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Gasull M, Camargo J, Pumarega J, Henríquez-Hernández LA, Campi L, Zumbado M, Contreras-Llanes M, Oliveras L, González-Marín P, Luzardo OP, Gómez-Gutiérrez A, Alguacil J, Porta M. Blood concentrations of metals, essential trace elements, rare earth elements and other chemicals in the general adult population of Barcelona: Distribution and associated sociodemographic factors. Sci Total Environ 2024; 909:168502. [PMID: 37977377 DOI: 10.1016/j.scitotenv.2023.168502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Very little information is available on the population distribution and on sociodemographic predictors of body concentrations of rare earth elements (REE) and other chemicals used in the manufacturing of high-tech devices. OBJECTIVES To analyze the distribution and associated sociodemographic factors of blood concentrations of chemical elements (including some metals, essential trace elements, rare earth elements and other minority elements) in a representative sample of the general population of Barcelona (Spain). METHODS A sample of participants in the Barcelona Health Survey of 2016 (N = 240) were interviewed face-to-face, gave blood, and underwent a physical exam. Concentrations of 50 chemical elements were analyzed by ICP-MS in whole blood samples. RESULTS All 50 chemicals studied, including 26 REE and minority elements, were detected. Lead, silver, arsenic, cadmium, mercury, antimony, strontium, thallium and six essential trace elements were detected in more than 70% of the population. The most frequently detected REE and minority elements were europium (62%), thulium (56%), gold (41%), indium (31%), ruthenium (24%), and tantalum (20%). Less affluent occupational social classes had higher percentages of detection of some REE. Median concentrations of silver, arsenic, cadmium and mercury were: 0.091, 3.01, 0.309, and 3.33 ng/mL, respectively. Women had lower median concentrations than men of lead (1.47 vs. 2.04 μg/dL, respectively), iron and zinc, and higher concentrations of copper and manganese. The influence of sociodemographic characteristics on chemical concentrations differed by sex. CONCLUSIONS While well-known contaminants as lead, mercury, cadmium, or arsenic were detected in the majority of the population, numerous individuals had also detectable concentrations of chemicals as europium, indium, thulium, or gold. Sociodemographic and physical characteristics (sex, age, social class, weight change) influenced concentrations of some chemicals.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Judit Camargo
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Pumarega
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Alberto Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Laura Campi
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Manuel Contreras-Llanes
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente, Universidad de Huelva, Huelva, Spain
| | - Laura Oliveras
- Qualitat i Intervenció Ambiental, Agència de Salut Pública de Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Patricia González-Marín
- Qualitat i Intervenció Ambiental, Agència de Salut Pública de Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Octavio P Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Anna Gómez-Gutiérrez
- Qualitat i Intervenció Ambiental, Agència de Salut Pública de Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Juan Alguacil
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente, Universidad de Huelva, Huelva, Spain
| | - Miquel Porta
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Pumarega J, Gasull M, Koponen J, Campi L, Rantakokko P, Henríquez-Hernández LA, Aguilar R, Donat-Vargas C, Zumbado M, Villar-García J, Rius C, Santiago-Díaz P, Vidal M, Jimenez A, Iglesias M, Dobaño C, Moncunill G, Porta M. Prepandemic personal concentrations of per- and polyfluoroalkyl substances (PFAS) and other pollutants: Specific and combined effects on the incidence of COVID-19 disease and SARS-CoV-2 infection. Environ Res 2023; 237:116965. [PMID: 37652221 DOI: 10.1016/j.envres.2023.116965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To investigate the specific and combined effects of personal concentrations of some per- and polyfluoroalkyl substances (PFAS), other persistent organic pollutants (POPs), and chemical elements -measured in individuals' blood several years before the pandemic- on the development of SARS-CoV-2 infection and COVID-19 disease in the general population. METHODS We conducted a prospective cohort study in 240 individuals from the general population of Barcelona. PFAS, other POPs, and chemical elements were measured in plasma, serum, and whole blood samples, respectively, collected in 2016-2017. PFAS were analyzed by liquid chromatography-triple quadrupole mass spectrometry. SARS-CoV-2 infection was detected by rRT-PCR in nasopharyngeal swabs and/or antibody serology in blood samples collected in 2020-2021. RESULTS No individual PFAS nor their mixtures were significantly associated with SARS-CoV-2 seropositivity or COVID-19 disease. Previously identified mixtures of POPs and elements (Porta et al., 2023) remained significantly associated with seropositivity and COVID-19 when adjusted for PFAS (all OR > 4 or p < 0.05). Nine chemicals comprised mixtures associated with COVID-19: thallium, ruthenium, lead, benzo[b]fluoranthene, DDD, other DDT-related compounds, manganese, tantalum, and aluminium. And nine chemicals comprised the mixtures more consistently associated with SARS-CoV-2 seropositivity: thallium, ruthenium, lead, benzo[b]fluoranthene, DDD, gold, and (protectively) selenium, indium, and iron. CONCLUSIONS The PFAS studied were not associated with SARS-CoV-2 seropositivity or COVID-19. The results confirm the associations between personal blood concentrations of some POPs and chemical elements and the risk of COVID-19 and SARS-CoV-2 infection in what remains the only prospective and population-based cohort study on the topic. Mixtures of POPs and chemical elements may contribute to explain the heterogeneity in the risks of SARS-CoV-2 infection and COVID-19 in the general population.
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Affiliation(s)
- José Pumarega
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Magda Gasull
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Jani Koponen
- Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Laura Campi
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Panu Rantakokko
- Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Luis A Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Carolina Donat-Vargas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; ISGlobal, Campus Mar, Barcelona, Spain; Cardiovascular and Nutritonal Epidemiology Unit, Institut of Enviornmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | | | - Cristina Rius
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Alfons Jimenez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Mar Iglesias
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Miquel Porta
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
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Pumarega J, Buscà O, Gasull M, Porta M. Supporting legislative action: Urinary levels of phthalates and phenols among influencers in the 'Plastics in the spotlight' advocacy initiative. Environ Res 2023; 231:116205. [PMID: 37217124 DOI: 10.1016/j.envres.2023.116205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Society-wide initiatives to prevent human exposure to plastic residues include laws and policies. Such measures require citizens' support, which can be increased by honest advocacy and pedagogic projects. These efforts must have a scientific basis. OBJECTIVE To assist the 'Plastics in the spotlight' advocacy initiative raise awareness among the general public of the presence of plastic residues in the human body, and to increase citizens' support for legislation on plastic control in the European Union. METHODS Spot urine samples of 69 volunteers with cultural and political influence from Spain, Portugal, Latvia, Slovenia, Belgium, and Bulgaria were collected. Concentrations of 30 phthalate metabolites and phenols were determined through a high-performance liquid chromatography with tandem mass spectrometry and ultra-high-performance liquid chromatography with tandem mass spectrometry, respectively. RESULTS At least 18 compounds were detected in all urine samples. The maximum number of compounds detected per participant was 23, and the mean, 20.5. Phthalates were detected more frequently than phenols. Median concentrations were highest for monoethyl phthalate (41.6 ng/mL, adjusted for specific gravity), and maximum concentrations were highest for mono-iso-butyl phthalate (1345.1 ng/mL), oxybenzone (1915.1 ng/mL), and triclosan (949.6 ng/mL). Most reference values were not exceeded. Women had higher concentrations of the 14 phthalate metabolites and oxybenzone than men. Urinary concentrations were not correlated with age. DISCUSSION The study had three main limitations: method of subject selection (volunteers), small sample size, and limited data on determinants of exposure. Studies on volunteers do not pretend to be representative of the general population and are no substitute for biomonitoring studies in representative samples of the populations of interest. Studies as ours can only illustrate the existence and some aspects of the problem, and can raise awareness among citizens concerned by the evidence that the studies provide in a group of subjects who are humanly appealing. CONCLUSIONS The results illustrate that human exposure to phthalates and phenols is widespread. All countries appeared to be similarly exposed to these contaminants, with higher levels in females. Most concentrations did not exceed reference values. The effects of this study on the objectives of the 'Plastics in the spotlight' advocacy initiative deserve a specific analysis from policy science.
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Affiliation(s)
- José Pumarega
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Hospital Del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Oriol Buscà
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Hospital Del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Magda Gasull
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Hospital Del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Miquel Porta
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Hospital Del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
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Porta M, Pumarega J, Gasull M, Aguilar R, Henríquez-Hernández LA, Basagaña X, Zumbado M, Villar-García J, Rius C, Mehta S, Vidal M, Jimenez A, Campi L, Lop J, Pérez Luzardo OL, Dobaño C, Moncunill G. Individual blood concentrations of persistent organic pollutants and chemical elements, and COVID-19: A prospective cohort study in Barcelona. Environ Res 2023; 223:115419. [PMID: 36740154 PMCID: PMC9898057 DOI: 10.1016/j.envres.2023.115419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND There is wide, largely unexplained heterogeneity in immunological and clinical responses to SARS-CoV-2 infection. Numerous environmental chemicals, such as persistent organic pollutants (POPs) and chemical elements (including some metals, essential trace elements, rare earth elements, and minority elements), are immunomodulatory and cause a range of adverse clinical events. There are no prospective studies on the effects of such substances on the incidence of SARS-CoV-2 infection and COVID-19. OBJECTIVE To investigate the influence of blood concentrations of POPs and elements measured several years before the pandemic on the development of SARS-CoV-2 infection and COVID-19 in individuals from the general population. METHODS We conducted a prospective cohort study in 154 individuals from the general population of Barcelona. POPs and elements were measured in blood samples collected in 2016-2017. SARS-CoV-2 infection was detected by rRT-PCR in nasopharyngeal swabs and/or by antibody serology using eighteen isotype-antigen combinations measured in blood samples collected in 2020-2021. We analyzed the associations between concentrations of the contaminants and SARS-CoV-2 infection and development of COVID-19, taking into account personal habits and living conditions during the pandemic. RESULTS Several historically prevalent POPs, as well as arsenic, cadmium, mercury, and zinc, were not associated with COVID-19, nor with SARS-CoV-2 infection. However, DDE (adjusted OR = 5.0 [95% CI: 1.2-21]), lead (3.9 [1.0-15]), thallium (3.4 [1.0-11]), and ruthenium (5.0 [1.8-14]) were associated with COVID-19, as were tantalum, benzo(b)fluoranthene, DDD, and manganese. Thallium (3.8 [1.6-8.9]), and ruthenium (2.9 [1.3-6.7]) were associated with SARS-CoV-2 infection, and so were lead, gold, and (protectively) iron and selenium. We identified mixtures of up to five substances from several chemical groups, with all substances independently associated to the outcomes. CONCLUSIONS Our results provide the first prospective and population-based evidence of an association between individual concentrations of some contaminants and COVID-19 and SARS-CoV-2 infection. POPs and elements may contribute to explain the heterogeneity in the development of SARS-CoV-2 infection and COVID-19 in the general population. If the associations are confirmed as causal, means are available to mitigate the corresponding risks.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - José Pumarega
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Luis A Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Xavier Basagaña
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal - PSMar - PRBB, Barcelona, Spain
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | | | - Cristina Rius
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Sneha Mehta
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; Columbia Mailman School of Public Health, New York, USA
| | - Marta Vidal
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Alfons Jimenez
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Laura Campi
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Lop
- Hospital del Mar Medical Research Institute (IMIM PSMar), Barcelona, Spain
| | - Octavio L Pérez Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences, Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; CIBER de Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Carlota Dobaño
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal - Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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Porta M, Gasull M, Pumarega J, Kiviranta H, Rantakokko P, Raaschou-Nielsen O, Bergdahl IA, Sandanger TM, Agudo A, Rylander C, Nøst TH, Donat-Vargas C, Aune D, Heath AK, Cirera L, Goñi-Irigoyen F, Alguacil J, Giménez-Robert À, Tjønneland A, Sund M, Overvad K, Mancini FR, Rebours V, Boutron-Ruault MC, Kaaks R, Schulze MB, Trichopoulou A, Palli D, Grioni S, Tumino R, Naccarati A, Panico S, Vermeulen R, Quirós JR, Rodríguez-Barranco M, Colorado-Yohar SM, Chirlaque MD, Ardanaz E, Wareham N, Key T, Johansson M, Murphy N, Ferrari P, Huybrechts I, Chajes V, Gonzalez CA, Bueno-de-Mesquita B, Gunter M, Weiderpass E, Riboli E, Duell EJ, Katzke V, Vineis P. Plasma concentrations of persistent organic pollutants and pancreatic cancer risk. Int J Epidemiol 2022; 51:479-490. [PMID: 34259837 PMCID: PMC9082788 DOI: 10.1093/ije/dyab115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Findings and limitations of previous studies on persistent organic pollutants (POPs) and pancreatic cancer risk support conducting further research in prospective cohorts. METHODS We conducted a prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Participants were 513 pancreatic cancer cases and 1020 matched controls. Concentrations of 22 POPs were measured in plasma collected at baseline. RESULTS Some associations were observed at higher concentrations of p, p'-DDT, trans-nonachlor, β-hexachlorocyclohexane and the sum of six organochlorine pesticides and of 16 POPs. The odds ratio (OR) for the upper quartile of trans-nonachlor was 1.55 (95% confidence interval 1.06-2.26; P for trend = 0.025). Associations were stronger in the groups predefined as most valid (participants having fasted >6 h, with microscopic diagnostic confirmation, normal weight, and never smokers), and as most relevant (follow-up ≥10 years). Among participants having fasted >6 h, the ORs were relevant for 10 of 11 exposures. Higher ORs were also observed among cases with microscopic confirmation than in cases with a clinical diagnosis, and among normal-weight participants than in the rest of participants. Among participants with a follow-up ≥10 years, estimates were higher than in participants with a shorter follow-up (for trans-nonachlor: OR = 2.14, 1.01 to 4.53, P for trend = 0.035). Overall, trans-nonachlor, three PCBs and the two sums of POPs were the exposures most clearly associated with pancreatic cancer risk. CONCLUSIONS Individually or in combination, most of the 22 POPs analysed did not or only moderately increased the risk of pancreatic cancer.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Institute of Medical Research (IMIM PSMar), Barcelona, Catalonia, Spain
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Magda Gasull
- Hospital del Mar Institute of Medical Research (IMIM PSMar), Barcelona, Catalonia, Spain
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José Pumarega
- Hospital del Mar Institute of Medical Research (IMIM PSMar), Barcelona, Catalonia, Spain
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Hannu Kiviranta
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Panu Rantakokko
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | | | - Ingvar A Bergdahl
- Department of Biobank Research, Umeå University, Umeå, Sweden
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Antoni Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Charlotta Rylander
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Therese Haugdahl Nøst
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Carolina Donat-Vargas
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Madrid, Spain
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Lluís Cirera
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB—Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Fernando Goñi-Irigoyen
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Department of Basque Government, Public Health Laboratory in Gipuzkoa, San Sebastian, Spain
- Health Research Institute Biodonostia, San Sebastian, Spain
| | - Juan Alguacil
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Huelva, Huelva, Spain
| | - Àlex Giménez-Robert
- Hospital del Mar Institute of Medical Research (IMIM PSMar), Barcelona, Catalonia, Spain
- Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | | | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Francesca Romana Mancini
- CESP, Faculté de médecine (USVQ), Université Paris-Sud, INSERM, Université Paris-Saclay, Villejuif, France
- Inserm UMR1018, Institut Gustave Roussy, Villejuif, France
| | - Vinciane Rebours
- Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, France
- Inserm UMR1149, DHU Unit, Paris-Diderot University, Paris, France
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de médecine (USVQ), Université Paris-Sud, INSERM, Université Paris-Saclay, Villejuif, France
- Inserm UMR1018, Institut Gustave Roussy, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam, Rehbruecke, Nuthetal, Germany
- Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany
| | | | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, “Civic—M.P. Arezzo” Hospital, ASP Ragusa, Ragusa, Italy
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM), Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | | | - Miguel Rodríguez-Barranco
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública (EASP), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Sandra M Colorado-Yohar
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB—Arrixaca, Murcia, Spain
- National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - María-Dolores Chirlaque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB—Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Eva Ardanaz
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mattias Johansson
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Veronique Chajes
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | | | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marc Gunter
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Eric J Duell
- Oncology Data Analytics Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM), Turin, Italy
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6
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Pumarega J, Camargo J, Gasull M, Olshan AF, Soliman A, Chen Y, Richardson D, Alguacil J, Poole C, Trasande L, Porta M. Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias. Expo Health 2022; 14:581-593. [PMID: 34722949 PMCID: PMC8533671 DOI: 10.1007/s12403-021-00436-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 05/03/2023]
Abstract
UNLABELLED Trace elements such as cadmium, arsenic, zinc or selenium increase or decrease risk of a wide range of human diseases. Their levels in toenails may provide a measure of mid-term intake of trace elements for studies in humans. However, in biologically and clinically aggressive diseases as pancreatic cancer, the progression of the disease could modify such concentrations and produce reverse causation bias. The aim was to analyze the influence of specific time intervals between several clinical events and the collection of toenails upon concentrations of trace elements in patients with pancreatic cancer. Subjects were 118 incident cases of pancreatic adenocarcinoma prospectively recruited in eastern Spain. Toenails were collected at cancer diagnosis, and soon thereafter interviews were conducted. Information on cancer signs and symptoms was obtained from medical records and patient interviews. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. General linear models adjusting for potential confounders were applied to analyze relations between log concentrations of trace elements and the time intervals, including the interval from first symptom of cancer to toenail collection (iST). Toenail concentrations of the 12 trace elements were weakly or not influenced by the progression of the disease or the diagnostic procedures. Concentrations of aluminum were slightly higher in subjects with a longer iST (age, sex and stage adjusted geometric means: 11.44 vs. 7.75 µg/g for iST > 120 days vs. ≤ 40 days). There was a weak inverse relation of iST with concentrations of zinc and selenium (maximum differences of about 20 and 0.08 µg/g, respectively). Conclusions: concentrations of the trace elements were weakly or not influenced by the development of the disease before toenail collection. Only concentrations of aluminum increased slightly with increasing iST, whereas levels of zinc and selenium decreased weakly. Even in an aggressive disease as pancreatic cancer, toenail concentrations of trace elements may provide a valid measure of mid-term intake of trace elements, unaffected by clinical events and disease progression. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12403-021-00436-2.
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Affiliation(s)
- José Pumarega
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Judit Camargo
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Amr Soliman
- Medical School of the City University of New York, New York, USA
| | - Yu Chen
- Departments of Environmental Medicine, and Population Health, New York University School of Medicine, New York, USA
| | - David Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Juan Alguacil
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universidad de Huelva, Huelva, Spain
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Leonardo Trasande
- Departments of Environmental Medicine, and Population Health, New York University School of Medicine, New York, USA
- Department of Pediatrics, New York University School of Medicine, New York, USA
- New York University College of Global Public Health, New York, USA
| | - Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
- Department of Pediatrics, New York University School of Medicine, New York, USA
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7
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Porta M, Gasull M, Pumarega J, Kiviranta H, Rantakokko P, Raaschou-Nielsen O, Bergdahl I, Sandanger TM, Rylander C, Nøst TH, Duell E, Katzke V, Gunter M, Vineis P. 588Plasma concentrations of persistent organic pollutants and pancreatic cancer risk. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Findings and limitations of previous studies on persistent organic pollutants (POPs) and pancreatic cancer risk support conducting further research in prospective cohorts.
Objective
To investigate the association between plasma concentrations of selected POPs and pancreatic cancer risk.
Methods
Prospective case-control study nested within the EPIC cohort. Participants were 513 pancreatic cancer cases and 1020 matched controls. Concentrations of 22 POPs (organochlorine pesticides, polychlorinated biphenyls, and polybrominated diphenyl ethers) were measured in plasma collected at baseline by GC-MS/MS.
Results
Some, generally moderate effects were observed at higher concentrations of p,p’-DDT, trans-nonachlor, β-hexachlorocyclohexane, and the sum of 6 organochlorine pesticides and of 16 POPs. The odds ratio (OR) for the upper quartile of trans-nonachlor was 1.55 (95% confidence interval 1.06 to 2.26; P for trend=0.025). Associations were stronger in the groups predefined as most valid or relevant. Among participants having fasted >6 hours at blood collection, the ORs were significant for 10 of 11 exposure categories. Higher ORs were also observed among cases with microscopic confirmation than in cases with a clinical diagnosis. Higher ORs were also observed among normal-weight participants, with relevant estimates for all 11 exposure categories. Among participants with a follow-up ≥10 years, estimates were also higher (e.g., for trans-nonachlor: OR = 2.14, 1.01 to 4.53, P for trend=0.035). Overall, trans-nonachlor, 3 PCBs, and the 2 sums of POPs were the exposures more clearly associated with pancreatic cancer risk.
Conclusions
A few moderately increased risks were apparent for the highest concentrations of certain POPs, sometimes with a dose-response relationship.
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Affiliation(s)
- Miquel Porta
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Magda Gasull
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - José Pumarega
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Hannu Kiviranta
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Panu Rantakokko
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Ole Raaschou-Nielsen
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Ingvar Bergdahl
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | | | - Charlotta Rylander
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Therese Haugdahl Nøst
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Eric Duell
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Verena Katzke
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Marc Gunter
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
| | - Paolo Vineis
- IMIM - Univ Autonoma Barcelona on behalf of EPIC Pancreas Working Group, Barcelona, Spain
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8
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Porta M, Pumarega J, Amaral AFS, Genkinger JM, Camargo J, Mucci L, Alguacil J, Gasull M, Zhang X, Morales E, Iglesias M, Ogino S, Engel LS. Influence of KRAS mutations, persistent organic pollutants, and trace elements on survival from pancreatic ductal adenocarcinoma. Environ Res 2020; 190:109781. [PMID: 32791343 PMCID: PMC7689512 DOI: 10.1016/j.envres.2020.109781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/02/2020] [Accepted: 06/02/2020] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Reasons why pancreatic ductal adenocarcinoma (PDAC) continues to have poor survival are only partly known. No previous studies have analyzed the combined influence of KRAS mutations, persistent organic pollutants (POPs), and trace elements upon survival in PDAC or in any other human cancer. OBJECTIVE To analyze the individual and combined influence of KRAS mutations, POPs, and trace elements upon survival from PDAC. METHODS Incident cases of PDAC (n = 185) were prospectively identified in five hospitals in Eastern Spain in 1992-1995 and interviewed face-to-face during hospital admission. KRAS mutational status was determined from tumour tissue through polymerase chain reaction and artificial restriction fragment length polymorphism. Blood and toenail samples were obtained before treatment. Serum concentrations of POPs were analyzed by high-resolution gas chromatography with electron-capture detection. Concentrations of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. Multivariable Cox proportional hazards regression was used to assess prognostic associations. RESULTS Patients with a KRAS mutated tumor had a 70% higher risk of early death than patients with a KRAS wild-type PDAC (hazard ratio [HR] = 1.7, p = 0.026), adjusting for age, sex, and tumor stage. KRAS mutational status was only modestly and not statistically significantly associated with survival when further adjusting by treatment or by treatment intention. The beneficial effects of treatment remained unaltered when KRAS mutational status was taken into account, and treatment did not appear to be less effective in the subgroup of patients with a KRAS mutated tumor. POPs did not materially influence survival: the adjusted HR of the highest POP tertiles was near unity for all POPs. When considering the joint effect on survival of POPs and KRAS, patients with KRAS mutated tumors had modest and nonsignificant HRs (most HRs around 1.3 to 1.4). Higher concentrations of lead, cadmium, arsenic, vanadium, and aluminium were associated with better survival. When KRAS status, POPs, and trace elements were simultaneously considered along with treatment, only the latter was statistically significantly related to survival. CONCLUSIONS In this study based on molecular, clinical, and environmental epidemiology, KRAS mutational status, POPs, and trace elements were not adversely related to PDAC survival when treatment was simultaneously considered; only treatment was independently related to survival. The lack of adverse prognostic effects of POPs and metals measured at the time of diagnosis provide scientific and clinical reassurance on the effects of such exposures upon survival of patients with PDAC. The weak association with KRAS mutations contributes to the scant knowledge on the clinical implications of a genetic alteration highly frequent in PDAC.
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Affiliation(s)
- Miquel Porta
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
| | - José Pumarega
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - André F S Amaral
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Jeanine M Genkinger
- Department of Epidemiology, Columbia University, New York, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA
| | - Judit Camargo
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Lorelei Mucci
- Harvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA
| | - Juan Alguacil
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universidad de Huelva, Huelva, Spain
| | - Magda Gasull
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Xuehong Zhang
- Harvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA
| | - Eva Morales
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIB-Arrixaca, Department of Public Health Sciences, University of Murcia
| | - Mar Iglesias
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Shuji Ogino
- Harvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
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9
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Gómez-Tomás Á, Pumarega J, Alguacil J, Amaral AF, Malats N, Pallarès N, Gasull M, Porta M. Concentrations of trace elements and KRAS mutations in pancreatic ductal adenocarcinoma. Environ Mol Mutagen 2019; 60:693-703. [PMID: 31066938 PMCID: PMC6786909 DOI: 10.1002/em.22296] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/10/2019] [Accepted: 04/26/2019] [Indexed: 05/04/2023]
Abstract
Trace elements are a possible risk factor for pancreatic ductal adenocarcinoma (PDAC). However, their role in the occurrence and persistence of KRAS mutations remains unstudied. There appear to be no studies analyzing biomarkers of trace elements and KRAS mutations in any human cancer. We aimed to determine whether patients with KRAS mutated and nonmutated tumors exhibit differences in concentrations of trace elements. Incident cases of PDAC were prospectively identified in five hospitals in Spain. KRAS mutational status was determined through polymerase chain reaction from tumor tissue. Concentrations of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. Concentrations of trace elements were compared in 78 PDAC cases and 416 hospital-based controls (case-control analyses), and between 17 KRAS wild-type tumors and 61 KRAS mutated tumors (case-case analyses). Higher levels of iron, arsenic, and vanadium were associated with a statistically nonsignificant increased risk of a KRAS wild-type PDAC (OR for higher tertile of arsenic = 3.37, 95% CI 0.98-11.57). Lower levels of nickel and manganese were associated with a statistically significant higher risk of a KRAS mutated PDAC (OR for manganese = 0.34, 95% CI 0.14-0.80). Higher levels of selenium appeared protective for both mutated and KRAS wild-type PDAC. Higher levels of cadmium and lead were clear risk factors for both KRAS mutated and wild-type cases. This is the first study analyzing biomarkers of trace elements and KRAS mutations in any human cancer. Concentrations of trace elements differed markedly between PDAC cases with and without mutations in codon 12 of the KRAS oncogene, thus suggesting a role for trace elements in pancreatic and perhaps other cancers with such mutations. Environ. Mol. Mutagen., 60:693-703, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Álvaro Gómez-Tomás
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - José Pumarega
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Juan Alguacil
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universidad de Huelva, Huelva, Spain
| | - André F.S. Amaral
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Natàlia Pallarès
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Magda Gasull
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Miquel Porta
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
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10
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Gasull M, Pumarega J, Kiviranta H, Rantakokko P, Raaschou-Nielsen O, Bergdahl IA, Sandanger TM, Goñi F, Cirera L, Donat-Vargas C, Alguacil J, Iglesias M, Tjønneland A, Overvad K, Mancini FR, Boutron-Ruault MC, Severi G, Johnson T, Kühn T, Trichopoulou A, Karakatsani A, Peppa E, Palli D, Pala V, Tumino R, Naccarati A, Panico S, Verschuren M, Vermeulen R, Rylander C, Nøst TH, Rodríguez-Barranco M, Molinuevo A, Chirlaque MD, Ardanaz E, Sund M, Key T, Ye W, Jenab M, Michaud D, Matullo G, Canzian F, Kaaks R, Nieters A, Nöthlings U, Jeurnink S, Chajes V, Matejcic M, Gunter M, Aune D, Riboli E, Agudo A, Gonzalez CA, Weiderpass E, Bueno-de-Mesquita B, Duell EJ, Vineis P, Porta M. Methodological issues in a prospective study on plasma concentrations of persistent organic pollutants and pancreatic cancer risk within the EPIC cohort. Environ Res 2019; 169:417-433. [PMID: 30529143 DOI: 10.1016/j.envres.2018.11.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. OBJECTIVES First, to summarize the main design features of a prospective case-control study -nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort- on plasma concentrations of persistent organic pollutants (POPs) and pancreatic cancer risk. And second, to assess the main methodological challenges posed by associations among characteristics and habits of study participants, fasting status, time from blood draw to cancer diagnosis, disease progression bias, basis of cancer diagnosis, and plasma concentrations of lipids and POPs. Results from etiologic analyses on POPs and pancreatic cancer risk, and other analyses, will be reported in future articles. METHODS Study subjects were 1533 participants (513 cases and 1020 controls matched by study centre, sex, age at blood collection, date and time of blood collection, and fasting status) enrolled between 1992 and 2000. Plasma concentrations of 22 POPs were measured by gas chromatography - triple quadrupole mass spectrometry (GC-MS/MS). To estimate the magnitude of the associations we calculated multivariate-adjusted odds ratios by unconditional logistic regression, and adjusted geometric means by General Linear Regression Models. RESULTS There were differences among countries in subjects' characteristics (as age, gender, smoking, lipid and POP concentrations), and in study characteristics (as time from blood collection to index date, year of last follow-up, length of follow-up, basis of cancer diagnosis, and fasting status). Adjusting for centre and time of blood collection, no factors were significantly associated with fasting status. Plasma concentrations of lipids were related to age, body mass index, fasting, country, and smoking. We detected and quantified 16 of the 22 POPs in more than 90% of individuals. All 22 POPs were detected in some participants, and the smallest number of POPs detected in one person was 15 (median, 19) with few differences by country. The highest concentrations were found for p,p'-DDE, PCBs 153 and 180 (median concentration: 3371, 1023, and 810 pg/mL, respectively). We assessed the possible occurrence of disease progression bias (DPB) in eight situations defined by lipid and POP measurements, on one hand, and by four factors: interval from blood draw to index date, tumour subsite, tumour stage, and grade of differentiation, on the other. In seven of the eight situations results supported the absence of DPB. CONCLUSIONS The coexistence of differences across study centres in some design features and participant characteristics is of relevance to other multicentre studies. Relationships among subjects' characteristics and among such characteristics and design features may play important roles in the forthcoming analyses on the association between plasma concentrations of POPs and pancreatic cancer risk.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José Pumarega
- Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Hannu Kiviranta
- National Institute for Health and Welfare, Department of Health Security, Kuopio, Finland
| | - Panu Rantakokko
- National Institute for Health and Welfare, Department of Health Security, Kuopio, Finland
| | | | - Ingvar A Bergdahl
- Department of Biobank Research, Umeå University, Umeå, Sweden; Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Fernando Goñi
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Biodonostia Health Research Institute; Public Health Laboratory in Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Lluís Cirera
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain
| | | | - Juan Alguacil
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universidad de Huelva, Huelva, Spain
| | - Mar Iglesias
- Department of Pathology, Hospital del Mar (PSMar), Barcelona, Spain
| | | | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Francesca Romana Mancini
- CESP, Faculté de Médecine - Univ. Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de Médecine - Univ. Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- CESP, Faculté de Médecine - Univ. Paris-Sud, Faculté de Médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tilman Kühn
- Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece; 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | | | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM), Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Charlotta Rylander
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Therese Haugdahl Nøst
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Miguel Rodríguez-Barranco
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Amaia Molinuevo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Biodonostia Health Research Institute; Public Health Laboratory in Gipuzkoa, Basque Government, San Sebastian, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain; Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Weimin Ye
- Department of Biobank Research, Umeå University, Umeå, Sweden; Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm, Sweden
| | - Mazda Jenab
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Dominique Michaud
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Giuseppe Matullo
- Department Medical Sciences, University of Torino, Italian Institute for Genomic Medicine -IIGM/HuGeF, Torino, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Suzanne Jeurnink
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Veronique Chajes
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Marco Matejcic
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Antoni Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-Idibell), Barcelona, Spain
| | | | - Elisabete Weiderpass
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Eric J Duell
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-Idibell), Barcelona, Spain
| | - Paolo Vineis
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM), Turin, Italy; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Miquel Porta
- Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain; Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Gasull M, Castell C, Pallarès N, Miret C, Pumarega J, Téllez-Plaza M, López T, Salas-Salvadó J, Lee DH, Goday A, Porta M. Blood Concentrations of Persistent Organic Pollutants and Unhealthy Metabolic Phenotypes in Normal-Weight, Overweight, and Obese Individuals. Am J Epidemiol 2018; 187:494-506. [PMID: 29106481 DOI: 10.1093/aje/kwx267] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 06/23/2017] [Indexed: 12/19/2022] Open
Abstract
Factors underlying metabolic phenotypes, such as the metabolically healthy but obese phenotype, remain unclear. Differences in metabolic phenotypes-particularly, among individuals with a similar body mass index-could be related to concentrations of persistent organic pollutants (POPs). To our knowledge, no studies have analyzed POPs and metabolic phenotypes in normal-weight persons. We investigated the relationships between serum concentrations of POPs and metabolic phenotypes in 860 normal-weight, overweight, and obese participants in the 2002 Catalan Health Interview Survey (Spain). POP concentrations were significantly higher in metabolically unhealthy than in metabolically healthy individuals. In models adjusting for body mass index and other confounders, hexachlorobenzene, β-hexachlorocyclohexane, and polychlorinated biphenyls were associated with the unhealthy metabolic phenotype and metabolic syndrome. Among normal-weight individuals, the adjusted prevalence ratio of having an unhealthy phenotype for the upper category of the sum of orders of the 6 mentioned POPs (all individually associated with metabolic phenotypes) was 4.1 (95% confidence interval: 1.7, 10.0). Among overweight and obese individuals, the corresponding prevalence ratio for the sum of polychlorinated biphenyls was 1.4 (95% confidence interval: 1.0, 1.8). Our results supported the hypothesis that POP concentrations are associated with unhealthy metabolic phenotypes, not only in obese and overweight individuals but also (and probably more strongly) in normal-weight individuals.
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Affiliation(s)
- Magda Gasull
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Conxa Castell
- Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Natàlia Pallarès
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carme Miret
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Pumarega
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
| | - María Téllez-Plaza
- Institute for Biomedical Research, Hospital Clinic de Valencia
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tomàs López
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Albert Goday
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - Miquel Porta
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Pumarega J, Gasull M, Lee DH, López T, Porta M. Number of Persistent Organic Pollutants Detected at High Concentrations in Blood Samples of the United States Population. PLoS One 2016; 11:e0160432. [PMID: 27508420 PMCID: PMC4979965 DOI: 10.1371/journal.pone.0160432] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022] Open
Abstract
Human exposure to environmental chemicals as persistent organic pollutants (POPs) is usually assessed considering each pollutant individually, with little attention to concentrations of mixtures in individuals or social groups. Yet, it may be relatively common for humans to have low and high concentrations of numerous POPs. The study objectives were to analyze the number of POPs detected per person at high concentrations in the U.S. population, and the associations between such type of indicators and socioeconomic factors as gender, race / ethnicity, education, and poverty level. From 91 POPs analyzed in serum samples of 4,739 individuals in three subsamples of the National Health and Nutrition Examination Survey (NHANES) 2003-2004 (the last period with valid updated individual data for the compounds considered in the present study), we computed the number of POPs whose serum concentrations were above selected cutoff points. POPs included were 13 organochlorine compounds (OCs), 10 polybrominated diphenyl ethers (PBDEs), the polybrominated biphenyl (PBB) 153, 38 polychlorinated biphenyls (PCBs), 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs), and 12 perfluorinated compounds (PFCs). Over 13% of participants had ≥10 of the 37 most detected POPs each at a concentration in the top decile (P90). Over 30% of subjects with total toxic equivalency (TEQ) ≥P75, had ≥10 of 24 POPs not included in TEQ calculations at concentrations ≥P90. Compared to non-Hispanic whites, the adjusted odds ratio of having ≥10 of the 37 POPs at P90 was 9.2 for non-Hispanic blacks and 0.18 for Mexican Americans. Poverty, body mass index, age, and gender were also independently associated with having ≥10 POPs in the top decile. More than one tenth of the US population may have ≥10 POPs each at concentrations in the top decile. Such pattern is nine times more frequent in Non-Hispanic blacks and four times less frequent in Mexican Americans than in non-Hispanic whites.
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Affiliation(s)
- José Pumarega
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tomàs López
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
- * E-mail:
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Lope V, García-Esquinas E, Pérez-Gómez B, Altzibar JM, Gracia-Lavedan E, Ederra M, Molina de la Torre AJ, LLorca FJ, Tardón A, Moreno V, Bayo J, Salas-Trejo D, Marcos-Gragera R, Pumarega J, Dierssen-Sotos T, Lera JPB, de Miguel Medina MAC, Tusquets I, Amiano P, Boldo E, Kogevinas M, Aragonés N, Castaño-Vinyals G, Pollán M. Perinatal and childhood factors and risk of breast cancer subtypes in adulthood. Cancer Epidemiol 2015; 40:22-30. [PMID: 26613540 DOI: 10.1016/j.canep.2015.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes. METHODS This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors. RESULTS Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93). CONCLUSION These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli.
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Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
| | - Esther García-Esquinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Jone M Altzibar
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain
| | - Esther Gracia-Lavedan
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Early Detection Section, Public Health Institute of Navarra, Leyre 15, 31003 Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain
| | | | - Francisco Javier LLorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Instituto Universitario de Oncología, Universidad de Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006 Oviedo, Asturias, Spain
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; IDIBELL-Catalan Institute of Oncology, Gran Via km 2.7, 08907L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n 08907, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Juan Bayo
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez, Avenida de la Orden s/n, 21005 Huelva, Spain; Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071 Huelva, Spain
| | - Dolores Salas-Trejo
- General Directorate Public Health, and FISABIO, Avenida de Catalunya, 21, 46020 Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Carrer del Sol 15, 17004 Girona, Spain
| | - José Pumarega
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer (GRECMC), Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain
| | - Juan Pablo Barrio Lera
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, 24071 León, Spain
| | - M A Concepción de Miguel Medina
- Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain; Pathology Department, Navarra Hospital Complex, Irunlarrea 3, 31008 Pamplona, Spain
| | - Ignasi Tusquets
- Servei d'Oncologia Mèdica, Hospital del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain; Cancer Research Program IMIM (Hospital del Mar Medical Research Institute). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Autònoma de Barcelona, Plaza Cívica s/n, 08193 Bellaterra, Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain
| | - Elena Boldo
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
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Gasull M, Pallarès N, Salcedo N, Pumarega J, Alonso J, Porta M. Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain. Environ Res 2015; 143:211-220. [PMID: 26505651 DOI: 10.1016/j.envres.2015.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/09/2015] [Accepted: 10/05/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH. OBJECTIVES To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12). METHODS POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey. RESULTS Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-value<0.001). In crude models and in models adjusted for sex and BMI, the POPs-SRH association was often dose-dependent, and the likelihood of poor or regular SRH was 2 to 4-times higher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12. CONCLUSIONS Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Natàlia Pallarès
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Natalia Salcedo
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain
| | - José Pumarega
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jordi Alonso
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra, Catalonia, Spain
| | - Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain.
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Porta M, Pumarega J, Gasull M, López T, Lee DH. Number of Persistent Organic Pollutants (POPs) Detected at High Concentrations in the U.S. Population (NHANES 2003–04). Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Analyses of the concentrations of a given environmental compound usually show that most citizens have much lower concentrations than a certain minority, whose members have high body concentrations. Surveys of human exposure to chemicals do not usually integrate the number of chemical compounds detected per person and the concentration of each compound. This leaves untested relevant exposure situations, for example, whether individuals with low concentrations of some compounds have high concentrations of the other compounds. On scientific grounds, it is puzzling that this possibility, arithmetically and conceptually rather simple, has seldom if ever been tested in studies based on a representative sample of the general population. A study based on a representative sample of the general population of Catalonia (Spain) (Porta, Pumarega, & Gasull, 2012), which integrated the number of compounds detected per person and the concentration of each compound, found that more than half of the population had concentrations in the top quartile of 1 or more of the 19 persistent toxic substances (PTS) (pesticides and polychlorinated biphenyls) analyzed. Significant subgroups of the population accumulated PTS mixtures at high concentrations. For instance, 48% of women 60-74 years had concentrations of 6 or more PTS in the top quartile; half of the entire population had levels of 1-5 PTS above 500 ng/g, and less than 4% of citizens had all PTS in the lowest quartile. Thus, PTS concentrations appear low in most of the population only when each individual compound is looked at separately. It is not accurate to state that most of the population has low concentrations of PTS. The assessment of mixture effects must address the fact that most individuals are contaminated by PTS mixtures made of compounds at both low and high concentrations.
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Affiliation(s)
- Miquel Porta
- Unit of Clinical and Molecular Epidemiology of Cancer, Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
| | - José Pumarega
- Unit of Clinical and Molecular Epidemiology of Cancer, Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - Magda Gasull
- Unit of Clinical and Molecular Epidemiology of Cancer, Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - Tomàs Lopez
- Unit of Clinical and Molecular Epidemiology of Cancer, Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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Gasull M, Pumarega J, Rovira G, López T, Alguacil J, Porta M. Relative effects of educational level and occupational social class on body concentrations of persistent organic pollutants in a representative sample of the general population of Catalonia, Spain. Environ Int 2013; 60:190-201. [PMID: 24064380 DOI: 10.1016/j.envint.2013.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 07/04/2013] [Accepted: 08/02/2013] [Indexed: 05/19/2023]
Abstract
Scant evidence is available worldwide on the relative influence of occupational social class and educational level on body concentrations of persistent organic pollutants (POPs) in the general population. The objective was to analyse such influence in a representative sample of the general population of Catalonia, Spain. Participants in the Catalan Health Interview Survey aged 18-74 were interviewed face-to-face, gave blood, and underwent a physical exam. The role of age, body mass index (BMI), and parity was analysed with General Linear Models, and adjusted geometric means (GMs) were obtained. Crude (unadjusted) concentrations were higher in women and men with lower education, and in women, but not men, in the less affluent social class. After adjusting for age, in women there were no associations between POP levels and social class or education. After adjusting for age and BMI, men in the less affluent class had higher p,p'-DDE concentrations than men in class I (p-value=0.016), while men in class IV had lower HCB than men in the upper class (p-value<0.03). Also in contrast with some expectations, positive associations between education and POP levels were observed after adjusting for age and BMI in men; e.g., men with university studies had higher HCB concentrations than men with first stage of primary schooling (adjusted GM 153.9 and 80.5ng/g, respectively) (p-value<0.001). When education and social class were co-adjusted for, some positive associations with education in men remained statistically significant, whereas class remained associated only with p,p'-DDE. Educational level influenced blood concentrations of POPs more than occupational social class, especially in men. In women, POP concentrations were mainly explained by age/birth cohort, parity and BMI. In men, while concentrations were also mainly explained by age/birth cohort and BMI, both social class and education showed positive associations. Important characteristics of socioeconomic groups as age and BMI may largely explain crude differences among such groups in internal contamination by POPs. The absence of clear patterns of relationships between blood concentrations of POPs and indicators of socioeconomic position may fundamentally be due to the widespread, lifelong, and generally invisible contamination of human food webs. Decreasing historical trends would also partly explain crude socioeconomic differences apparently due to birth cohort effects.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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Arrebola JP, Pumarega J, Gasull M, Fernandez MF, Martin-Olmedo P, Molina-Molina JM, Fernández-Rodríguez M, Porta M, Olea N. Adipose tissue concentrations of persistent organic pollutants and prevalence of type 2 diabetes in adults from Southern Spain. Environ Res 2013; 122:31-37. [PMID: 23290489 DOI: 10.1016/j.envres.2012.12.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/28/2012] [Accepted: 12/03/2012] [Indexed: 06/01/2023]
Abstract
There is increasing evidence that environmental factors play an important role in the development of type 2 diabetes. Several persistent organic pollutants are suspected to contribute to the increasing prevalence and risk of type 2 diabetes. The aim of this study was to investigate the association of the body burden of three organochlorine pesticides and three polychlorinated biphenyls and the overall estrogenic activity with the risk of type 2 diabetes in a sample of adults from Southern Spain. Samples of adipose tissue and serum were obtained from 386 subjects undergoing non-cancer-related surgery and were extracted using validated methodologies. Residues of persistent organic pollutants were analyzed by means of high-resolution gas chromatography with a mass spectrometry detector in tandem mode. The overall estrogenicity of the adipose tissue extracts was measured by using the total effective xenoestrogen burden (TEXB) biomarker. Data on lifestyle, dietary habits, and health status were gathered from face-to-face interviews and clinical records. Statistical analyses were performed with unconditional logistic regression and different adjustment levels. In the models adjusted for adipose tissue origin, sex, age, and body mass index, the 2nd and 3rd tertiles of adipose tissue concentrations of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) were positively associated with the risk of diabetes [odds ratios (95% confidence interval)=3.6 (0.8-17.3) and 4.4 (1.0-21.0), respectively]. A positive association with β-hexachlorocyclohexane was also found when body mass index and adipose tissue origin were removed from the models, with odds ratios (95% confidence interval) of 3.3 (1.0-10.4) and 5.5 (1.7-17.3), for the 2nd and 3rd tertiles of exposure, respectively. In addition, a statistically significant interaction was observed between p,p'-DDE and body mass index, such that the risk of diabetes increased with tertiles of exposure in a linear manner in non-obese subjects but not in the obese, in whom an inverted U-shape pattern was observed.
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Affiliation(s)
- Juan P Arrebola
- Laboratory of Medical Investigations, San Cecilio University Hospital, University of Granada, 18071 Granada, Spain.
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Porta M, Pumarega J, Gasull M. Number of persistent organic pollutants detected at high concentrations in a general population. Environ Int 2012; 44:106-11. [PMID: 22425898 DOI: 10.1016/j.envint.2012.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 01/28/2012] [Accepted: 02/17/2012] [Indexed: 05/22/2023]
Abstract
BACKGROUND Surveys of human exposure to environmental chemicals do not integrate the number of compounds detected per person and the concentration of each compound. This leaves untested relevant exposure scenarios, such as whether individuals with low concentrations of some compounds have high concentrations of the other compounds. OBJECTIVE To analyze the number of persistent organic pollutants (POPs) detected at high concentrations. METHODS Serum concentrations of 19 POPs were analyzed by gas chromatography with electron-capture detection in a representative sample of the general population of Catalonia, Spain (N=919). RESULTS Over 58% of participants had concentrations in the top quartile of ≥1 of the eight most prevalent POPs, and 34% of ≥3 POPs. 83% of women 60 to 74 years old had concentrations of ≥3 POPs in the top quartile; 56% of women 60 to 74 years had p,p'-DDE, HCB and β-HCH all in their respective top quartiles, and 48% had concentrations of ≥6 POPs in the top quartile. Over 30% of subjects had concentrations in the top decile of 1 to 5 of the eight most prevalent POPs. Half of the population had levels of 1 to 5 POPs >500 ng/g. Less than 4% had all eight POPs in the lowest quartile. CONCLUSIONS More than half of the study population had concentrations in the top quartile of ≥1 POPs. Significant subgroups of the population accumulate POP mixtures at high concentrations. POP concentrations appear low in most of the population only when each individual compound is looked at separately.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Research Institute-IMIM, Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain.
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Gasull M, Pumarega J, Téllez-Plaza M, Castell C, Tresserras R, Lee DH, Porta M. Blood concentrations of persistent organic pollutants and prediabetes and diabetes in the general population of Catalonia. Environ Sci Technol 2012; 46:7799-810. [PMID: 22681243 DOI: 10.1021/es300712g] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The aim was to analyze the effects of body mass index (BMI), low-dose exposure, mixtures of persistent organic pollutants (POPs), and lipid adjustment on the relationship between POP concentrations and diabetes and prediabetes in the general adult population of Catalonia (Spain). Serum concentrations of POPs were measured by gas chromatography with electron-capture detection in 886 participants in a health interview survey. The highest concentrations of all POPs analyzed were found in subjects who had diabetes. Levels were also higher in individuals with prediabetes than in subjects without the disorder. In models adjusted by age, sex and BMI, the prevalence of diabetes and prediabetes increased in a dose-dependent manner across quartiles of PCBs 118, 138, 153, and 180, and HCB. When models were further adjusted for lipids, the associations were slightly lower and statistically significant, the ORs for the upper quartile ranging from 2.0 to 2.8 (all p-values for linear trend <0.05). Concentrations of p,p'-DDT, p,p'-DDE and β-HCH were not associated with diabetes or prediabetes. Increasing concentrations of PCBs and HCB were positively associated with diabetes and prediabetes. Only part of the association was due to age and BMI. Findings support the hypothesis that exposure to POPs may be a diabetogenic factor in both obese and nonobese individuals.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Research Institute-IMIM, Barcelona, Spain
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Porta M, Pumarega J, Guarner L, Malats N, Solà R, Real FX. Relationships of hepatic and pancreatic biomarkers with the cholestatic syndrome and tumor stage in pancreatic cancer. Biomarkers 2012; 17:557-65. [PMID: 22793268 DOI: 10.3109/1354750x.2012.701331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We analyzed relationships of hepatic and pancreatic biomarkers with the cholestatic syndrome and tumor stage in exocrine pancreatic cancer (N = 183). Information on laboratory tests and on signs and symptoms was obtained from medical records and patient interviews. Bilirubin, aspartate aminotransferase (AST), γ-glutamyltransferase (GGT) and alkaline phosphatase were lower in tumor stage IV. The association was due to the relationship between cholestatic syndrome and earlier presentation of patients. There was no association between hepatic biomarkers and stage when adjusting by cholestatic syndrome. Relationships of hepatic and pancreatic biomarkers with pancreatic symptoms and tumor stage must be controlled in "-omics" and other studies using biomarkers.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Research Institute - IMIM, Barcelona, Catalonia, Spain.
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Porta M, López T, Gasull M, Rodríguez-Sanz M, Garí M, Pumarega J, Borrell C, Grimalt JO. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Barcelona in 2006, and comparison with levels in 2002. Sci Total Environ 2012; 423:151-161. [PMID: 22397902 DOI: 10.1016/j.scitotenv.2012.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/31/2012] [Accepted: 02/01/2012] [Indexed: 05/31/2023]
Abstract
INTRODUCTION POP biomonitoring programs are useful for exposure assessment, to analyze patterns, and to evaluate policies. However, population-representative surveys are scarce and heterogeneous. Reports on time trends in representative samples using the same methods are rare. OBJECTIVES To analyze the distribution of serum concentrations of 19 POPs in the general population of Barcelona city in 2006, and to compare it with the distribution in 2002. METHODS 231 participants in the Barcelona Health Survey were interviewed face-to-face, gave blood, and underwent a physical exam. Density plots ("POP Geoffrey Rose curves") were used to represent the full population distribution of each compound. RESULTS Eight POPs were each detected in >80% of the study subjects: p,p'-DDT, p,p'-DDE, PCB congeners 118, 138, 153 and 180, HCB and β-HCH. The minimum number of POPs detected in one person was 5, and 72% of the population accumulated ≥ 10 compounds. p,p'-DDE and HCB showed the highest concentrations (median=219 and 109 ng/g lipid, respectively). Concentrations decreased by 34-56% from 2002 to 2006. The decrease was similar in women and men, and in all age groups/birth cohorts. It was larger with increasing BMI; for p,p'-DDT, HCB and β-HCH the decrease in obese individuals was 31-44 percentage points larger than in subjects with normal weight. The distribution of POP concentrations was always switched towards higher values in women than men. POP levels also differed significantly by age, body mass index, weight gain, birth place and social class, but not by parity and breastfeeding. The two younger cohorts had a higher DDT/DDE ratio than the oldest cohort. CONCLUSION Although human POP contamination remains common in the city of Barcelona, concentrations decreased significantly in 4years. Our approach suggests innovative ways to conceive, analyze and present results for other monitoring programs.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Research Institute- IMIM, Barcelona, Catalonia, Spain.
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Porta M, Gasull M, Pumarega J. Commentary: a step towards more comprehensive analyses of life course effects of mixtures of environmental factors. Int J Epidemiol 2012; 41:843-6. [PMID: 22421055 DOI: 10.1093/ije/dys014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Miquel Porta
- Hospital del Mar Research Institute-IMIM, Barcelona, Spain
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Gasull M, Bosch de Basea M, Puigdomènech E, Pumarega J, Porta M. Empirical analyses of the influence of diet on human concentrations of persistent organic pollutants: a systematic review of all studies conducted in Spain. Environ Int 2011; 37:1226-35. [PMID: 21683445 DOI: 10.1016/j.envint.2011.05.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 05/12/2011] [Accepted: 05/13/2011] [Indexed: 05/04/2023]
Abstract
BACKGROUND Numerous studies analyzed concentrations of persistent organic pollutants (POPs) in human samples, and in many types of foods; however, food consumption is less commonly included in studies on the determinants of POP concentrations in humans, and these approaches are rarely integrated with surveys of food intake to estimate the amount and safety of human POP intake from food. OBJECTIVE To analyze the main characteristics and findings of all studies conducted in Spain that quantitatively assessed the influence of diet on human concentrations of POPs. METHODS Studies published until December 2010 (with no other time restrictions) were identified through Medline/PubMed, ISI-Thomson, ScienceDirect, and SciELO databases. RESULTS We identified 25 papers, from 19 different studies. Twelve papers were published in 2009-2010. All studies but one were based on subgroups not representative of the general population, and over half were limited to women. Serum was the most used biological matrix, while p,p'-DDE, HCB and PCBs were the most frequently analyzed compounds. Food intakes were measured with heterogeneous food frequency questionnaires. The most consistent association was between fish consumption and PCBs and HCB, followed by dairy products and PCBs. A few studies observed a relationship between meat and some POPs, whilst intake of vegetables, fruits and cereals was rarely related to POP levels. Only 3 studies did not find any relationship between dietary habits and POP concentrations. CONCLUSIONS In spite of methodological heterogeneity, the studies were able to quantify to what extent consumption of foods from animal origin (fish, milk, dairy products and meat) is related to higher body concentrations of POPs. As in a few other countries, in Spain food consumption is increasingly analyzed as a major determinant of human POP intake.
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Affiliation(s)
- Magda Gasull
- Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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Porta M, Gasull M, Puigdomènech E, Garí M, Bosch de Basea M, Guillén M, López T, Bigas E, Pumarega J, Llebaria X, Grimalt JO, Tresserras R. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Catalonia. Environ Int 2010; 36:655-64. [PMID: 20569985 DOI: 10.1016/j.envint.2010.04.013] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 04/12/2010] [Accepted: 04/20/2010] [Indexed: 05/09/2023]
Abstract
BACKGROUND Although virtually all populations worldwide are commonly exposed to numerous persistent organic pollutants (POPs) and human concentrations vary widely, only a few countries conduct nationwide surveillance programs of POP concentrations in representative samples of the general population. OBJECTIVE To evaluate the distribution of serum concentrations of nineteen POPs and their main predictors in a representative sample of the general population of Catalonia. METHODS Participants in the Catalan Health Interview Survey aged 18-74 years were interviewed face-to-face, gave blood, and underwent a physical exam. Graphs (including "POP Geoffrey Rose curves") were used to represent the full population distribution of each POP in the 919 participants. Through multivariate statistical models we analyzed the influence on POP concentrations of sex, age, body mass index (BMI), socioeconomic status and, in women, parity. RESULTS We detected dichlorodiphenyltrichloroethane (p,p'-DDT), dichlorodiphenyldichloroethane (p,p'-DDE), polychlorinated biphenyls (PCBs) congeners 118, 138, 153 and 180, hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH) in more than 85% of the subjects. p,p'-DDE, HCB and beta-HCH showed the highest concentrations (median=399, 159 and 92 ng/g lipid, respectively). Distributions were highly skewed and interindividual differences were up to 7700-fold. POP levels differed significantly by gender, age, BMI, educational level, and parity. CONCLUSIONS In Catalonia, an advanced European society, exposure to POPs remains common, a vast majority of the population has much lower blood concentrations than a relative minority, and the population distributions of POP are hence highly skewed to the right. Shifting distributions towards lower concentrations requires more energetic policies and population strategies.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Catalonia, Spain.
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Gasull M, Porta M, Pumarega J, Vioque J, Bosch de Basea M, Puigdomènech E, Morales E, Grimalt JO, Malats N. The relative influence of diet and serum concentrations of organochlorine compounds on K-ras mutations in exocrine pancreatic cancer. Chemosphere 2010; 79:686-697. [PMID: 20350743 DOI: 10.1016/j.chemosphere.2010.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 02/24/2010] [Accepted: 03/06/2010] [Indexed: 05/29/2023]
Abstract
BACKGROUND In exocrine pancreatic cancer (EPC) mechanistic relationships may exist among some organochlorine compounds (OCs) and mutations in the K-ras oncogene, as well as among the latter and dietary factors. OBJECTIVE To analyze (1) the relationship between food intake and serum concentrations of OCs in EPC patients and (2) the relative influence of food and OCs on the frequency of K-ras mutations in EPC. PATIENTS AND METHODS Incident cases of EPC were prospectively identified, and interviewed face-to-face during hospital admission (N=135 patients with data on OCs and diet, and N=97 with additional information on K-ras status). OCs were measured by high-resolution gas chromatography with electron-capture detection. RESULTS Consumption of milk and other dairy products was positively associated with concentrations of p,p'-DDT, PCB 138 and PCB 153 (log-transformed betas=0.652, 0.588 and 0.317, respectively; all p<0.05). When adjusted by OCs, dairy products were no longer associated with K-ras. By contrast, after adjusting by consumption of dairy products, patients with the highest concentrations of p,p'-DDT and some PCBs remained more likely to have a K-ras-mutated EPC than patients with lower concentrations (OR for upper tertile of PCB 138=5.5, 95% CI: 1.3-23.4). CONCLUSIONS Dairy products were a source of OCs. The association between dairy products and K-ras mutations was not independent of OCs. By contrast, the association between OCs and K-ras was not confounded by dairy products. OCs may be more likely to contribute to the occurrence of K-ras mutations than nutrients contained in dairy products.
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Affiliation(s)
- Magda Gasull
- Institut Municipal d'Investigació Mèdica, Barcelona, Catalonia, Spain
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Porta M, López T, Pumarega J, Jariod M, Crous-Bou M, Marco E, Rifà J, Grimalt JO, Malats N, Real FX. In pancreatic ductal adenocarcinoma blood concentrations of some organochlorine compounds and coffee intake are independently associated with KRAS mutations. Mutagenesis 2009; 24:513-21. [PMID: 19797353 DOI: 10.1093/mutage/gep037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
While KRAS activation is a fundamental initiating event in the aetiopathogenesis of pancreatic ductal adenocarcinoma (PDA), environmental factors influencing the occurrence and persistence of KRAS mutations remain largely unknown. The objective was to test the hypothesis that in PDA there are aetiopathogenic relationships among concentrations of some organochlorine compounds (OCs) and the mutational status of the KRAS oncogene, as well as among the latter and coffee intake. Incident cases of PDA were interviewed and had blood drawn at hospital admission (N = 103). OCs were measured by high-resolution gas chromatography with electron capture detection. Cases whose tumours harboured a KRAS mutation had higher concentrations of p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethene (DDE) and polychlorinated biphenyls (PCBs) 138, 153 and 180 than cases with wild-type KRAS, but differences were statistically significant only for p,p'-DDT and PCBs 138 and 153. The association between coffee intake and KRAS mutations remained significant (P-trend < 0.015) when most OCs where accounted for. When p,p'-DDT, PCB 153, coffee and alcohol intake were included in the same model, all were associated with KRAS (P = 0.042, 0.007, 0.016 and 0.025, respectively). p,p'-DDT, p,p'-DDE and PCB 138 were significantly associated with the two most prevalent KRAS mutations (Val and Asp). OCs and coffee may have independent roles in the aetiopathogenesis of PDA through modulation of KRAS activation, acquisition or persistence, plausibly through non-genotoxic or epigenetic mechanisms. Given that KRAS mutations are the most frequent abnormality of oncogenes in human cancers, and the lifelong accumulation of OCs in humans, refutation or replication of the findings is required before any implications are assessed.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica-Hospital del Mar, E-08003 Barcelona, Catalonia, Spain.
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Porta M, Jariod M, López T, Pumarega J, Puigdomènech E, Marco E, Malats N, Grimalt JO, Real FX. Correcting serum concentrations of organochlorine compounds by lipids: alternatives to the organochlorine/total lipids ratio. Environ Int 2009; 35:1080-1085. [PMID: 19581003 DOI: 10.1016/j.envint.2009.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 05/11/2009] [Accepted: 06/05/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION When studying the effects of organochlorine compounds (OCs) on human health it is common to correct serum concentrations of OC by total lipids (TL). However, the relationship between serum OCs and serum TL is far from established in many diseases, including several cancers. Our aim was to analyze the relationship between serum OC and TL in patients with pancreatic ductal adenocarcinoma (PDA), and to explore several alternatives to perform the OC lipid correction. METHODS Incident cases of PDA were interviewed and had blood drawn soon around hospital admission (n=144). Serum concentrations of OCs were analysed by high-resolution gas chromatography with electron-capture detection. RESULTS Most patients with high TL had moderate or low concentrations of OCs. By contrast, the variability of OC values among patients with normal TL was large. Correlations were of a similar magnitude between OC and TL and between OC and total cholesterol; while these correlations were weak (all Spearman's rho<0.3 and R(2)<0.11), no OC were significantly correlated with triglycerides. Although all alternatives to the OC/TL linear ratio were statistically significant for at least one OC, their R(2) was always below 10%. CONCLUSIONS In patients with severe diseases as PDA, linear correction of OC by TL as commonly performed in epidemiologic studies may be inappropriate. Results contribute to the scant literature on the rationale to correct serum concentrations of OC by lipids. They suggest that it is unwarranted to routinely correct OC by TL, offer ways to assess such need, and present alternatives as no TL correction, correction by total cholesterol only or use of different statistical models.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica - Hospital del Mar, E-08003 Barcelona, Catalonia, Spain.
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Porta M, Gasull M, Puigdomènech E, Rodríguez-Sanz M, Pumarega J, Rebato C, Borrell C. Sociodemographic factors influencing participation in the Barcelona Health Survey study on serum concentrations of persistent organic pollutants. Chemosphere 2009; 76:216-25. [PMID: 19386342 DOI: 10.1016/j.chemosphere.2009.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 03/10/2009] [Accepted: 03/13/2009] [Indexed: 05/19/2023]
Abstract
BACKGROUND Little is known about factors affecting participation in population-based biomonitoring studies. We analyzed socioeconomic factors influencing participation in the Barcelona Health Survey (BHS) study on the distribution of serum concentrations of persistent organic pollutants (POPs). METHODS After completing the BHS personal interview at home participants aged >or=15 years were invited to donate blood. Conducted on a different date and location, the POPs study included additional questions, blood extraction, and a brief physical examination. Factors influencing participation were analyzed by logistic regression. RESULTS Of 523 BHS participants that we contacted to participate in the study, 231 (44%) participated; they were broadly representative of the city population regarding sex, birth place, body mass index (BMI), employment status and occupational social class. Participants in the POPs study had higher educational level and family income. Controlling for confounders, participation was slightly higher among women than men (odds ratio [OR]=1.38, p=0.02), and lower among the youngest and oldest subjects (p=0.002), with a strong and monotonic trend of increasing participation with increasing educational level (p<0.001) (OR for university level vs. no studies=4.58, 95% CI: 2.3-9.3). CONCLUSIONS Although participation was somewhat low, participants were similar to the city population regarding sex, BMI, birth place, employment, and occupational social class. Health surveys that integrate environmental biomarkers should invest specific resources to encourage participation of the youngest and oldest individuals, and of those with more disadvantaged socioeconomic position (particularly, citizens with lowest education).
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Affiliation(s)
- Miquel Porta
- Clinical and Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
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Porta M, Ferrer-Armengou O, Pumarega J, López T, Crous-Bou M, Alguacil J, Fitó M, Jariod M, Vicente Á, Morales E, Covas MI, Puigdomènech E, Gupta N. Exocrine pancreatic cancer clinical factors were related to timing of blood extraction and influenced serum concentrations of lipids. J Clin Epidemiol 2008; 61:695-704. [DOI: 10.1016/j.jclinepi.2007.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 08/02/2007] [Accepted: 08/09/2007] [Indexed: 12/22/2022]
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Pérez-Cadahía B, Laffon B, Porta M, Lafuente A, Cabaleiro T, López T, Caride A, Pumarega J, Romero A, Pásaro E, Méndez J. Relationship between blood concentrations of heavy metals and cytogenetic and endocrine parameters among subjects involved in cleaning coastal areas affected by the 'Prestige' tanker oil spill. Chemosphere 2008; 71:447-455. [PMID: 18221981 DOI: 10.1016/j.chemosphere.2007.10.053] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 10/18/2007] [Accepted: 10/28/2007] [Indexed: 05/25/2023]
Abstract
The sinking of the 'Prestige' oil tanker in front of the Galician coast (NW of Spain) in November 2002 offered a unique opportunity to analyze intermediate cytogenetic and endocrine effects among people exposed to the complex mixture of substances that oil constitutes, including several toxic heavy metals. In this work we evaluated the relationship between exposure to heavy metals (blood concentrations of aluminium, cadmium, nickel, lead and zinc) and genotoxic parameters (sister chromatid exchanges, micronucleus test and comet assay) or endocrine parameters (plasmatic concentrations of prolactin and cortisol) in subjects exposed to 'Prestige' oil during cleaning tasks developed after the spillage. Concentrations of lead were significantly related to the comet assay even after adjusting by age, sex and smoking. Cortisol concentrations were significantly influenced by aluminium, nickel (both, inversely) and cadmium (positively). Women had clearly higher concentrations of prolactin and cortisol, even when adjusting by age, smoking, cadmium, aluminium or nickel. Plasmatic cortisol was jointly influenced by gender, smoking and aluminium or nickel (all p<0.05). In women there was a strong relationship between concentrations of cadmium and prolactin (beta=0.37, p=0.031). When the effects of cadmium, aluminium and nickel on cortisol were simultaneously assessed, only the latter two metals remained statistically significant. Among parameters analysed, cortisol appeared to be the most sensitive to the effects of metal exposure. Plasma levels of cortisol deserve further evaluation as a potentially relevant biomarker to assess the effects of exposure to heavy metals.
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Affiliation(s)
- Beatriz Pérez-Cadahía
- Toxicology Unit, University of A Coruña, Edificio de Servicios Centrales de Investigación, Campus Elviña s/n, E-15071 A Coruña, Spain
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Porta M, Pumarega J, Ferrer-Armengou O, López T, Alguacil J, Malats N, Fernàndez E. Timing of blood extraction in epidemiologic and proteomic studies: results and proposals from the PANKRAS II Study. Eur J Epidemiol 2007; 22:577-88. [PMID: 17636417 DOI: 10.1007/s10654-007-9149-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 05/29/2007] [Indexed: 12/22/2022]
Abstract
There are no consensus guidelines or standards for epidemiologic and '-omics' studies using blood biomarkers on how to report the timing of extraction of blood samples. However, disease-induced changes in blood concentrations of exogenous and endogenous compounds may bias studies. The aim of the present report is to describe the timing of blood collection with respect to a variety of relevant clinical events in the PANKRAS II Study, and to suggest ways to display graphically the quantitative information. Subjects were 167 incident cases of exocrine pancreatic cancer prospectively recruited in five teaching hospitals in eastern Spain. Over 80% of patients had blood extracted during the first 6 months since onset of cancer symptoms, and 82% within the first month of admission to a study hospital. Over 80% of cases had blood drawn after an ultrasound, a CT scan or an ERCP, 25% after a laparotomy, and 37% after treatment onset. All three intervals from blood extraction to diagnosis, to treatment onset and to interview had a median of 0 days, and 88% of cases had blood drawn within 2 weeks of diagnosis. Over 72% of cases had concentrations of total lipids in the medium, normal range. Results suggest ways to report intervals involving blood biomarkers and may contribute to develop consensus guidelines and standards on the collection of blood samples in epidemiologic and '-omics' research.
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Affiliation(s)
- Miquel Porta
- Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Carrer del Dr. Aiguader 88, 08003 Barcelona, Catalonia, Spain.
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Morales E, Porta M, Vioque J, López T, Mendez MA, Pumarega J, Malats N, Crous-Bou M, Ngo J, Rifà J, Carrato A, Guarner L, Corominas JM, Real FX. Food and nutrient intakes and K-ras mutations in exocrine pancreatic cancer. J Epidemiol Community Health 2007; 61:641-9. [PMID: 17568059 PMCID: PMC2465759 DOI: 10.1136/jech.2007.060632] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2007] [Indexed: 12/30/2022]
Abstract
BACKGROUND No studies have investigated the relation between K-ras mutations and dietary factors in exocrine pancreatic cancer (EPC), and fewer than 10 studies have done so in other neoplasms. PATIENTS AND METHODS Incident cases of EPC were prospectively identified, and interviewed face-to-face during hospital admission. Food and nutrient intakes were measured with a food frequency questionnaire. Logistic regression was used to compare EPC cases (n = 107) with and without K-ras mutations (case-case study). RESULTS K-ras mutations were more common among daily consumers of milk and other dairy products than among non-daily consumers: the odds ratio adjusted by total energy, age, sex, smoking, alcohol and coffee consumption (ORa) was 5.1 (95% CI 1.1 to 24.5, p = 0.040). For all dairy products, including butter, the ORa for the medium and upper tertiles of intake were 5.4 and 11.6, respectively (p for trend = 0.023). The ORa for regular coffee drinkers further adjusted by dairy consumption was 4.7 (95% CI 1.1 to 20.7, p = 0.043). K-ras mutated cases reported a lower intake of vitamin E (ORa = 0.2, p for trend = 0.036), polyunsaturated fats and omega 3 fatty acids (ORa = 0.2; p for trend <0.03). CONCLUSIONS Results support the hypothesis that in EPC exposure to specific dietary components or contaminants may influence the occurrence or persistence of K-ras mutations.
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Affiliation(s)
- Eva Morales
- Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, Carrer del Dr Aiguader 88, E-08003 Barcelona, Spain
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