlandic population between 1994 and 2015. The continuing biomonitoring of contaminants of concern is important to protect the Arctic population heath.
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Affiliation(s)
- Manhai Long
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (M.W.); (E.C.B.-J.)
| | - Maria Wielsøe
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (M.W.); (E.C.B.-J.)
| | - Eva Cecilie Bonefeld-Jørgensen
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (M.W.); (E.C.B.-J.)
- Greenland Center for Health Research, University of Greenland, 3905 Nuuk, Greenland
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13
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Adamou TY, Riva M, Muckle G, Laouan Sidi EA, Lemire M, Ayotte P. Blood mercury and plasma polychlorinated biphenyls concentrations in pregnant Inuit women from Nunavik: Temporal trends, 1992-2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 743:140495. [PMID: 32758811 DOI: 10.1016/j.scitotenv.2020.140495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 05/18/2023]
Abstract
The Inuit of Nunavik (Northern Quebec, Canada) are exposed to polychlorinated biphenyls (PCBs) and mercury (Hg) through their consumption of marine country foods. A temporal trend study was initiated in 1992 to monitor circulating levels of PCBs and Hg in pregnant Inuit women, since the fetus is most at risk of adverse health effects. We set out (1) to describe temporal trends of PCBs and Hg levels in pregnant Nunavik women between 1992 and 2017; (2) to determine the prevalence of participants exceeding the guidance values in 2017; (3) to investigate relations between marine country food intake and contaminant levels over the study period. A total of 559 pregnant women provided a blood sample for contaminant analysis from 1992 to 2017. PCB congeners were quantified in plasma (serum) by gas chromatography (GC) coupled to electron capture detection or mass spectrometry (MS). We determined whole blood mercury concentration by cold vapor atomic absorption or inductively-coupled plasma MS. We performed multilevel modeling to assess temporal trends in contaminant levels and relations with marine country food consumption. Concentrations of total PCBs and Hg decreased by 84% and 65% between 1992 and 2017, respectively. Nevertheless, 10% and 22% of women in 2017 exceeded guidance values for PCBs and Hg, respectively. While the decline in marine country food intake is the only factor associated with decreasing Hg levels, other factors may explain the decline in PCB levels. Despite the significant decline in PCBs and Hg levels from 1992 to 2017, exposure to these contaminants is still quite prevalent among pregnant Nunavik women. Most of the decline in Hg exposure is likely due to a shift away from marine country foods to store-bought foods, which is a concern given the cultural and nutritional importance of country foods and the high food insecurity that prevails in Nunavik.
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Affiliation(s)
- Thérèse Yéro Adamou
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Faculté des sciences infirmières, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada.
| | - Mylène Riva
- Canada Research Chair in Housing, Community, and Health, Institute for Health and Social Policy, McGill University, Avenue des Pins, Montréal, QC H3A 1A3, Canada; Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Gina Muckle
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada.
| | - Elhadji Anassour Laouan Sidi
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada.
| | - Mélanie Lemire
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada.
| | - Pierre Ayotte
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada; Centre de toxicologie, Institut National de Santé Publique du Québec, 945 avenue Wolfe, Québec, QC G1V 5B3, Canada.
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Timmermann CAG, Pedersen HS, Budtz-Jørgensen E, Bjerregaard P, Oulhote Y, Weihe P, Nielsen F, Grandjean P. Environmental chemical exposures among Greenlandic children in relation to diet and residence. Int J Circumpolar Health 2020; 78:1642090. [PMID: 31339476 PMCID: PMC6711189 DOI: 10.1080/22423982.2019.1642090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The objective of this study was to identify geographic, dietary, and other predictors for childhood exposure to perfluoroalkyl substances (PFASs), polychlorinated biphenyls (PCBs), and methylmercury in Greenlandic children. The study includes cross-sectional data from 367 Greenlandic children aged 7 to 12 years examined during 2012-2015. A parent or guardian participated in a structured interview, and a blood sample from the child was analysed for PFASs, PCBs and total mercury. Predictors for the environmental exposures were identified using linear regression. Area of residence was found to have the strongest explanatory power, accounting for 24% to 68% of the variance in the serum concentrations. Information about diet was available for two-thirds of the children, and among these, consumption of traditional Greenlandic food accounted for 2% to 10% of the variance in the biomarker concentrations. Models including all predictors associated with at least one of the environmental chemicals explained 19% to 54% of the total variance. In conclusion, area is a likely proxy for a traditional marine diet, and together area and diet constitute the most important predictors of exposure to methylmercury, PCBs and PFASs among Greenlandic children.
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Affiliation(s)
| | - Henning Sloth Pedersen
- a Department of Environmental Medicine, University of Southern Denmark , Odense C , Denmark.,b Greenland Centre for Health Research, University of Greenland , Nuuk , Greenland
| | | | - Peter Bjerregaard
- b Greenland Centre for Health Research, University of Greenland , Nuuk , Greenland.,d National Institute of Public Health, University of Southern Denmark , Copenhagen K , Denmark
| | - Youssef Oulhote
- e Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Pál Weihe
- f Department of Occupational Medicine and Public Health, The Faroese Hospital System , Tórshavn , Faroe Islands.,g Center of Health Science, University of The Faroe Islands , Tórshavn , Faroe Islands
| | - Flemming Nielsen
- a Department of Environmental Medicine, University of Southern Denmark , Odense C , Denmark
| | - Philippe Grandjean
- a Department of Environmental Medicine, University of Southern Denmark , Odense C , Denmark.,e Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston , MA , USA
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15
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Hjermitslev MH, Long M, Wielsøe M, Bonefeld-Jørgensen EC. Persistent organic pollutants in Greenlandic pregnant women and indices of foetal growth: The ACCEPT study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 698:134118. [PMID: 31494415 DOI: 10.1016/j.scitotenv.2019.134118] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 06/10/2023]
Abstract
The Greenlandic population has some of the highest levels of environmental persistent organic pollutants (POPs) globally. Studies have previously found POPs to be linked with disturbance of child development, immune function and reproductive abilities. We investigated the associations between serum POP levels of pregnant women in Greenland and their infant's birth weight, length, head circumference and gestational age (GA) at birth. Pregnant Greenlandic women (n = 504) were enrolled during pregnancy and serum levels of the lipophilic POPs (Organochlorine pesticides, Polychlorinated biphenyls and Polybrominated diphenyl ethers) and the amphiphilic POPs, Perfluoroalkylated substances (PFASs), were measured. We analysed the associations between maternal serum levels of POPs and birth weight, length, head circumference and GA using linear regression analysis. We found significant inverse associations between Perfluorooctanoic Acid (PFOA) and birth weight (adjusted β = -119 g, 95% CI: -201; -36), birth length (adjusted β = -0.37 cm, 95% CI: -0.76; 0.02, borderline significant) and head circumference (adjusted β = -0.35 cm, 95% CI: -0.59; -0.10) and a positive association with GA (adjusted β = 0.45 week, 95% CI: 0.17; 0.74). For the lipophilic POPs, we found an overall trend of inverse associations to foetal growth indices. In conclusion, we found that the amphiphilic PFOA had a significant inversely association with foetal growth indices, whereas GA was positively associated. The data indicate that POPs have a negative effect on foetal growth.
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Affiliation(s)
- Marie Harthøj Hjermitslev
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Manhai Long
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Maria Wielsøe
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Eva C Bonefeld-Jørgensen
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Denmark; Greenland Center for Health Research, University of Greenland, Nuuk, Greenland.
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Abstract
OBJECTIVE To compare the dietary habits of children living in northern villages and in the capital of Greenland, given the reported transition from traditional to westernised diet in adults over recent decades, and to explore the association between consumption of marine mammals and fish (MMF) and the children's metabolic profile and vitamin D status. DESIGN Children answered an FFQ encompassing sixty-four individual food types pooled into six food categories. Their pubertal stage, body fat, fitness level, metabolic profile (non-HDL-cholesterol, glycated Hb, insulin, glucose, high-sensitivity C-reactive protein) as well as serum 25-hydroxyvitamin D (25(OH)D) concentration were evaluated. SETTING Siorapaluk and Qaanaaq (north of Greenland) and Nuuk (west). PARTICIPANTS Children aged 6-18 years (n 177). RESULTS MMF were most frequently eaten by children from Siorapaluk (mean (sd): 73·4 (14·1) times/month), followed by children from Qaanaaq (37·0 (25·0) times/month), and least often eaten by children from Nuuk (23·7 (24·6) times/month; P < 0·001). Children from Qaanaaq consumed 'junk food' more frequently (P < 0·001) and fruits and vegetables less frequently (P < 0·01) than children from Nuuk. MMF consumption was positively associated with serum 25(OH)D concentration (P < 0·05), but the overall prevalence of vitamin D deficiency was high (18 %). No association was found between MMF consumption and metabolic parameters. CONCLUSIONS The dietary transition and influence of western diets have spread to the north of Greenland and only the most remote place consumed a traditional diet highly based on MMF. We found no strong associations of MMF consumption with metabolic health, but a positive association with vitamin D status.
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Bank-Nielsen PI, Long M, Bonefeld-Jørgensen EC. Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010⁻2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1171. [PMID: 30939809 PMCID: PMC6479494 DOI: 10.3390/ijerph16071171] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 12/23/2022]
Abstract
Environmental contaminants such as heavy metals are transported to the Arctic regions via atmospheric and ocean currents and enter the Arctic food web. Exposure is an important risk factor for health and can lead to increased risk of a variety of diseases. This study investigated the association between pregnant women's levels of heavy and essential metals and the birth outcomes of the newborn child. This cross-sectional study is part of the ACCEPT birth cohort (Adaption to Climate Change, Environmental Pollution, and dietary Transition) and included 509 pregnant Inuit women ≥18 years of age. Data were collected in five Greenlandic regions during 2010⁻2015. Population characteristics and birth outcomes were obtained from medical records and midwives, respectively, and blood samples were analyzed for 13 metals. Statistical analysis included one-way ANOVA, Spearman's rho, and multiple linear and logistic regression analyses. The proportion of current smokers was 35.8%. The levels of cadmium, chromium, and nickel were higher compared to reported normal ranges. Significant regional differences were observed for several metals, smoking, and parity. Cadmium and copper were significantly inversely related to birth outcomes. Heavy metals in maternal blood can adversely influence fetal development and growth in a dose⁻response relationship. Diet and lifestyle factors are important sources of toxic heavy metals and deviant levels of essential metals. The high frequency of smokers in early pregnancy is of concern, and prenatal exposure to heavy metals and other environmental contaminants in the Greenlandic Inuit needs further research.
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Affiliation(s)
- Per I. Bank-Nielsen
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
| | - Manhai Long
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
| | - Eva C. Bonefeld-Jørgensen
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
- Greenland Center for Health Research, University of Greenland, 3900 Nuuk, Greenland
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18
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Knudsen AKS, Long M, Pedersen HS, Bonefeld-Jørgensen EC. Persistent organic pollutants and haematological markers in Greenlandic pregnant women: the ACCEPT sub-study. Int J Circumpolar Health 2019; 77:1456303. [PMID: 29595373 PMCID: PMC5912198 DOI: 10.1080/22423982.2018.1456303] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Arctic populations have high blood concentrations of persistent organic pollutants (POPs). Exposure to POPs was related to adverse health effects e.g. immune, neurological and reproductive systems. This study investigates associations between serum POP levels and haematological markers in Greenlandic pregnant women. This cross-sectional study included 189 women enrolled in 2010–2011 at the Greenlandic West coast by the inclusion criteria ≥18 years of age and had lived for 50% or more of their life in Greenland. The associations between the sum of the POP variables polychlorinated biphenyls (sumPCBs), organochlorine pesticides (sumOCPs), perfluoroalkylated substances (sumPFASs) and 24 haematological markers were analysed using linear regression adjusted for age, pre-pregnancy BMI, parity, gestation week, plasma-cotinine and alcohol intake. It showed a significantly inverse association between several haematological markers (eosinophil, lymphocyte, neutrophil and white blood cells) and sumPCBs, sumOCPs and sumPFASs. In addition, the monocyte, mean corpuscular haemoglobin concentration, plateletcrit and platelet count markers were significantly inversely associated with sumPFASs, but the haematocrit and mean erythrocyte corpuscular volume were positively associated with sumPFASs. In conclusion, exposure to POPs influenced several haematological markers, especially cell count parameters, suggesting immunosuppressive potential of POPs in Greenlandic pregnant women. The data need further investigations.
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Affiliation(s)
- Ane-Kersti Skaarup Knudsen
- a Centre for Arctic Health & Molecular Epidemiology, Department of Public Health , Aarhus University , Aarhus , Denmark.,b Emergency Department , Regional Hospital of Randers , Randers , Denmark
| | - Manhai Long
- a Centre for Arctic Health & Molecular Epidemiology, Department of Public Health , Aarhus University , Aarhus , Denmark
| | | | - Eva Cecilie Bonefeld-Jørgensen
- a Centre for Arctic Health & Molecular Epidemiology, Department of Public Health , Aarhus University , Aarhus , Denmark.,d Greenland Center for Health Research , University of Greenland , Nuuk , Greenland
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The Grocery Store Food Environment in Northern Greenland and Its Implications for the Health of Reproductive Age Women. J Community Health 2019; 43:175-185. [PMID: 28689340 DOI: 10.1007/s10900-017-0400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The population of Greenland is diminishing and environmental and social shifts implicate food availability and the health of reproductive age women. There is little knowledge of the grocery store food environment in Greenland. To address this gap and provide baseline information the present study measured food availability in five grocery stores in northern Greenland. As well, 15 interviews were conducted with reproductive age women, three grocery store managers were interviewed and one interview was conducted with a food distribution manager. Results show few fresh fruits and vegetables are available in grocery stores and in some stores no fresh foods are available. In Kullorsuaq, the primary location for this study, the Nutrition Environment Measures Survey in Stores score in spring 2016 was (3/30) and the Freedman Grocery Store Survey Score was (11/49). Interview results highlight a need to increase communication within the food system and to tailor food distribution policies to the Arctic context with longer term planning protocols for food distribution. These findings can be used to inform future food store environment research in Greenland and for informing policies that improve healthful food availability in grocery stores in northern Greenland.
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20
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Gomes CS, Pirkle CM, Barbosa JFS, Vafaei A, Câmara SMA, Guerra RO. Age at First Birth, Parity and History of Hysterectomy Are Associated to Frailty Status: Cross-Sectional Analysis from the International Mobility in Aging Study -Imias. J Cross Cult Gerontol 2018; 33:337-354. [DOI: 10.1007/s10823-018-9360-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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21
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Watson ZA, Miles MP, Shanks CB, Rink E. Sleep, physical activity, waist circumference and diet as factors that influence health for reproductive age women in northern Greenland. Glob Health Promot 2018; 27:6-14. [PMID: 29809106 DOI: 10.1177/1757975918764380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study explored community and individual factors that influence the health of reproductive age women in a settlement in northern Greenland. This is important because Greenland has a declining population, a high abortion rate and because of projected environmental shifts due to climate change. METHODS This study collected mixed methods data to explore diet, physical activity, sleep and waist circumference for reproductive age women in Kullorsuaq, Greenland. The daily steps and sleeping hours of 13 reproductive age women were measured using activity monitoring bracelets. Waist circumference measurements and in-depth interviews about daily eating and physical activity were conducted with 15 participants and ethnographic participant observations were recorded using field notes. RESULTS Waist circumference measurements were above recommended cutoffs established by the World Health Organization. Physical activity measured by daily steps was within the 'active' range using the cutoff points established by Tudor and Locke. Physical activity is social and is important for communal relationships. Sleeping hours were within normal ranges based on US guidelines; however, the quality of this sleep, its variability across seasons and cultural expectations of what healthy sleep means must be further explored. Diets of women included a mixture of locally harvested meats and imported packaged foods. Study participants experienced less satiety and reported getting hungrier faster when eating packaged foods. This research took place in Spring 2016 and women reported that their sleep, physical activity and diet fluctuate seasonally. CONCLUSION The reported findings suggest further investigation of sleep, diet and physical activity combined with the measurement of reproductive hormones to determine linkages between lifestyle factors and reproductive health outcomes is needed.
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Terkelsen AS, Long M, Hounsgaard L, Bonefeld-Jørgensen EC. Reproductive factors, lifestyle and dietary habits among pregnant women in Greenland: The ACCEPT sub-study 2013-2015. Scand J Public Health 2017; 46:252-261. [PMID: 28669327 DOI: 10.1177/1403494817714188] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. AIM To describe age and regional differences in reproductive factors, lifestyle and diet among Greenlandic pregnant women in their first trimester. METHODS A cross-sectional study during 2013-2015 including 373 pregnant women was conducted in five Greenlandic regions (West, Disko Bay, South, North and East). Interview-based questionnaires on reproductive factors, lifestyle and dietary habits were compared in relation to two age groups (median age ≤28 years and >28 years). RESULTS In total, 72.4% were Inuit, 46.6% had BMI >25.0 kg/m2, 29.0% were smoking during pregnancy and 54.6% had used hashish. BMI, educational level, personal income, previous pregnancies and planned breastfeeding period were significantly higher in the age group >28 years of age compared to the age group ≤28 years of age. In region Disko Bay, 90.9% were Inuit, in region South more had a university degree (37.9%) and region East had the highest number of previous pregnancies, the highest number of smokers during pregnancy and the most frequent intake of sauce with hot meals and fast-food. CONCLUSIONS Overall a high BMI and a high smoking frequency were found. Age differences were found for BMI and planned breastfeeding period, while regional differences were found for smoking and intake of sauce with hot meals and fast-food. Future recommendations aimed at pregnant women in Greenland should focus on these health issues.
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Affiliation(s)
- Anne Seneca Terkelsen
- 1 Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Manhai Long
- 1 Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lise Hounsgaard
- 2 Institute of Nursing & Health Science, University of Greenland, Nuuk, Greenland
| | - Eva Cecilie Bonefeld-Jørgensen
- 1 Centre for Arctic Health & Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.,2 Institute of Nursing & Health Science, University of Greenland, Nuuk, Greenland
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23
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Weihe P, Bjerregaard P, Bonefeld-Jørgensen E, Dudarev A, Halling J, Hansen S, Muckle G, Nøst T, Odland JØ, Petersen MS, Rautio A, Veyhe AS, Wennberg M, Bergdahl I. Overview of ongoing cohort and dietary studies in the Arctic. Int J Circumpolar Health 2016; 75:33803. [PMID: 27974135 PMCID: PMC5156866 DOI: 10.3402/ijch.v75.33803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article gives an overview of the ongoing cohort and dietary studies underlying the assessment of population health in the Arctic. The emphasis here is on a description of the material, methods and results or preliminary results for each study. Detailed exposure information is available in an article in this journal, whereas another paper describes the effects associated with contaminant exposure in the Arctic. The cohort descriptions have been arranged geographically, beginning in Norway and moving east to Finland, Sweden, Russia and the other Arctic countries and ultimately to the Faroe Islands. No cohort studies have been reported for Alaska or Iceland.
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Affiliation(s)
- Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands;
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Eva Bonefeld-Jørgensen
- Centre for Arctic Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Alexey Dudarev
- Northwest Public Health Research Center, St. Petersburg, Russia
| | - Jónrit Halling
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands
| | - Solrunn Hansen
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Gina Muckle
- École de Psychologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
| | - Therese Nøst
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands
| | - Arja Rautio
- Thule Institute, University of Oulu, Oulu, Finland
| | - Anna Sofía Veyhe
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Maria Wennberg
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Ingvar Bergdahl
- Department of Biobank Research, Umeå University, Umeå, Sweden
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24
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Moffitt P, Dickinson R. Creating exclusive breastfeeding knowledge translation tools with First Nations mothers in Northwest Territories, Canada. Int J Circumpolar Health 2016; 75:32989. [PMID: 27938644 PMCID: PMC5149661 DOI: 10.3402/ijch.v75.32989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/27/2016] [Accepted: 09/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background Breastfeeding is an ideal method of infant feeding affecting lifelong health, and yet the uptake of breastfeeding in some Indigenous communities in Canada's north is low. Objective The aims of this project were to determine the rate and determinants of exclusive breastfeeding in a remote community in the Northwest Territories and to create knowledge translation tools to enhance breastfeeding locally. Methods The study methodology followed three steps. Firstly, a series of retrospective chart audits were conducted from hospital birth records of Tłı̨chǫ women (n=198) who gave birth during the period of 1 January 2010 to 31 December 2012. A second follow-up chart audit determined the rate of exclusive breastfeeding and was conducted in the local Community Health Centre. Chart audit data included the following factors related to breastfeeding: age of mother, parity, birthweight and Apgar scores. Secondly, semi-structured interviews with a purposive sample of Tłı̨chǫ mothers (n=8) and one Elder were conducted to identify breastfeeding practices, beliefs and the most appropriate medium to use to deliver health messages in Tłı̨chǫ. Third, based on the information obtained in Step 2, two knowledge translation tools were developed in collaboration with a local community Advisory Committee. Results The rate of exclusive breastfeeding initiation in the Tłı̨chǫ region is less than 30%. Physiological and demographic factors related to breastfeeding were identified. Thematic analysis revealed two overarching themes from the data, namely, “the pull to formula” (lifestyle preferences, drug and alcohol use, supplementation practices and limited role models) and “the pull to breast feeding” (traditional feeding method, spiritual practice and increased bonding with infant). Conclusion There are a myriad of influences on breastfeeding for women living in remote locations. Ultimately, society informs the choice of infant feeding for the new mother, since mothers’ feeding choices are based on contextual realities and circumstances in their lives that are out of their control. As health care providers, it is imperative that we recognize the realities of women's lives and the overlapping social determinants of health that may limit a mother's ability or choice to breastfeed. Further health promotion efforts, grounded in community-based research and a social determinants framework, are needed to improve prenatal and postnatal care of Indigenous women and children in Canada.
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Affiliation(s)
- Pertice Moffitt
- Health Research Programs, Aurora Research Institute, Aurora College, Yellowknife, NWT, Canada;
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25
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Wielsøe M, Gudmundsdottir S, Bonefeld-Jørgensen E. Reproductive history and dietary habits and breast cancer risk in Greenlandic Inuit: a case control study. Public Health 2016; 137:50-8. [DOI: 10.1016/j.puhe.2016.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/14/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
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