1
|
Suthar H, Manea T, Pak D, Woodbury M, Eick SM, Cathey A, Watkins DJ, Strakovsky RS, Ryva BA, Pennathur S, Zeng L, Weller D, Park JS, Smith S, DeMicco E, Padula A, Fry RC, Mukherjee B, Aguiar A, Geiger SD, Ng S, Huerta-Montanez G, Vélez-Vega C, Rosario Z, Cordero JF, Zimmerman E, Woodruff TJ, Morello-Frosch R, Schantz SL, Meeker JD, Alshawabkeh AN, Aung MT. Cross-Sectional Associations between Prenatal Per- and Poly-Fluoroalkyl Substances and Bioactive Lipids in Three Environmental Influences on Child Health Outcomes (ECHO) Cohorts. Environ Sci Technol 2024. [PMID: 38691655 DOI: 10.1021/acs.est.4c00094] [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] [Indexed: 05/03/2024]
Abstract
Prenatal per- and poly-fluoroalkyl substances (PFAS) exposure may influence gestational outcomes through bioactive lipids─metabolic and inflammation pathway indicators. We estimated associations between prenatal PFAS exposure and bioactive lipids, measuring 12 serum PFAS and 50 plasma bioactive lipids in 414 pregnant women (median 17.4 weeks' gestation) from three Environmental influences on Child Health Outcomes Program cohorts. Pairwise association estimates across cohorts were obtained through linear mixed models and meta-analysis, adjusting the former for false discovery rates. Associations between the PFAS mixture and bioactive lipids were estimated using quantile g-computation. Pairwise analyses revealed bioactive lipid levels associated with PFDeA, PFNA, PFOA, and PFUdA (p < 0.05) across three enzymatic pathways (cyclooxygenase, cytochrome p450, lipoxygenase) in at least one combined cohort analysis, and PFOA and PFUdA (q < 0.2) in one linear mixed model. The strongest signature revealed doubling in PFOA corresponding with PGD2 (cyclooxygenase pathway; +24.3%, 95% CI: 7.3-43.9%) in the combined cohort. Mixture analysis revealed nine positive associations across all pathways with the PFAS mixture, the strongest signature indicating a quartile increase in the PFAS mixture associated with PGD2 (+34%, 95% CI: 8-66%), primarily driven by PFOS. Bioactive lipids emerged as prenatal PFAS exposure biomarkers, deepening insights into PFAS' influence on pregnancy outcomes.
Collapse
Affiliation(s)
- Himal Suthar
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Tomás Manea
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Dominic Pak
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Megan Woodbury
- Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts 02115, United States
| | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia 30322, United States
| | - Amber Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Rita S Strakovsky
- Institute for Integrative Toxicology, Michigan State University, East Lansing, Michigan 48824, United States
- Department of Food Sciences and Human Nutrition, Michigan State University, East Lansing, Michigan 48824, United States
| | - Brad A Ryva
- Institute for Integrative Toxicology, Michigan State University, East Lansing, Michigan 48824, United States
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan 48824, United States
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48824, United States
| | - Subramaniam Pennathur
- Department of Internal Medicine-Nephrology, University of Michigan, Ann Arbor, Michigan 48824, United States
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Lixia Zeng
- Department of Internal Medicine-Nephrology, University of Michigan, Ann Arbor, Michigan 48824, United States
| | - David Weller
- NSF International, Ann Arbor, Michigan 48105, United States
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, California 94710, United States
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, California 94710, United States
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California 94143, United States
| | - Amy Padula
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California 94143, United States
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina 27599, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Andrea Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, Illinois 61801, United States
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Champaign, Illinois 61802, United States
| | - Sarah Dee Geiger
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Champaign, Illinois 61802, United States
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, United States
| | - Shukhan Ng
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Champaign, Illinois 61802, United States
| | - Gredia Huerta-Montanez
- Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts 02115, United States
| | - Carmen Vélez-Vega
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia 30606, United States
| | - Zaira Rosario
- University of Puerto Rico Graduate School of Public Health, San Juan, Puerto Rico 00935, United States
| | - Jose F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia 30606, United States
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts 02115, United States
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California 94143, United States
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California 94143, United States
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, California 94720, United States
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, Illinois 61801, United States
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Champaign, Illinois 61802, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Akram N Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts 02115, United States
| | - Max T Aung
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| |
Collapse
|
2
|
Oh J, Buckley JP, Li X, Gachigi KK, Kannan K, Lyu W, Ames JL, Barrett ES, Bastain TM, Breton CV, Buss C, Croen LA, Dunlop AL, Ferrara A, Ghassabian A, Herbstman JB, Hernandez-Castro I, Hertz-Picciotto I, Kahn LG, Karagas MR, Kuiper JR, McEvoy CT, Meeker JD, Morello-Frosch R, Padula AM, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Simhan H, Starling AP, Tylavsky FA, Volk HE, Woodruff TJ, Zhu Y, Bennett DH. Erratum: "Associations of Organophosphate Ester Flame Retardant Exposures during Pregnancy with Gestational Duration and Fetal Growth: The Environmental influences on Child Health Outcomes (ECHO) Program". Environ Health Perspect 2024; 132:49003. [PMID: 38598327 PMCID: PMC11005959 DOI: 10.1289/ehp14968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/12/2024]
|
3
|
Ulaganathan G, Jiang H, Canio N, Oke A, Armstrong SS, Abrahamsson D, Varshavsky JR, Lam J, Cooper C, Robinson JF, Fung JC, Woodruff TJ, Allard P. Screening and characterization of 133 physiologically-relevant environmental chemicals for reproductive toxicity. bioRxiv 2024:2024.03.22.584808. [PMID: 38585844 PMCID: PMC10996516 DOI: 10.1101/2024.03.22.584808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Reproduction is a functional outcome that relies on complex cellular, tissue, and organ interactions that span the developmental period to adulthood. Thus, the assessment of its disruption by environmental chemicals is remarkably painstaking in conventional toxicological animal models and does not scale up to the number of chemicals present in our environment and requiring testing. We adapted a previously described low-throughput in vivo chromosome segregation assay using C. elegans predictive of reproductive toxicity and leveraged available public data sources (ToxCast, ICE) to screen and characterize 133 physiologically-relevant chemicals in a high-throughput manner. The screening outcome was further validated in a second, independent in vivo assay assessing embryonic viability. In total, 13 chemicals were classified as reproductive toxicants with the two most active chemicals belonging to the large family of Quaternary Ammonium Compounds (QACs) commonly used as disinfectants but with limited available reproductive toxicity data. We compared the results from the C. elegans assay with ToxCast in vitro data compiled from 700+ cell response assays and 300+ signaling pathways-based assays. We did not observe a difference in the bioactivity or in average potency (AC50) between the top and bottom chemicals. However, the intended target categories were significantly different between the classified chemicals with, in particular, an over-representation of steroid hormone targets for the high Z-score chemicals. Taken together, these results point to the value of in vivo models that scale to high-throughput level for reproductive toxicity assessment and to the need to prioritize the assessment of QACs impacts on reproduction.
Collapse
|
4
|
Woodruff TJ. Health Effects of Fossil Fuel-Derived Endocrine Disruptors. N Engl J Med 2024; 390:922-933. [PMID: 38446677 DOI: 10.1056/nejmra2300476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- Tracey J Woodruff
- From the Program on Reproductive Health and the Environment, Environmental Research and Translation for Health Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco
| |
Collapse
|
5
|
Zheng S, Mansolf M, McGrath M, Churchill ML, Bekelman TA, Brennan PA, Margolis AE, Nozadi SS, Bastain TM, Elliott AJ, LeWinn KZ, Hofheimer JA, Leve LD, Rennie B, Zimmerman E, Marable CA, McEvoy CT, Liu C, Sullivan A, Woodruff TJ, Ghosh S, Leventhal B, Ferrara A, Lewis J, Bishop S. Measurement bias in caregiver-report of early childhood behavior problems across demographic factors in an ECHO-wide diverse sample. JCPP Adv 2024; 4:e12198. [PMID: 38486952 PMCID: PMC10933609 DOI: 10.1002/jcv2.12198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 08/11/2023] [Indexed: 03/17/2024] Open
Abstract
Background Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown. Methods Item-level data of CBCL/1.5-5 from a large sample of young children (N = 9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses. Results Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status. Conclusions The CBCL/1.5-5, a caregiver-report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.
Collapse
Affiliation(s)
- Shuting Zheng
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Maxwell Mansolf
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Monica McGrath
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Marie L. Churchill
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Traci A. Bekelman
- Department of EpidemiologyColorado School of Public HealthAuroraCOUSA
| | | | - Amy E. Margolis
- Department of PsychiatryColumbia University Irving Medical CenterNew York State Psychiatric InstituteNew YorkNYUSA
| | - Sara S. Nozadi
- Community Environmental HealthCollege of PharmacyHealth Sciences CenterUniversity of New MexicoAlbuquerqueNMUSA
| | - Theresa M. Bastain
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Julie A. Hofheimer
- Department of PediatricsDivision of Neonatal‐Perinatal MedicineNorth Carolina at Chapel HillChapel HillNCUSA
| | - Leslie D. Leve
- Prevention Science InstituteUniversity of OregonEugeneORUSA
| | - Brandon Rennie
- Health Sciences CenterDepartment of PediatricsCenter for Development and DisabilityUniversity of New MexicoNavajo Birth Cohort StudyAlbuquerqueNMUSA
| | - Emily Zimmerman
- Communication Sciences & DisordersNortheastern UniversityBostonMAUSA
| | - Carmen A. Marable
- School of MedicineUniversity of North Carolina at Chapel HillNeuroscience CurriculumChapel HillNCUSA
| | - Cindy T. McEvoy
- Department of PediatricsPape Pediatric Research InstituteOregon Health & Science UniversityPortlandORUSA
| | - Chang Liu
- Department of PsychologyWashington State UniversityPullmanWAUSA
| | - Alexis Sullivan
- Center for Health and CommunityUniversity of CaliforniaSan FranciscoCAUSA
| | - Tracey J. Woodruff
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Samiran Ghosh
- Department of Biostatistics and Data Science & Coordinating Center for Clinical Trials (CCCT)University of Texas School of Public HealthHoustonTXUSA
| | - Bennett Leventhal
- University of ChicagoNavajo Birth Cohort StudyUniversity of New MexicoAlbuquerqueNMUSA
| | - Assiamira Ferrara
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCAUSA
| | - Johnnye Lewis
- Navajo Birth Cohort StudyCommunity Environmental Health ProgramCollege of PharmacyUniversity of New MexicoAlbuquerqueNMUSA
| | - Somer Bishop
- Department of Psychiatry and Behavioral SciencesWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCAUSA
| | | |
Collapse
|
6
|
Bland GD, Abrahamsson D, Wang M, Zlatnik MG, Morello-Frosch R, Park JS, Sirota M, Woodruff TJ. Exploring applications of non-targeted analysis in the characterization of the prenatal exposome. Sci Total Environ 2024; 912:169458. [PMID: 38142008 PMCID: PMC10947484 DOI: 10.1016/j.scitotenv.2023.169458] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/25/2023]
Abstract
Capturing the breadth of chemical exposures in utero is critical in understanding their long-term health effects for mother and child. We explored methodological adaptations in a Non-Targeted Analysis (NTA) pipeline and evaluated the effects on chemical annotation and discovery for maternal and infant exposure. We focus on lesser-known/underreported chemicals in maternal and umbilical cord serum analyzed with liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF/MS). The samples were collected from a demographically diverse cohort of 296 maternal-cord pairs (n = 592) recruited in San Francisco Bay area. We developed and evaluated two data processing pipelines, primarily differing by detection frequency cut-off, to extract chemical features from non-targeted analysis (NTA). We annotated the detected chemical features by matching with EPA CompTox Chemicals Dashboard (n = 860,000 chemicals) and Human Metabolome Database (n = 3140 chemicals) and applied a Kendrick Mass Defect filter to detect homologous series. We collected fragmentation spectra (MS/MS) on a subset of serum samples and matched to an experimental MS/MS database within the MS-Dial website and other experimental MS/MS spectra collected from standards in our lab. We annotated ~72 % of the features (total features = 32,197, levels 1-4). We confirmed 22 compounds with analytical standards, tentatively identified 88 compounds with MS/MS spectra, and annotated 4862 exogenous chemicals with an in-house developed annotation algorithm. We detected 36 chemicals that appear to not have been previously reported in human blood and 9 chemicals that were reported in less than five studies. Our findings underline the importance of NTA in the discovery of lesser-known/unreported chemicals important to characterize human exposures.
Collapse
Affiliation(s)
- Garret D Bland
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States
| | - Dimitri Abrahamsson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States.
| | - Miaomiao Wang
- Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, United States
| | - Marya G Zlatnik
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, School of Public Health, University of California Berkeley, Berkeley, CA, United States
| | - June-Soo Park
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States; Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, United States
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, Department of Pediatrics, University of California San Francisco, San Francisco 94158, CA, United States
| | - Tracey J Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States.
| |
Collapse
|
7
|
Oh J, Buckley JP, Li X, Gachigi KK, Kannan K, Lyu W, Ames JL, Barrett ES, Bastain TM, Breton CV, Buss C, Croen LA, Dunlop AL, Ferrara A, Ghassabian A, Herbstman JB, Hernandez-Castro I, Hertz-Picciotto I, Kahn LG, Karagas MR, Kuiper JR, McEvoy CT, Meeker JD, Morello-Frosch R, Padula AM, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Simhan H, Starling AP, Tylavsky FA, Volk HE, Woodruff TJ, Zhu Y, Bennett DH. Associations of Organophosphate Ester Flame Retardant Exposures during Pregnancy with Gestational Duration and Fetal Growth: The Environmental influences on Child Health Outcomes (ECHO) Program. Environ Health Perspect 2024; 132:17004. [PMID: 38262621 PMCID: PMC10805613 DOI: 10.1289/ehp13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Widespread exposure to organophosphate ester (OPE) flame retardants with potential reproductive toxicity raises concern regarding the impacts of gestational exposure on birth outcomes. Previous studies of prenatal OPE exposure and birth outcomes had limited sample sizes, with inconclusive results. OBJECTIVES We conducted a collaborative analysis of associations between gestational OPE exposures and adverse birth outcomes and tested whether associations were modified by sex. METHODS We included 6,646 pregnant participants from 16 cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program. Nine OPE biomarkers were quantified in maternal urine samples collected primarily during the second and third trimester and modeled as log 2 -transformed continuous, categorized (high/low/nondetect), or dichotomous (detect/nondetect) variables depending on detection frequency. We used covariate-adjusted linear, logistic, and multinomial regression with generalized estimating equations, accounting for cohort-level clustering, to estimate associations of OPE biomarkers with gestational length and birth weight outcomes. Secondarily, we assessed effect modification by sex. RESULTS Three OPE biomarkers [diphenyl phosphate (DPHP), a composite of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP), and bis(1,3-dichloro-2-propyl) phosphate] were detected in > 85 % of participants. In adjusted models, DBUP/DIBP [odds ratio (OR) per doubling = 1.07 ; 95% confidence interval (CI): 1.02, 1.12] and bis(butoxyethyl) phosphate (OR for high vs. nondetect = 1.25 ; 95% CI: 1.06, 1.46), but not other OPE biomarkers, were associated with higher odds of preterm birth. We observed effect modification by sex for associations of DPHP and high bis(2-chloroethyl) phosphate with completed gestational weeks and odds of preterm birth, with adverse associations among females. In addition, newborns of mothers with detectable bis(1-chloro-2-propyl) phosphate, bis(2-methylphenyl) phosphate, and dipropyl phosphate had higher birth weight-for-gestational-age z -scores (β for detect vs. nondetect = 0.04 - 0.07 ); other chemicals showed null associations. DISCUSSION In the largest study to date, we find gestational exposures to several OPEs are associated with earlier timing of birth, especially among female neonates, or with greater fetal growth. https://doi.org/10.1289/EHP13182.
Collapse
Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
| | - Xuan Li
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kennedy K. Gachigi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kurunthachalam Kannan
- Wadsworth Center, Division of Environmental Health Sciences, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Wenjie Lyu
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Claudia Buss
- Department of Medical Psychology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Pediatrics, UC-Irvine School of Medicine, Orange, California, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
- Medical Investigations of Neurodevelopmental Disorders Institute, UC-Davis, Sacramento, California, USA
| | - Linda G. Kahn
- Department of Pediatrics, New York University (NYU) Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jordan R. Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cindy T. McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, UC-Berkeley, Berkeley, California, USA
| | - Amy M. Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
- Medical Investigations of Neurodevelopmental Disorders Institute, UC-Davis, Sacramento, California, USA
| | - Hyagriv Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Anne P. Starling
- Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Lifecourse Epidemiology of Adiposity and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Heather E. Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Deborah H. Bennett
- Department of Public Health Sciences, University of California Davis (UC-Davis), Davis, California, USA
| | | |
Collapse
|
8
|
Chen H, Kapidzic M, Gantar D, Aksel S, Levan J, Abrahamsson DP, Jigmeddagva U, Basrai S, San A, Gaw SL, Woodruff TJ, Fisher SJ, Robinson JF. Perfluorooctanoic acid induces transcriptomic alterations in second trimester human cytotrophoblasts. Toxicol Sci 2023; 196:187-199. [PMID: 37738295 PMCID: PMC10682971 DOI: 10.1093/toxsci/kfad097] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Poly- and perfluroroalkylated substances (PFAS) are a major class of surfactants used in industry applications and consumer products. Despite efforts to reduce the usage of PFAS due to their environmental persistence, compounds such as perfluorooctanoic acid (PFOA) are widely detected in human blood and tissue. Although growing evidence supports that prenatal exposures to PFOA and other PFAS are linked to adverse pregnancy outcomes, the target organs and pathways remain unclear. Recent investigations in mouse and human cell lines suggest that PFAS may impact the placenta and impair trophoblast function. In this study, we investigated the effects of PFOA on cytotoxicity and the transcriptome in cultured second trimester human cytotrophoblasts (CTBs). We show that PFOA significantly reduces viability and induces cell death at 24 h, in a concentration-dependent manner. At subcytotoxic concentrations, PFOA impacted expression of hundreds of genes, including several molecules (CRH, IFIT1, and TNFSF10) linked with lipid metabolism and innate immune response pathways. Furthermore, in silico analyses suggested that regulatory factors such as peroxisome proliferator-activated receptor-mediated pathways may be especially important in response to PFOA. In summary, this study provides evidence that PFOA alters primary human CTB viability and gene pathways that could contribute to placental dysfunction and disease.
Collapse
Affiliation(s)
- Hao Chen
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Mirhan Kapidzic
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Danielle Gantar
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Sena Aksel
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Justine Levan
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Dimitri P Abrahamsson
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Unurzul Jigmeddagva
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Sanah Basrai
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Ali San
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Stephanie L Gaw
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Susan J Fisher
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| | - Joshua F Robinson
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, California 94143, USA
| |
Collapse
|
9
|
Suthar H, Manea T, Pak D, Woodbury M, Eick SM, Cathey A, Watkins DJ, Strakovsky RS, Ryva BA, Pennathur S, Zeng L, Weller D, Park JS, Smith S, DeMicco E, Padula A, Fry RC, Mukherjee B, Aguiar A, Dee Geiger S, Ng S, Huerta-Montanez G, Vélez-Vega C, Rosario Z, Cordero JF, Zimmerman E, Woodruff TJ, Morello-Frosch R, Schantz SL, Meeker JD, Alshawabkeh A, Aung MT. Cross-sectional associations between prenatal maternal per- and poly-fluoroalkyl substances and bioactive lipids in three Environmental influences on Child Health Outcomes (ECHO) cohorts. medRxiv 2023:2023.11.03.23297930. [PMID: 37961525 PMCID: PMC10635258 DOI: 10.1101/2023.11.03.23297930] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Per- and poly-fluoroalkyl substances (PFAS) exposure can occur through ingestion of contaminated food and water, and inhalation of indoor air contaminated with these chemicals from consumer and industrial products. Prenatal PFAS exposures may confer risk for pregnancy-related outcomes such as hypertensive and metabolic disorders, preterm birth, and impaired fetal development through intermediate metabolic and inflammation pathways. Objective Estimate associations between maternal pregnancy PFAS exposure (individually and as a mixture) and bioactive lipids. Methods Our study included pregnant women in the Environmental influences on Child Health Outcomes Program: Chemicals in our Bodies cohort (CiOB, n=73), Illinois Kids Developmental Study (IKIDS, n=287), and the ECHO-PROTECT cohort (n=54). We measured twelve PFAS in serum and 50 plasma bioactive lipids (parent fatty acids and eicosanoids derived from cytochrome p450, lipoxygenase, and cyclooxygenase) during pregnancy (median 17 gestational weeks). Pairwise associations across cohorts were estimated using linear mixed models and meta-analysis. Associations between the PFAS mixture and individual bioactive lipids were estimated using quantile g-computation. Results PFDeA, PFOA, and PFUdA were associated (p<0.05) with changes in bioactive lipid levels in all three enzymatic pathways (cyclooxygenase [n=6 signatures]; cytochrome p450 [n=5 signatures]; lipoxygenase [n=7 signatures]) in at least one combined cohort analysis. The strongest signature indicated that a doubling in PFOA corresponded with a 24.3% increase (95% CI [7.3%, 43.9%]) in PGD2 (cyclooxygenase pathway) in the combined cohort. In the mixtures analysis, we observed nine positive signals across all pathways associated with the PFAS mixture. The strongest signature indicated that a quartile increase in the PFAS mixture was associated with a 34% increase in PGD2 (95% CI [8%, 66%]), with PFOS contributing most to the increase. Conclusions Bioactive lipids were revealed as biomarkers of PFAS exposure and could provide mechanistic insights into PFAS' influence on pregnancy outcomes, informing more precise risk estimation and prevention strategies.
Collapse
Affiliation(s)
- Himal Suthar
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tomás Manea
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Dominic Pak
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Megan Woodbury
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Stephanie M. Eick
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Amber Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rita S. Strakovsky
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, USA
- Department of Food Sciences and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Brad A. Ryva
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, USA
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Subramaniam Pennathur
- Department of Internal Medicine-Nephrology, University of Michigan, Ann Arbor, MI, USA
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Lixia Zeng
- Department of Internal Medicine-Nephrology, University of Michigan, Ann Arbor, MI, USA
| | | | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Padula
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Andrea Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Illinois, USA
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, IL, USA
| | - Sarah Dee Geiger
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, IL, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Shukhan Ng
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, IL, USA
| | - Gredia Huerta-Montanez
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Carmen Vélez-Vega
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Zaira Rosario
- University of Puerto Rico Graduate School of Public Health, San Juan, PR, USA
| | - Jose F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, USA
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Illinois, USA
- Department of Comparative Biosciences, University of Illinois Urbana-Champaign, IL, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Max T. Aung
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
10
|
Abrahamsson D, Brueck CL, Prasse C, Lambropoulou DA, Koronaiou LA, Wang M, Park JS, Woodruff TJ. Extracting Structural Information from Physicochemical Property Measurements Using Machine Learning─A New Approach for Structure Elucidation in Non-targeted Analysis. Environ Sci Technol 2023; 57:14827-14838. [PMID: 37746919 PMCID: PMC10569036 DOI: 10.1021/acs.est.3c03003] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
Non-targeted analysis (NTA) has made critical contributions in the fields of environmental chemistry and environmental health. One critical bottleneck is the lack of available analytical standards for most chemicals in the environment. Our study aims to explore a novel approach that integrates measurements of equilibrium partition ratios between organic solvents and water (KSW) to predictions of molecular structures. These properties can be used as a fingerprint, which with the help of a machine learning algorithm can be converted into a series of functional groups (RDKit fragments), which can be used to search chemical databases. We conducted partitioning experiments using a chemical mixture containing 185 chemicals in 10 different organic solvents and water. Both a liquid chromatography quadrupole time-of-flight mass spectrometer (LC-QTOF MS) and a LC-Orbitrap MS were used to assess the feasibility of the experimental method and the accuracy of the algorithm at predicting the correct functional groups. The two methods showed differences in log KSW with the QTOF method showing a mean absolute error (MAE) of 0.22 and the Orbitrap method 0.33. The differences also culminated into errors in the predictions of RDKit fragments with the MAE for the QTOF method being 0.23 and for the Orbitrap method being 0.31. Our approach presents a new angle in structure elucidation for NTA and showed promise in assisting with compound identification.
Collapse
Affiliation(s)
- Dimitri Abrahamsson
- Department
of Pediatrics, New York University Grossman
School of Medicine, New York, New York 10016, United States
- Department
of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive
Health and the Environment, University of
California, San Francisco, California 94107, United States
| | - Christopher L. Brueck
- Department
of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland 21205, United States
- Exponent, Environmental and Earth Sciences Practice, Bellevue, Washington 98007, United States
| | - Carsten Prasse
- Department
of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland 21205, United States
- Risk
Sciences
and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Dimitra A. Lambropoulou
- Department
of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki Greece
- Laboratory
of Environmental Pollution Control, Department of Chemistry, Aristotle University of Thessaloniki, GR-541 24 Thessaloniki, Greece
- Center for
Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, Thessaloniki, GR-57001, Greece
| | - Lelouda-Athanasia Koronaiou
- Department
of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki Greece
- Laboratory
of Environmental Pollution Control, Department of Chemistry, Aristotle University of Thessaloniki, GR-541 24 Thessaloniki, Greece
- Center for
Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, Thessaloniki, GR-57001, Greece
| | - Miaomiao Wang
- Department
of Toxic Substances Control, Environmental Chemistry Laboratory, California Environmental Agency, Berkeley, California 94710, United States
| | - June-Soo Park
- Department
of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive
Health and the Environment, University of
California, San Francisco, California 94107, United States
- Department
of Toxic Substances Control, Environmental Chemistry Laboratory, California Environmental Agency, Berkeley, California 94710, United States
| | - Tracey J. Woodruff
- Department
of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive
Health and the Environment, University of
California, San Francisco, California 94107, United States
| |
Collapse
|
11
|
Cathey AL, Nguyen VK, Colacino JA, Woodruff TJ, Reynolds P, Aung MT. Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses. J Expo Sci Environ Epidemiol 2023; 33:687-698. [PMID: 37718377 PMCID: PMC10541322 DOI: 10.1038/s41370-023-00601-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Some hormonally active cancers have low survival rates, but a large proportion of their incidence remains unexplained. Endocrine disrupting chemicals may affect hormone pathways in the pathology of these cancers. OBJECTIVE To evaluate cross-sectional associations between per- and polyfluoroalkyl substances (PFAS), phenols, and parabens and self-reported previous cancer diagnoses in the National Health and Nutrition Examination Survey (NHANES). METHODS We extracted concentrations of 7 PFAS and 12 phenols/parabens and self-reported diagnoses of melanoma and cancers of the thyroid, breast, ovary, uterus, and prostate in men and women (≥20 years). Associations between previous cancer diagnoses and an interquartile range increase in exposure biomarkers were evaluated using logistic regression models adjusted for key covariates. We conceptualized race as social construct proxy of structural social factors and examined associations in non-Hispanic Black, Mexican American, and other Hispanic participants separately compared to White participants. RESULTS Previous melanoma in women was associated with higher PFDE (OR:2.07, 95% CI: 1.25, 3.43), PFNA (OR:1.72, 95% CI: 1.09, 2.73), PFUA (OR:1.76, 95% CI: 1.07, 2.89), BP3 (OR: 1.81, 95% CI: 1.10, 2.96), DCP25 (OR: 2.41, 95% CI: 1.22, 4.76), and DCP24 (OR: 1.85, 95% CI: 1.05, 3.26). Previous ovarian cancer was associated with higher DCP25 (OR: 2.80, 95% CI: 1.08, 7.27), BPA (OR: 1.93, 95% CI: 1.11, 3.35) and BP3 (OR: 1.76, 95% CI: 1.00, 3.09). Previous uterine cancer was associated with increased PFNA (OR: 1.55, 95% CI: 1.03, 2.34), while higher ethyl paraben was inversely associated (OR: 0.31, 95% CI: 0.12, 0.85). Various PFAS were associated with previous ovarian and uterine cancers in White women, while MPAH or BPF was associated with previous breast cancer among non-White women. IMPACT STATEMENT Biomarkers across all exposure categories (phenols, parabens, and per- and poly- fluoroalkyl substances) were cross-sectionally associated with increased odds of previous melanoma diagnoses in women, and increased odds of previous ovarian cancer was associated with several phenols and parabens. Some associations differed by racial group, which is particularly impactful given the established racial disparities in distributions of exposure to these chemicals. This is the first epidemiological study to investigate exposure to phenols in relation to previous cancer diagnoses, and the first NHANES study to explore racial/ethnic disparities in associations between environmental phenol, paraben, and PFAS exposures and historical cancer diagnosis.
Collapse
Affiliation(s)
- Amber L Cathey
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Vy K Nguyen
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Justin A Colacino
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Max T Aung
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
| |
Collapse
|
12
|
Knapp EA, Kress AM, Parker CB, Page GP, McArthur K, Gachigi KK, Alshawabkeh AN, Aschner JL, Bastain TM, Breton CV, Bendixsen CG, Brennan PA, Bush NR, Buss C, Camargo, Jr. CA, Catellier D, Cordero JF, Croen L, Dabelea D, Deoni S, D’Sa V, Duarte CS, Dunlop AL, Elliott AJ, Farzan SF, Ferrara A, Ganiban JM, Gern JE, Giardino AP, Towe-Goodman NR, Gold DR, Habre R, Hamra GB, Hartert T, Herbstman JB, Hertz-Picciotto I, Hipwell AE, Karagas MR, Karr CJ, Keenan K, Kerver JM, Koinis-Mitchell D, Lau B, Lester BM, Leve LD, Leventhal B, LeWinn KZ, Lewis J, Litonjua AA, Lyall K, Madan JC, McEvoy CT, McGrath M, Meeker JD, Miller RL, Morello-Frosch R, Neiderhiser JM, O’Connor TG, Oken E, O’Shea M, Paneth N, Porucznik CA, Sathyanarayana S, Schantz SL, Spindel ER, Stanford JB, Stroustrup A, Teitelbaum SL, Trasande L, Volk H, Wadhwa PD, Weiss ST, Woodruff TJ, Wright RJ, Zhao Q, Jacobson LP, Influences on Child Health Outcomes ,OBOPCFE. The Environmental Influences on Child Health Outcomes (ECHO)-Wide Cohort. Am J Epidemiol 2023; 192:1249-1263. [PMID: 36963379 PMCID: PMC10403303 DOI: 10.1093/aje/kwad071] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 03/26/2023] Open
Abstract
The Environmental Influences on Child Health Outcomes (ECHO)-Wide Cohort Study (EWC), a collaborative research design comprising 69 cohorts in 31 consortia, was funded by the National Institutes of Health (NIH) in 2016 to improve children's health in the United States. The EWC harmonizes extant data and collects new data using a standardized protocol, the ECHO-Wide Cohort Data Collection Protocol (EWCP). EWCP visits occur at least once per life stage, but the frequency and timing of the visits vary across cohorts. As of March 4, 2022, the EWC cohorts contributed data from 60,553 children and consented 29,622 children for new EWCP data and biospecimen collection. The median (interquartile range) age of EWCP-enrolled children was 7.5 years (3.7-11.1). Surveys, interviews, standardized examinations, laboratory analyses, and medical record abstraction are used to obtain information in 5 main outcome areas: pre-, peri-, and postnatal outcomes; neurodevelopment; obesity; airways; and positive health. Exposures include factors at the level of place (e.g., air pollution, neighborhood socioeconomic status), family (e.g., parental mental health), and individuals (e.g., diet, genomics).
Collapse
Affiliation(s)
- Emily A Knapp
- Correspondence to Dr. Emily Knapp, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 700 E. Pratt Street, Suite 1000, Baltimore, Maryland 21202 (e-mail: )
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Around Him D, Aschner J, Talavera-Barber MM, Barrett ES, Bastain TM, Bendixsen C, Breton CV, Bush NR, Cacho F, Camargo CA, Carroll KN, Carter BS, Cassidy-Bushrow AE, Cowell W, Croen LA, Dabelea D, Duarte CS, Dunlop AL, Everson TM, Habre R, Hartert TV, Helderman JB, Hipwell AE, Karagas MR, Lester BM, LeWinn KZ, Magzamen S, Morello-Frosch R, O’Connor TG, Padula AM, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort. Int J Environ Res Public Health 2023; 20:6339. [PMID: 37510572 PMCID: PMC10379099 DOI: 10.3390/ijerph20146339] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a "high" exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.
Collapse
Affiliation(s)
- Sheena E. Martenies
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Mingyu Zhang
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anne E. Corrigan
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anton Kvit
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Timothy Shields
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - William Wheaton
- Research Triangle Institute, Research Triangle Park, NC 27709, USA
| | | | - Judy Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Ferdinand Cacho
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Kecia N. Carroll
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian S. Carter
- Department of Pediatrics-Neonatology, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | | | - Whitney Cowell
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA;
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
| | - Anne L. Dunlop
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Todd M. Everson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Tina V. Hartert
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jennifer B. Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Barry M. Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 41642, USA
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Michael Petriello
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, WA 98105, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Joseph B. Stanford
- Department of Pediatrics, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Rosalind J. Wright
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amii M. Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| |
Collapse
|
14
|
Trowbridge J, Abrahamsson D, Bland GD, Jiang T, Wang M, Park JS, Morello-Frosch R, Sirota M, Lee H, Goin DE, Zlatnik MG, Woodruff TJ. Extending Nontargeted Discovery of Environmental Chemical Exposures during Pregnancy and Their Association with Pregnancy Complications-A Cross-Sectional Study. Environ Health Perspect 2023; 131:77003. [PMID: 37466315 PMCID: PMC10355149 DOI: 10.1289/ehp11546] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Nontargeted analysis (NTA) methods identify novel exposures; however, few chemicals have been quantified and interrogated with pregnancy complications. OBJECTIVES We characterized levels of nine exogenous and endogenous chemicals in maternal and cord blood identified, selected, and confirmed in prior NTA steps, including linear and branched isomers perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), monoethylhexyl phthalate, 4-nitrophenol, tetraethylene glycol, tridecanedioic acid, octadecanedioic acid, and deoxycholic acid. We evaluated relationships between maternal and cord levels and between gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy in a diverse pregnancy cohort in San Francisco. METHODS We collected matched maternal and cord serum samples at delivery from 302 pregnant study participants from the Chemicals in Our Bodies cohort in San Francisco. Chemicals were identified via NTA and quantified using targeted approaches. We calculated distributions and Spearman correlation coefficients testing the relationship of chemicals within and between the maternal and cord blood matrices. We used adjusted logistic regression to calculate the odds of GDM and hypertensive disorders of pregnancy associated with an interquartile range increase in maternal chemical exposures. RESULTS We detected linear PFOS, PFHxS, octadecanedioic acid, and deoxycholic acid in at least 97% of maternal samples. Correlations ranged between - 0.1 and 0.9. We observed strong correlations between cord and maternal levels of PFHxS, linear PFOS, and branched PFOS (coefficient = 0.9 , 0.8, and 0.8, respectively). An interquartile range increase in linear and branched PFOS, tridecanedioic acid, octadecanedioic acid, and deoxycholic acid was associated with increased odds ratio (OR) of GDM [OR = 1.33 (95% CI: 0.89, 2.01), 1.24 (95% CI: 0.86, 1.80), 1.26 (95% CI: 0.93, 1.73), 1.24 (95% CI: 0.86, 1.80), and 1.23 (95% CI: 0.87, 1.75), respectively]. Tridecanedioic acid was positively associated with hypertensive disorders of pregnancy [OR = 1.28 (95% CI: 0.90, 1.86)]. DISCUSSION We identified both exogenous and endogenous chemicals seldom quantified in pregnant study participants that were also related to pregnancy complications and demonstrated the utility of NTA to identify chemical exposures of concern. https://doi.org/10.1289/EHP11546.
Collapse
Affiliation(s)
- Jessica Trowbridge
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Dimitri Abrahamsson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Garret D. Bland
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Ting Jiang
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, California, USA
| | - Miaomiao Wang
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, California, USA
| | - June-Soo Park
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, California, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science and Policy Management, University of California, Berkeley, Berkeley, California, USA
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Harim Lee
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Dana E. Goin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Marya G. Zlatnik
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
15
|
Goin DE, Abrahamsson D, Wang M, Park JS, Sirota M, Morello-Frosch R, DeMicco E, Trowbridge J, August L, O'Connell S, Ladella S, Zlatnik MG, Woodruff TJ. Investigating geographic differences in environmental chemical exposures in maternal and cord sera using non-targeted screening and silicone wristbands in California. J Expo Sci Environ Epidemiol 2023; 33:548-557. [PMID: 35449448 PMCID: PMC9585116 DOI: 10.1038/s41370-022-00426-9] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Differential risks for adverse pregnancy outcomes may be influenced by prenatal chemical exposures, but current exposure methods may not fully capture data to identify harms and differences. METHODS We collected maternal and cord sera from pregnant people in Fresno and San Francisco, and screened for over 2420 chemicals using LC-QTOF/MS. We matched San Francisco participants to Fresno participants (N = 150) and compared detection frequencies. Twenty-six Fresno participants wore silicone wristbands evaluated for over 1500 chemicals using quantitative chemical analysis. We assessed whether living in tracts with higher levels of pollution according to CalEnviroScreen correlated with higher numbers of chemicals detected in sera. RESULTS We detected 2167 suspect chemical features across maternal and cord sera. The number of suspect chemical features was not different by city, but a higher number of suspect chemicals in cosmetics or fragrances was detected in the Fresno versus San Francisco participants' sera. We also found high levels of chemicals used in fragrances measured in the silicone wristbands. Fresno participants living in tracts with higher pesticide scores had higher numbers of suspect pesticides in their sera. CONCLUSIONS Multiple exposure-assessment approaches can identify exposure to many chemicals during pregnancy that have not been well-studied for health effects.
Collapse
Affiliation(s)
- Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Dimitri Abrahamsson
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Miaomiao Wang
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute and Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Jessica Trowbridge
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Laura August
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Sacramento, CA, USA
| | | | - Subhashini Ladella
- Fresno Medical Education Program, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, Fresno, CA, USA
| | - Marya G Zlatnik
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA.
| |
Collapse
|
16
|
Enright EA, Eick SM, Morello-Frosch R, Aguiar A, Woodbury ML, Sprowles JLN, Geiger SD, Trowbridge J, Andrade A, Smith S, Park JS, DeMicco E, Padula AM, Woodruff TJ, Schantz SL. Associations of prenatal exposure to per- and polyfluoroalkyl substances (PFAS) with measures of cognition in 7.5-month-old infants: An exploratory study. Neurotoxicol Teratol 2023; 98:107182. [PMID: 37172619 PMCID: PMC10762627 DOI: 10.1016/j.ntt.2023.107182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/07/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to a wide array of adverse maternal and child health outcomes. However, studies examining PFAS in relation to offspring cognition have been inconclusive. OBJECTIVE We examined whether prenatal exposure to a mixture of PFAS was related to cognition in 7.5-month-old infants. METHODS Our analytic sample included participants enrolled in the Chemicals in Our Bodies (CIOB) and Illinois Kids Development Study (IKIDS) cohorts (N = 163). Seven PFAS were measured in 2nd trimester maternal serum samples and were detected in >65% of participants. Infant cognition was measured with a visual recognition memory task using an infrared eye tracker when infants were 7.5 months old. This task included familiarization trials where each infant was shown two identical faces and test trials where each infant was shown the familiar face paired with a novel face. In familiarization, we assessed average run duration (time looking at familiarization stimuli before looking away) as a measure of information processing speed, in addition to time to familiarization (time to reach 20 s of looking at stimuli) and shift rate (the number of times infants looked between stimuli), both as measures of attention. In test trials, we assessed novelty preference (proportion of time looking to the novel face) to measure recognition memory. Linear regression was used to estimate associations of individual PFAS with cognitive outcomes, while Bayesian kernel machine regression (BKMR) was used to estimate mixture effects. RESULTS In adjusted single-PFAS linear regression models, an interquartile range increase in PFNA, PFOA, PFOS, PFHxS, PFDeA, and PFUdA was associated with an increase in shift rate, reflecting better visual attention. Using BKMR, increasing quartiles of the PFAS mixture was similarly associated with a modest increase in shift rate. There were no significant associations between PFAS exposure and time to reach familiarization (another measure of attention), average run duration (information processing speed), or novelty preference (visual recognition memory). CONCLUSION In our study population, prenatal PFAS exposure was modestly associated with an increase in shift rate and was not strongly associated with any adverse cognitive outcomes in 7.5-month-old infants.
Collapse
Affiliation(s)
- Elizabeth A Enright
- Department of Psychology, St. Mary's College of Maryland, St. Mary's City, MD, USA.
| | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Andréa Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Megan L Woodbury
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA; College of Engineering, Northeastern University, Boston, MA, USA
| | - Jenna L N Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA; ICF, Durham, NC, USA
| | - Sarah Dee Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jessica Trowbridge
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Aileen Andrade
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
17
|
Gaber N, Bero L, Woodruff TJ. The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science. Ann Glob Health 2023; 89:37. [PMID: 37273487 PMCID: PMC10237242 DOI: 10.5334/aogh.4013] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/23/2023] [Indexed: 06/06/2023] Open
Abstract
Background Per-and polyfluoroalkyl substances (PFAS) are a class of widely-used chemicals that persist in the environment and bioaccumulate in humans and animals, becoming an increasing cause for global concern. While PFAS have been commercially produced since the 1940s, their toxicity was not publicly established until the late 1990s. The objective of this paper is to evaluate industry documents on PFAS and compare them to the public health literature in order to understand this consequential delay. Methods We reviewed a collection of previously secret industry documents archived at the UCSF Chemical Industry Documents Library, examining whether and how strategies of corporate manipulation of science were used by manufacturers of PFAS. Using well-established methods of document analysis, we developed deductive codes to assess industry influence on the conduct and publication of research. We also conducted a literature review using standard search strategies to establish when scientific information on the health effects of PFAS became public. Results Our review of industry documents shows that companies knew PFAS was "highly toxic when inhaled and moderately toxic when ingested" by 1970, forty years before the public health community. Further, the industry used several strategies that have been shown common to tobacco, pharmaceutical and other industries to influence science and regulation - most notably, suppressing unfavorable research and distorting public discourse. We did not find evidence in this archive of funding favorable research or targeted dissemination of those results. Conclusions The lack of transparency in industry-driven research on industrial chemicals has significant legal, political and public health consequences. Industry strategies to suppress scientific research findings or early warnings about the hazards of industrial chemicals can be analyzed and exposed, in order to guide prevention.
Collapse
Affiliation(s)
| | - Lisa Bero
- University of Colorado Anschutz Medical Campus, US
| | | |
Collapse
|
18
|
Liu Y, Wosu AC, Fleisch AF, Dunlop AL, Starling AP, Ferrara A, Dabelea D, Oken E, Buckley JP, Chatzi L, Karagas MR, Romano ME, Schantz S, O’Connor TG, Woodruff TJ, Zhu Y, Hamra GB, Braun JM. Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI z-Scores and Risk of Overweight/Obesity: Results from the ECHO Cohorts. Environ Health Perspect 2023; 131:67001. [PMID: 37283528 PMCID: PMC10246497 DOI: 10.1289/ehp11545] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Gestational per- and polyfluoroalkyl substances (PFAS) exposure may be associated with adiposity and increased risk of obesity among children and adolescents. However, results from epidemiological studies evaluating these associations are inconsistent. OBJECTIVES We estimated the associations of pregnancy PFAS concentrations with child body mass index (BMI) z -scores and risk of overweight/obesity in eight U.S. cohorts. METHODS We used data from 1,391 mother-child pairs who enrolled in eight Environmental influences on Child Health Outcomes (ECHO) cohorts (enrolled: 1999-2019). We quantified concentrations of seven PFAS in maternal plasma or serum in pregnancy. We measured child weight and height between the ages of 2 and 5 y and calculated age- and sex-specific BMI z -scores; 19.6% children had more than one BMI measurement. We estimated covariate-adjusted associations of individual PFAS and their mixture with child BMI z -scores and risk of overweight/obesity using linear mixed models, modified Poisson regression models, and Bayesian approaches for mixtures. We explored whether child sex modified these associations. RESULTS We observed a pattern of subtle positive associations of PFAS concentrations in pregnancy with BMI z -scores and risk of overweight/obesity. For instance, each doubling in perfluorohexane sulfonic acid concentrations was associated with higher BMI z -scores (β = 0.07 ; 95% CI: 0.01, 0.12). Each doubling in perfluroundecanoic acid [relative risk ( RR ) = 1.10 ; 95% CI: 1.04, 1.16] and N -methyl perfluorooctane sulfonamido acetic acid (RR = 1.06 ; 95% CI: 1.00, 1.12) was associated with increased risk of overweight/obesity, with some evidence of a monotonic dose-response relation. We observed weaker and more imprecise associations of the PFAS mixture with BMI or risk of overweight/obesity. Associations did not differ by child sex. DISCUSSION In eight U.S.-based prospective cohorts, gestational exposure to higher levels of PFAS were associated with slightly higher childhood BMI z -score and risk of overweight or obesity. Future studies should examine associations of gestational exposure to PFAS with adiposity and related cardiometabolic consequences in older children. https://doi.org/10.1289/EHP11545.
Collapse
Affiliation(s)
- Yun Liu
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Adaeze C. Wosu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abby F. Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center and Maine Medical Center Research Institute, Portland, Maine, USA
- Center for Outcomes Research and Evaluation, Maine Medical Center and Maine Medical Center Research Institute, Portland, Maine, USA
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Anne P. Starling
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Jessie P. Buckley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Megan E. Romano
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Thomas G. O’Connor
- Department of Psychiatry, University of Rochester, Rochester, New York, USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Yeyi Zhu
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ghassan B. Hamra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joseph M. Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - and the program collaborators for Environmental influences on Child Health Outcomes
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Pediatric Endocrinology and Diabetes, Maine Medical Center and Maine Medical Center Research Institute, Portland, Maine, USA
- Center for Outcomes Research and Evaluation, Maine Medical Center and Maine Medical Center Research Institute, Portland, Maine, USA
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychiatry, University of Rochester, Rochester, New York, USA
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
19
|
Eick SM, Geiger SD, Alshawabkeh A, Aung M, Barrett ES, Bush N, Carroll KN, Cordero JF, Goin DE, Ferguson KK, Kahn LG, Liang D, Meeker JD, Milne GL, Nguyen RHN, Padula AM, Sathyanarayana S, Taibl KR, Schantz SL, Woodruff TJ, Morello-Frosch R. Urinary oxidative stress biomarkers are associated with preterm birth: an Environmental Influences on Child Health Outcomes program study. Am J Obstet Gynecol 2023; 228:576.e1-576.e22. [PMID: 36400174 PMCID: PMC10149536 DOI: 10.1016/j.ajog.2022.11.1282] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Preterm birth is the leading cause of infant morbidity and mortality worldwide. Elevated levels of oxidative stress have been associated with an increased risk of delivering before term. However, most studies testing this hypothesis have been conducted in racially and demographically homogenous study populations, which do not reflect the diversity within the United States. OBJECTIVE We leveraged 4 cohorts participating in the Environmental Influences on Child Health Outcomes Program to conduct the largest study to date examining biomarkers of oxidative stress and preterm birth (N=1916). Furthermore, we hypothesized that elevated oxidative stress would be associated with higher odds of preterm birth, particularly preterm birth of spontaneous origin. STUDY DESIGN This study was a pooled analysis and meta-analysis of 4 birth cohorts spanning multiple geographic regions in the mainland United States and Puerto Rico (208 preterm births and 1708 full-term births). Of note, 8-iso-prostaglandin-F2α, 2,3-dinor-5,6-dihydro-8-iso-prostaglandin-F2α (F2-IsoP-M; the major 8-iso-prostaglandin-F2α metabolite), and prostaglandin-F2α were measured in urine samples obtained during the second and third trimesters of pregnancy. Logistic regression was used to calculate adjusted odds ratios and 95% confidence intervals for the associations between averaged biomarker concentrations for each participant and all preterm births, spontaneous preterm births, nonspontaneous preterm births (births of medically indicated or unknown origin), and categories of preterm birth (early, moderate, and late). Individual oxidative stress biomarkers were examined in separate models. RESULTS Approximately 11% of our analytical sample was born before term. Relative to full-term births, an interquartile range increase in averaged concentrations of F2-IsoP-M was associated with higher odds of all preterm births (odds ratio, 1.29; 95% confidence interval, 1.11-1.51), with a stronger association observed for spontaneous preterm birth (odds ratio, 1.47; 95% confidence interval, 1.16-1.90). An interquartile range increase in averaged concentrations of 8-iso-prostaglandin-F2α was similarly associated with higher odds of all preterm births (odds ratio, 1.19; 95% confidence interval, 0.94-1.50). The results from our meta-analysis were similar to those from the pooled combined cohort analysis. CONCLUSION Here, oxidative stress, as measured by 8-iso-prostaglandin-F2α, F2-IsoP-M, and prostaglandin-F2α in urine, was associated with increased odds of preterm birth, particularly preterm birth of spontaneous origin and delivery before 34 completed weeks of gestation.
Collapse
Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Sarah D Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | | | - Max Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Emily S Barrett
- Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Rutgers University, Piscataway, NJ
| | - Nicole Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA
| | - Kecia N Carroll
- Departments of Pediatrics and Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Ginger L Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Amy M Padula
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA; Seattle Children's Research Institute, Seattle, WA
| | - Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA; Department of Environmental Science, Policy, and Management, School of Public Health, University of California, Berkeley, Berkeley, CA
| |
Collapse
|
20
|
Ames JL, Burjak M, Avalos LA, Braun JM, Bulka CM, Croen LA, Dunlop AL, Ferrara A, Fry RC, Hedderson MM, Karagas MR, Liang D, Lin PID, Lyall K, Moore B, Morello-Frosch R, O’Connor TG, Oh J, Padula AM, Woodruff TJ, Zhu Y, Hamra GB. Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Childhood Autism-related Outcomes. Epidemiology 2023; 34:450-459. [PMID: 36630444 PMCID: PMC10074577 DOI: 10.1097/ede.0000000000001587] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Epidemiologic evidence linking prenatal exposure to per- and polyfluoroalkyl substances (PFAS) with altered neurodevelopment is inconclusive, and few large studies have focused on autism-related outcomes. We investigated whether blood concentrations of PFAS in pregnancy are associated with child autism-related outcomes. METHODS We included 10 cohorts from the National Institutes of Health (NIH)-funded Environmental influences on Child Health Outcomes (ECHO) program (n = 1,429). We measured 14 PFAS analytes in maternal blood collected during pregnancy; eight analytes met detection criteria for analysis. We assessed quantitative autism-related traits in children via parent report on the Social Responsiveness Scale (SRS). In multivariable linear models, we examined relationships of each PFAS (natural log-transformed) with SRS scores. We further modeled PFAS as a complex mixture using Bayesian methods and examined modification of these relationships by child sex. RESULTS Most PFAS in maternal blood were not associated with child SRS T-scores. Perfluorononanoic acid (PFNA) showed the strongest and most consistent association: each 1-unit increase in ln-transformed PFNA was associated with greater autism-related traits (adjusted β [95% confidence interval (CI)] = 1.5 [-0.1, 3.0]). The summed mixture, which included six PFAS detected in >70% of participants, was not associated with SRS T-scores (adjusted β [95% highest posterior density interval] = 0.7 [-1.4, 3.0]). We did not observe consistent evidence of sex differences. CONCLUSIONS Prenatal blood concentrations of PFNA may be associated with modest increases in child autism-related traits. Future work should continue to examine the relationship between exposures to both legacy and emerging PFAS and additional dimensional, quantitative measures of childhood autism-related outcomes.
Collapse
Affiliation(s)
- Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | | | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI USA
| | | | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA
| | | | | | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Pi-I D. Lin
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Brianna Moore
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | - Jiwon Oh
- Department of Public Health Sciences, University of California, Davis, Davis CA, USA
| | - Amy M. Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | | |
Collapse
|
21
|
Padula AM, Ning X, Bakre S, Barrett ES, Bastain T, Bennett DH, Bloom MS, Breton CV, Dunlop AL, Eick SM, Ferrara A, Fleisch A, Geiger S, Goin DE, Kannan K, Karagas MR, Korrick S, Meeker JD, Morello-Frosch R, O’Connor TG, Oken E, Robinson M, Romano ME, Schantz SL, Schmidt RJ, Starling AP, Zhu Y, Hamra GB, Woodruff TJ. Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental Influences on Child Health Outcomes (ECHO) Program. Environ Health Perspect 2023; 131:37006. [PMID: 36920051 PMCID: PMC10015888 DOI: 10.1289/ehp10723] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/01/2022] [Accepted: 02/06/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are persistent and ubiquitous chemicals associated with risk of adverse birth outcomes. Results of previous studies have been inconsistent. Associations between PFAS and birth outcomes may be affected by psychosocial stress. OBJECTIVES We estimated risk of adverse birth outcomes in relation to prenatal PFAS concentrations and evaluate whether maternal stress modifies those relationships. METHODS We included 3,339 participants from 11 prospective prenatal cohorts in the Environmental influences on the Child Health Outcomes (ECHO) program to estimate the associations of five PFAS and birth outcomes. We stratified by perceived stress scale scores to examine effect modification and used Bayesian Weighted Sums to estimate mixtures of PFAS. RESULTS We observed reduced birth size with increased concentrations of all PFAS. For a 1-unit higher log-normalized exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), we observed lower birthweight-for-gestational-age z-scores of β = - 0.15 [95% confidence interval (CI): - 0.27 , - 0.03 ], β = - 0.14 (95% CI: - 0.28 , - 0.002 ), β = - 0.22 (95% CI: - 0.23 , - 0.10 ), β = - 0.06 (95% CI: - 0.18 , 0.06), and β = - 0.25 (95% CI: - 0.37 , - 0.14 ), respectively. We observed a lower odds ratio (OR) for large-for-gestational-age: OR PFNA = 0.56 (95% CI: 0.38, 0.83), OR PFDA = 0.52 (95% CI: 0.35, 0.77). For a 1-unit increase in log-normalized concentration of summed PFAS, we observed a lower birthweight-for-gestational-age z-score [- 0.28 ; 95% highest posterior density (HPD): - 0.44 , - 0.14 ] and decreased odds of large-for-gestational-age (OR = 0.49 ; 95% HPD: 0.29, 0.82). Perfluorodecanoic acid (PFDA) explained the highest percentage (40%) of the summed effect in both models. Associations were not modified by maternal perceived stress. DISCUSSION Our large, multi-cohort study of PFAS and adverse birth outcomes found a negative association between prenatal PFAS and birthweight-for-gestational-age, and the associations were not different in groups with high vs. low perceived stress. This study can help inform policy to reduce exposures in the environment and humans. https://doi.org/10.1289/EHP10723.
Collapse
Affiliation(s)
- Amy M. Padula
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Xuejuan Ning
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shivani Bakre
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA
| | - Tracy Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Deborah H. Bennett
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Michael S. Bloom
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Stephanie M. Eick
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Abby Fleisch
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, Maine, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Dana E. Goin
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Susan Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachel Morello-Frosch
- School of Public Health and Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, California, USA
| | - Thomas G. O’Connor
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Anne P. Starling
- Center for Lifecourse Epidemiology of Adiposity and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Ghassan B. Hamra
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracey J. Woodruff
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | | |
Collapse
|
22
|
Trowbridge J, Goin DE, Abrahamsson D, Sklar R, Woodruff TJ. Fossil fuel is the common denominator between climate change and petrochemical exposures, and effects on women and children's health. Int J Gynaecol Obstet 2023; 160:368-371. [PMID: 36069123 PMCID: PMC9851939 DOI: 10.1002/ijgo.14408] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 01/22/2023]
Abstract
SynopsisFossil fuels contribute to climate change and petrochemicals, both of which increase maternal and child disease. Reducing fossil fuels can reap a double benefit for climate change and improved health.
Collapse
Affiliation(s)
- Jessica Trowbridge
- Program on Reproductive Health and the Environment, Dept Ob/Gyn & RS, San Francisco, California, USA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Dept Ob/Gyn & RS, San Francisco, California, USA
| | - Dimitri Abrahamsson
- Program on Reproductive Health and the Environment, Dept Ob/Gyn & RS, San Francisco, California, USA
| | - Rachel Sklar
- Program on Reproductive Health and the Environment, Dept Ob/Gyn & RS, San Francisco, California, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Dept Ob/Gyn & RS, San Francisco, California, USA
- Environmental Reserach and Translation for Health (EaRTH) Center, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
23
|
Aung MT, Eick SM, Padula AM, Smith S, Park JS, DeMicco E, Woodruff TJ, Morello-Frosch R. Maternal per- and poly-fluoroalkyl substances exposures associated with higher depressive symptom scores among immigrant women in the Chemicals in Our Bodies cohort in San Francisco. Environ Int 2023; 172:107758. [PMID: 36682206 PMCID: PMC10840585 DOI: 10.1016/j.envint.2023.107758] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 10/05/2022] [Revised: 12/17/2022] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Exposure to per- and poly-fluoroalkyl substances (PFAS) remains an important public health issue due to widespread detection and persistence in environmental media, slow metabolism in humans, and influences on physiological processes such as neurological signaling. Maternal depression is highly prevalent during pregnancy and postpartum and is potentially sensitive to PFAS. The health risks associated with PFAS may be further amplified in historically marginalized communities, including immigrants. OBJECTIVE Evaluate maternal concentrations of PFAS in association with depression scores during pregnancy and whether effects differ between US born and immigrant women. METHODS Our study sample included 282 US born and 235 immigrant pregnant women enrolled in the Chemicals in Our Bodies prospective birth cohort based in San Francisco, CA. We measured 12 PFAS in serum samples collected in the second trimester and depressive symptom scores were assessed using the Center for Epidemiologic Studies Depression Scale. Associations were estimated using linear regression, adjusting for maternal age, education, pre-pregnancy body mass index, and parity. Associations with a PFAS mixture were estimated using quantile g-computation. RESULTS In adjusted linear regression models, a twofold increase in two PFAS was associated with higher depression scores in the overall sample, and this association persisted only among immigrant women (β [95 % confidence interval]: perfluorooctane sulfonic acid (2.7 [0.7-4.7]) and methyl-perfluorooctane sulfonamide acetic acid (2.9 [1.2-4.7]). Quantile g-computation indicated that simultaneously increasing all PFAS in the mixture by one quartile was associated with increased depressive symptoms among immigrant women (mean change per quartile increase = 1.12 [0.002, 2.3]), and associations were stronger compared to US born women (mean change per quartile increase = 0.09 [-1.0, 0.8]). CONCLUSIONS Findings provide new evidence that PFAS are associated with higher depression symptoms among immigrant women during pregnancy. Results can inform efforts to address environmental factors that may affect depression among US immigrants.
Collapse
Affiliation(s)
- Max T Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| |
Collapse
|
24
|
Woodruff TJ, Charlesworth A, Zlatnik MG, Pandipati S, DeNicola N, Latif I. Code OB: We need urgent action on climate change and toxic chemicals. Int J Gynaecol Obstet 2023; 160:363-365. [PMID: 36649076 DOI: 10.1002/ijgo.14566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Tracey J Woodruff
- Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California San Francisco, San Francisco, California, USA
| | - Annemarie Charlesworth
- Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California San Francisco, San Francisco, California, USA
| | - Marya G Zlatnik
- Division of Maternal Fetal Medicine and Program in Reproductive Health & the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Santosh Pandipati
- Obstetrix Medical Group of California, APC, San Jose, California, USA
| | - Nathaniel DeNicola
- Department of Obstetrics and Gynecology, Johns Hopkins Health System, Washington, District of Columbia, USA
| | | |
Collapse
|
25
|
Herbstman JB, Romano ME, Li X, Jacobson LP, Margolis AE, Hamra GB, Bennett DH, Braun JM, Buckley JP, Colburn T, Deoni S, Hoepner LA, Morello-Frosch R, Riley KW, Sathyanarayana S, Schantz SL, Trasande L, Woodruff TJ, Perera FP, Karagas MR. Characterizing changes in behaviors associated with chemical exposures during the COVID-19 pandemic. PLoS One 2023; 18:e0277679. [PMID: 36638141 PMCID: PMC9838870 DOI: 10.1371/journal.pone.0277679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 11/01/2022] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 pandemic-and its associated restrictions-have changed many behaviors that can influence environmental exposures including chemicals found in commercial products, packaging and those resulting from pollution. The pandemic also constitutes a stressful life event, leading to symptoms of acute traumatic stress. Data indicate that the combination of environmental exposure and psychological stress jointly contribute to adverse child health outcomes. Within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort, a national consortium initiated to understand the effects of environmental exposures on child health and development, our objective was to assess whether there were pandemic-related changes in behavior that may be associated with environmental exposures. A total of 1535 participants from nine cohorts completed a survey via RedCap from December 2020 through May 2021. The questionnaire identified behavioral changes associated with the COVID-19 pandemic in expected directions, providing evidence of construct validity. Behavior changes reported by at least a quarter of the respondents include eating less fast food and using fewer ultra-processed foods, hair products, and cosmetics. At least a quarter of respondents reported eating more home cooked meals and using more antibacterial soaps, liquid soaps, hand sanitizers, antibacterial and bleach cleaners. Most frequent predictors of behavior change included Hispanic ethnicity and older age (35 years and older). Respondents experiencing greater COVID-related stress altered their behaviors more than those not reporting stress. These findings highlight that behavior change associated with the pandemic, and pandemic-related psychological stress often co-occur. Thus, prevention strategies and campaigns that limit environmental exposures, support stress reduction, and facilitate behavioral change may lead to the largest health benefits in the context of a pandemic. Analyzing biomarker data in these participants will be helpful to determine if behavior changes reported associate with measured changes in exposure.
Collapse
Affiliation(s)
- Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Megan E. Romano
- Department of Epidemiology, Dartmouth College Geisel School of Medicine, Hanover, NH, United States of America
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Lisa P. Jacobson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Amy E. Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Ghassan B. Hamra
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Deborah H. Bennett
- Department of Public Health Sciences, University of California—Davis, Davis, CA, United States of America
| | - Joseph M. Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Jessie P. Buckley
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Trina Colburn
- Department of Child Health, Behavior, and Development, Seattle Children’s Hospital, Seattle, WA, United States of America
| | - Sean Deoni
- Department of Pediatrics, Rhode Island Hospital, Providence, RI, United States of America
| | - Lori A. Hoepner
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health and Department of Environmental and Occupational Health Sciences, SUNY Downstate Health Sciences University School of Public Health, New York, NY, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Health Sciences, University of California—Berkeley, Berkeley, CA, United States of America
| | - Kylie Wheelock Riley
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, Health, New York, NY, United States of America
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, WA, United States of America
| | - Susan L. Schantz
- Department of Comparative Biosciences, University of Illinois—Urbana-Champaign, Champaign, IL, United States of America
| | - Leonardo Trasande
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Tracey J. Woodruff
- Department of Obstetrics and Gynecology, University of California San Francisco School of Medicine, San Francisco, CA, United States of America
| | - Frederica P. Perera
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Margaret R. Karagas
- Department of Epidemiology, Dartmouth College Geisel School of Medicine, Hanover, NH, United States of America
| | | |
Collapse
|
26
|
Nielsen GH, Heiger-Bernays WJ, Levy JI, White RF, Axelrad DA, Lam J, Chartres N, Abrahamsson DP, Rayasam SDG, Shaffer RM, Zeise L, Woodruff TJ, Ginsberg GL. Application of probabilistic methods to address variability and uncertainty in estimating risks for non-cancer health effects. Environ Health 2023; 21:129. [PMID: 36635712 PMCID: PMC9835218 DOI: 10.1186/s12940-022-00918-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Human health risk assessment currently uses the reference dose or reference concentration (RfD, RfC) approach to describe the level of exposure to chemical hazards without appreciable risk for non-cancer health effects in people. However, this "bright line" approach assumes that there is minimal risk below the RfD/RfC with some undefined level of increased risk at exposures above the RfD/RfC and has limited utility for decision-making. Rather than this dichotomous approach, non-cancer risk assessment can benefit from incorporating probabilistic methods to estimate the amount of risk across a wide range of exposures and define a risk-specific dose. We identify and review existing approaches for conducting probabilistic non-cancer risk assessments. Using perchloroethylene (PCE), a priority chemical for the U.S. Environmental Protection Agency under the Toxic Substances Control Act, we calculate risk-specific doses for the effects on cognitive deficits using probabilistic risk assessment approaches. Our probabilistic risk assessment shows that chronic exposure to 0.004 ppm PCE is associated with approximately 1-in-1,000 risk for a 5% reduced performance on the Wechsler Memory Scale Visual Reproduction subtest with 95% confidence. This exposure level associated with a 1-in-1000 risk for non-cancer neurocognitive deficits is lower than the current RfC for PCE of 0.0059 ppm, which is based on standard point of departure and uncertainty factor approaches for the same neurotoxic effects in occupationally exposed adults. We found that the population-level risk of cognitive deficit (indicating central nervous system dysfunction) is estimated to be greater than the cancer risk level of 1-in-100,000 at a similar chronic exposure level. The extension of toxicological endpoints to more clinically relevant endpoints, along with consideration of magnitude and severity of effect, will help in the selection of acceptable risk targets for non-cancer effects. We find that probabilistic approaches can 1) provide greater context to existing RfDs and RfCs by describing the probability of effect across a range of exposure levels including the RfD/RfC in a diverse population for a given magnitude of effect and confidence level, 2) relate effects of chemical exposures to clinical disease risk so that the resulting risk assessments can better inform decision-makers and benefit-cost analysis, and 3) better reflect the underlying biology and uncertainties of population risks.
Collapse
Affiliation(s)
- Greylin H Nielsen
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA
| | - Wendy J Heiger-Bernays
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA.
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA
| | | | - Juleen Lam
- Department of Public Health, California State University, East Bay, Hayward, CA, USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Dimitri Panagopoulos Abrahamsson
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Swati D G Rayasam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel M Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Lauren Zeise
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gary L Ginsberg
- Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT, USA
| |
Collapse
|
27
|
Varshavsky JR, Rayasam SDG, Sass JB, Axelrad DA, Cranor CF, Hattis D, Hauser R, Koman PD, Marquez EC, Morello-Frosch R, Oksas C, Patton S, Robinson JF, Sathyanarayana S, Shepard PM, Woodruff TJ. Current practice and recommendations for advancing how human variability and susceptibility are considered in chemical risk assessment. Environ Health 2023; 21:133. [PMID: 36635753 PMCID: PMC9835253 DOI: 10.1186/s12940-022-00940-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A key element of risk assessment is accounting for the full range of variability in response to environmental exposures. Default dose-response methods typically assume a 10-fold difference in response to chemical exposures between average (healthy) and susceptible humans, despite evidence of wider variability. Experts and authoritative bodies support using advanced techniques to better account for human variability due to factors such as in utero or early life exposure and exposure to multiple environmental, social, and economic stressors.This review describes: 1) sources of human variability and susceptibility in dose-response assessment, 2) existing US frameworks for addressing response variability in risk assessment; 3) key scientific inadequacies necessitating updated methods; 4) improved approaches and opportunities for better use of science; and 5) specific and quantitative recommendations to address evidence and policy needs.Current default adjustment factors do not sufficiently capture human variability in dose-response and thus are inadequate to protect the entire population. Susceptible groups are not appropriately protected under current regulatory guidelines. Emerging tools and data sources that better account for human variability and susceptibility include probabilistic methods, genetically diverse in vivo and in vitro models, and the use of human data to capture underlying risk and/or assess combined effects from chemical and non-chemical stressors.We recommend using updated methods and data to improve consideration of human variability and susceptibility in risk assessment, including the use of increased default human variability factors and separate adjustment factors for capturing age/life stage of development and exposure to multiple chemical and non-chemical stressors. Updated methods would result in greater transparency and protection for susceptible groups, including children, infants, people who are pregnant or nursing, people with disabilities, and those burdened by additional environmental exposures and/or social factors such as poverty and racism.
Collapse
Affiliation(s)
- Julia R Varshavsky
- Department of Health Sciences and Department of Civil and Environmental Engineering Northeastern University, Boston, MA, 02115, USA.
| | - Swati D G Rayasam
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Carl F Cranor
- Department of Philosophy, University of California, Riverside, Riverside, CA, USA
- Environmental Toxicology Graduate Program, College of Natural and Agricultural Sciences, University of California, Riverside, Riverside, CA, USA
| | - Dale Hattis
- The George Perkins Marsh Institute, Clark University, Worcester, MA, USA
| | - Russ Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Patricia D Koman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Rachel Morello-Frosch
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Catherine Oksas
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | | | - Joshua F Robinson
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | | | - Tracey J Woodruff
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
28
|
Vandenberg LN, Rayasam SDG, Axelrad DA, Bennett DH, Brown P, Carignan CC, Chartres N, Diamond ML, Joglekar R, Shamasunder B, Shrader-Frechette K, Subra WA, Zarker K, Woodruff TJ. Addressing systemic problems with exposure assessments to protect the public's health. Environ Health 2023; 21:121. [PMID: 36635700 PMCID: PMC9835264 DOI: 10.1186/s12940-022-00917-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Understanding, characterizing, and quantifying human exposures to environmental chemicals is critical to protect public health. Exposure assessments are key to determining risks to the general population and for specific subpopulations given that exposures differ between groups. Exposure data are also important for understanding where interventions, including public policies, should be targeted and the extent to which interventions have been successful. In this review, we aim to show how inadequacies in exposure assessments conducted by polluting industries or regulatory agencies have led to downplaying or disregarding exposure concerns raised by communities; that underestimates of exposure can lead regulatory agencies to conclude that unacceptable risks are, instead, acceptable, allowing pollutants to go unregulated; and that researchers, risk assessors, and policy makers need to better understand the issues that have affected exposure assessments and how appropriate use of exposure data can contribute to health-protective decisions. METHODS We describe current approaches used by regulatory agencies to estimate human exposures to environmental chemicals, including approaches to address limitations in exposure data. We then illustrate how some exposure assessments have been used to reach flawed conclusions about environmental chemicals and make recommendations for improvements. RESULTS Exposure data are important for communities, public health advocates, scientists, policy makers, and other groups to understand the extent of environmental exposures in diverse populations. We identify four areas where exposure assessments need to be improved due to systemic sources of error or uncertainty in exposure assessments and illustrate these areas with examples. These include: (1) an inability of regulatory agencies to keep pace with the increasing number of chemicals registered for use or assess their exposures, as well as complications added by use of 'confidential business information' which reduce available exposure data; (2) the failure to keep assessments up-to-date; (3) how inadequate assumptions about human behaviors and co-exposures contribute to underestimates of exposure; and (4) that insufficient models of toxicokinetics similarly affect exposure estimates. CONCLUSION We identified key issues that impact capacity to conduct scientifically robust exposure assessments. These issues must be addressed with scientific or policy approaches to improve estimates of exposure and protect public health.
Collapse
Affiliation(s)
- Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
| | - Swati D G Rayasam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | | | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Phil Brown
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, USA
| | - Courtney C Carignan
- Department of Food Science and Human Nutrition, Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, Toronto, ON, Canada
- School of the Environment, University of Toronto, Toronto, ON, Canada
| | - Rashmi Joglekar
- Earthjustice, New York, NY, USA
- Earthjustice, Washington, DC, USA
| | - Bhavna Shamasunder
- Department of Urban & Environmental Policy and Public Health, Occidental College, Los Angeles, CA, USA
| | - Kristin Shrader-Frechette
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, USA
- Department of Philosophy, University of Notre Dame, Notre Dame, IN, USA
| | - Wilma A Subra
- Louisiana Environmental Action Network, Baton Rouge, LA, USA
| | - Ken Zarker
- Washington State Department of Ecology, Olympia, WA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| |
Collapse
|
29
|
Maffini MV, Rayasam SDG, Axelrad DA, Birnbaum LS, Cooper C, Franjevic S, MacRoy PM, Nachman KE, Patisaul HB, Rodgers KM, Rossi MS, Schettler T, Solomon GM, Woodruff TJ. Advancing the science on chemical classes. Environ Health 2023; 21:120. [PMID: 36635752 PMCID: PMC9835214 DOI: 10.1186/s12940-022-00919-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Hazard identification, risk assessment, regulatory, and policy activity are usually conducted on a chemical-by-chemical basis. Grouping chemicals into categories or classes is an underutilized approach that could make risk assessment and management of chemicals more efficient for regulators. OBJECTIVE AND METHODS While there are some available methods and regulatory frameworks that include the grouping of chemicals (e.g.,same molecular mechanism or similar chemical structure) there has not been a comprehensive evaluation of these different approaches nor a recommended course of action to better consider chemical classes in decision-making. This manuscript: 1) reviews current national and international approaches to grouping; 2) describes how groups could be defined based on the decision context (e.g., hazard/risk assessment, restrictions, prioritization, product development) and scientific considerations (e.g., intrinsic physical-chemical properties); 3) discusses advantages of developing a decision tree approach for grouping; 4) uses ortho-phthalates as a case study to identify and organize frameworks that could be used across agencies; and 5) discusses opportunities to advance the class concept within various regulatory decision-making scenarios. RESULTS Structural similarity was the most common grouping approach for risk assessment among regulatory agencies (national and state level) and non-regulatory organizations, albeit with some variations in its definition. Toxicity to the same target organ or to the same biological function was also used in a few cases. The phthalates case study showed that a decision tree approach for grouping should include questions about uses regulated by other agencies to encourage more efficient, coherent, and protective chemical risk management. DISCUSSION AND CONCLUSION Our evaluation of how classes of chemicals are defined and used identified commonalities and differences based on regulatory frameworks, risk assessments, and business strategies. We also identified that using a class-based approach could result in a more efficient process to reduce exposures to multiple hazardous chemicals and, ultimately, reduce health risks. We concluded that, in the absence of a prescribed method, a decision tree approach could facilitate the selection of chemicals belonging to a pre-defined class (e.g., chemicals with endocrine-disrupting activity; organohalogen flame retardants [OFR]) based on the decision-making context (e.g., regulatory risk management).
Collapse
Affiliation(s)
| | - Swati D G Rayasam
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| | | | - Linda S Birnbaum
- Scientist Emeritus and Former Director, National Institutes of Environmental Health Sciences and National Toxicology Program, Research Triangle Park, NC, USA
- Scholar in Residence, Duke University, Durham, NC, USA
| | - Courtney Cooper
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| | | | | | - Keeve E Nachman
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Risk Sciences and Public Policy Institute Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Heather B Patisaul
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | | | | | - Ted Schettler
- Science and Environmental Health Network, Ames, Iowa, USA
| | - Gina M Solomon
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
- Public Health Institute, Oakland, CA, USA
| | - Tracey J Woodruff
- Department of Obstetrics, Program on Reproductive Health and the Environment, Gynecology and Reproductive Sciences, University of California, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| |
Collapse
|
30
|
Woodruff TJ, Rayasam SDG, Axelrad DA, Koman PD, Chartres N, Bennett DH, Birnbaum LS, Brown P, Carignan CC, Cooper C, Cranor CF, Diamond ML, Franjevic S, Gartner EC, Hattis D, Hauser R, Heiger-Bernays W, Joglekar R, Lam J, Levy JI, MacRoy PM, Maffini MV, Marquez EC, Morello-Frosch R, Nachman KE, Nielsen GH, Oksas C, Abrahamsson DP, Patisaul HB, Patton S, Robinson JF, Rodgers KM, Rossi MS, Rudel RA, Sass JB, Sathyanarayana S, Schettler T, Shaffer RM, Shamasunder B, Shepard PM, Shrader-Frechette K, Solomon GM, Subra WA, Vandenberg LN, Varshavsky JR, White RF, Zarker K, Zeise L. A science-based agenda for health-protective chemical assessments and decisions: overview and consensus statement. Environ Health 2023; 21:132. [PMID: 36635734 PMCID: PMC9835243 DOI: 10.1186/s12940-022-00930-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 06/17/2023]
Abstract
The manufacture and production of industrial chemicals continues to increase, with hundreds of thousands of chemicals and chemical mixtures used worldwide, leading to widespread population exposures and resultant health impacts. Low-wealth communities and communities of color often bear disproportionate burdens of exposure and impact; all compounded by regulatory delays to the detriment of public health. Multiple authoritative bodies and scientific consensus groups have called for actions to prevent harmful exposures via improved policy approaches. We worked across multiple disciplines to develop consensus recommendations for health-protective, scientific approaches to reduce harmful chemical exposures, which can be applied to current US policies governing industrial chemicals and environmental pollutants. This consensus identifies five principles and scientific recommendations for improving how agencies like the US Environmental Protection Agency (EPA) approach and conduct hazard and risk assessment and risk management analyses: (1) the financial burden of data generation for any given chemical on (or to be introduced to) the market should be on the chemical producers that benefit from their production and use; (2) lack of data does not equate to lack of hazard, exposure, or risk; (3) populations at greater risk, including those that are more susceptible or more highly exposed, must be better identified and protected to account for their real-world risks; (4) hazard and risk assessments should not assume existence of a "safe" or "no-risk" level of chemical exposure in the diverse general population; and (5) hazard and risk assessments must evaluate and account for financial conflicts of interest in the body of evidence. While many of these recommendations focus specifically on the EPA, they are general principles for environmental health that could be adopted by any agency or entity engaged in exposure, hazard, and risk assessment. We also detail recommendations for four priority areas in companion papers (exposure assessment methods, human variability assessment, methods for quantifying non-cancer health outcomes, and a framework for defining chemical classes). These recommendations constitute key steps for improved evidence-based environmental health decision-making and public health protection.
Collapse
Affiliation(s)
- Tracey J Woodruff
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA.
| | - Swati D G Rayasam
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA
| | | | - Patricia D Koman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Chartres
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Linda S Birnbaum
- National Institutes of Environmental Health Sciences and National Toxicology Program, Research Triangle Park, NC, USA
- Duke University, Durham, NC, USA
| | - Phil Brown
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, USA
| | - Courtney C Carignan
- Department of Food Science and Human Nutrition, Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA
| | - Courtney Cooper
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA
| | - Carl F Cranor
- Department of Philosophy, University of California, Riverside, Riverside, CA, USA
- Environmental Toxicology Graduate Program, College of Natural and Agricultural Sciences, University of California, Riverside, Riverside, CA, USA
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, Toronto, ON, Canada
- School of the Environment, University of Toronto, Toronto, ON, Canada
| | | | | | - Dale Hattis
- The George Perkins Marsh Institute, Clark University, Worcester, MA, USA
| | - Russ Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Wendy Heiger-Bernays
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | | | - Juleen Lam
- Department of Public Health, California State University, East Bay, Hayward, CA, USA
| | - Jonathan I Levy
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | | | | | | | - Rachel Morello-Frosch
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Keeve E Nachman
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Greylin H Nielsen
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Catherine Oksas
- School of Medicine, University of California, San Francisco, CA, USA
| | - Dimitri Panagopoulos Abrahamsson
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA
| | - Heather B Patisaul
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | | | - Joshua F Robinson
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 490 Illinois Street, Floor 10, Box 0132, San Francisco, CA, 94143, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Department of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Ted Schettler
- Science and Environmental Health Network, Ames, IA, USA
| | - Rachel M Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, USA
| | - Bhavna Shamasunder
- Department of Urban & Environmental Policy and Public Health, Occidental College, Los Angeles, CA, USA
| | | | - Kristin Shrader-Frechette
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, USA
- Department of Philosophy, University of Notre Dame, Notre Dame, IN, USA
| | - Gina M Solomon
- School of Medicine, University of California, San Francisco, CA, USA
- Public Health Institute, Oakland, CA, USA
| | - Wilma A Subra
- Louisiana Environmental Action Network, Baton Rouge, LA, USA
| | - Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts, Amherst, Amherst, MA, USA
| | - Julia R Varshavsky
- Department of Health Sciences, Northeastern University, Boston, MA, USA
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Roberta F White
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Ken Zarker
- Washington State Department of Ecology, Olympia, WA, USA
| | - Lauren Zeise
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| |
Collapse
|
31
|
Eick SM, Goin DE, Trowbridge J, Cushing L, Smith SC, Park JS, DeMicco E, Padula AM, Woodruff TJ, Morello-Frosch R. Dietary predictors of prenatal per- and poly-fluoroalkyl substances exposure. J Expo Sci Environ Epidemiol 2023; 33:32-39. [PMID: 34615969 PMCID: PMC8983786 DOI: 10.1038/s41370-021-00386-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/23/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Per- and poly-fluoroalkyl substances (PFAS) are commonly detected in a variety of foods and food packaging materials. However, few studies have examined diet as a potential source of PFAS exposure during pregnancy. In the present cross-sectional study, we examined prenatal PFAS levels in relation to self-reported consumption of meats, dairy products, and processed foods during pregnancy. METHODS Participants were enrolled in the Chemicals in Our Bodies study, a demographically diverse pregnancy cohort in San Francisco, CA (N = 509). Diet was assessed using a self-reported interview questionnaire administered during the second trimester. Participants were asked on average how many times a day, week, or month they ate 11 different foods since becoming pregnant. Responses were categorized as at least once a week or less than once a week and foods were grouped into three categories: processed foods, dairy products, and meats. Twelve PFAS (ng/mL) were measured in second trimester serum samples. We investigated relationships between consumption of individual dairy products, meats, and processed foods and natural log-transformed PFAS using separate linear regression models adjusted for maternal age, education, race/ethnicity, and nativity. RESULTS Seven PFAS were detected in ≥65% of participants. Consumption of dairy milk and cheese at least once per week was moderately associated with elevated levels of perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDeA) relative to those who ate dairy products less than once week. The strongest associations observed were with PFDeA for dairy milk (β = 0.2, 95% confidence interval [CI] = 0.02, 0.39) and PFNA for cheese (β = 0.22, 95% CI = 0.02, 0.41). Eating fish, poultry, and red meat at least once per week was associated with higher levels of perfluoroundecanoic acid, PFDeA, PFNA, and perflucorooctane sulfonic acid. CONCLUSIONS Results indicate that consumption of animal products may contribute to elevated prenatal PFAS levels.
Collapse
Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Trowbridge
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sabrina Crispo Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| |
Collapse
|
32
|
Goin DE, Abrahamsson D, Wang M, Jiang T, Park JS, Sirota M, Morello-Frosch R, DeMicco E, Zlatnik MG, Woodruff TJ. Disparities in chemical exposures among pregnant women and neonates by socioeconomic and demographic characteristics: A nontargeted approach. Environ Res 2022; 215:114158. [PMID: 36049512 PMCID: PMC10016233 DOI: 10.1016/j.envres.2022.114158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Exposure to environmental chemicals during pregnancy adversely affects maternal and infant health, and identifying socio-demographic differences in exposures can inform contributions to health inequities. METHODS We recruited 294 demographically diverse pregnant participants in San Francisco from the Mission Bay/Moffit Long (MB/ML) hospitals, which serve a primarily higher income population, and Zuckerberg San Francisco General Hospital (ZSFGH), which serves a lower income population. We collected maternal and cord sera, which we screened for 2420 unique formulas and their isomers using high-resolution mass spectrometry using LC-QTOF/MS. We assessed differences in chemical abundances across socioeconomic and demographic groups using linear regression adjusting for false discovery rate. RESULTS Our participants were racially diverse (31% Latinx, 16% Asian/Pacific Islander, 5% Black, 5% other or multi-race, and 43% white). A substantial portion experienced financial strain (28%) and food insecurity (20%) during pregnancy. We observed significant abundance differences in maternal (9 chemicals) and cord sera (39 chemicals) between participants who delivered at the MB/ML hospitals versus ZSFGH. Of the 39 chemical features differentially detected in cord blood, 18 were present in pesticides, one per- or poly-fluoroalkyl substance (PFAS), 21 in plasticizers, 24 in cosmetics, and 17 in pharmaceuticals; 4 chemical features had unknown sources. A chemical feature annotated as 2,4-dichlorophenol had higher abundances among Latinx compared to white participants, those delivering at ZSFGH compared to MB/ML, those with food insecurity, and those with financial strain. Post-hoc QTOF analyses indicated the chemical feature was either 2,4-dichlorophenol or 2,5-dichlorophenol, both of which have potential endocrine-disrupting effects. CONCLUSIONS Chemical exposures differed between delivery hospitals, likely due to underlying social conditions faced by populations served. Differential exposures to 2,4-dichlorophenol or 2,5-dichlorophenol may contribute to disparities in adverse outcomes.
Collapse
Affiliation(s)
- Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Dimitri Abrahamsson
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Miaomiao Wang
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Ting Jiang
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute and Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Marya G Zlatnik
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA.
| |
Collapse
|
33
|
Rayasam SDG, Koman PD, Axelrad DA, Woodruff TJ, Chartres N. Rebuttal to Correspondence: "Toxic Substances Control Act (TSCA) Implementation: How the Amended Law Has Failed to Protect Vulnerable Populations from Toxic Chemicals in the United States". Environ Sci Technol 2022; 56:16535-16537. [PMID: 36322049 DOI: 10.1021/acs.est.2c07446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Swati D G Rayasam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California94143, United States
| | - Patricia D Koman
- Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan48109, United States
| | | | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California94143, United States
- Environmental Research and Translation for Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California94143, United States
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California94143, United States
| |
Collapse
|
34
|
Taibl KR, Schantz S, Aung MT, Padula A, Geiger S, Smith S, Park JS, Milne GL, Robinson JF, Woodruff TJ, Morello-Frosch R, Eick SM. Associations of per- and polyfluoroalkyl substances (PFAS) and their mixture with oxidative stress biomarkers during pregnancy. Environ Int 2022; 169:107541. [PMID: 36191484 PMCID: PMC9846434 DOI: 10.1016/j.envint.2022.107541] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 06/01/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Oxidative stress from excess reactive oxygen species (ROS) is a hypothesized contributor to preterm birth. Per- and polyfluoroalkyl substances (PFAS) exposure is reported to generate ROS in laboratory settings, and is linked to adverse birth outcomes globally. However, to our knowledge, the relationship between PFAS and oxidative stress has not been examined in the context of human pregnancy. OBJECTIVE To investigate the associations between prenatal PFAS exposure and oxidative stress biomarkers among pregnant people. METHODS Our analytic sample included 428 participants enrolled in the Illinois Kids Development Study and Chemicals In Our Bodies prospective birth cohorts between 2014 and 2019. Twelve PFAS were measured in second trimester serum. We focused on seven PFAS that were detected in >65 % of participants. Urinary levels of 8-isoprostane-prostaglandin-F2α, prostaglandin-F2α, 2,3-dinor-8-iso-PGF2α, and 2,3-dinor-5,6-dihydro-8-iso-PGF2α were measured in the second and third trimesters as biomarkers of oxidative stress. We fit linear mixed-effects models to estimate individual associations between PFAS and oxidative stress biomarkers. We used quantile g-computation and Bayesian kernel machine regression (BKMR) to assess associations between the PFAS mixture and averaged oxidative stress biomarkers. RESULTS Linear mixed-effects models showed that an interquartile range increase in perfluorooctane sulfonic acid (PFOS) was associated with an increase in 8-isoprostane-prostaglandin-F2α (β = 0.10, 95 % confidence interval = 0, 0.20). In both quantile g-computation and BKMR, and across all oxidative stress biomarkers, PFOS contributed the most to the overall mixture effect. The six remaining PFAS were not significantly associated with changes in oxidative stress biomarkers. CONCLUSIONS Our study is the first to investigate the relationship between PFAS exposure and biomarkers of oxidative stress during human pregnancy. We found that PFOS was associated with elevated levels of oxidative stress, which is consistent with prior work in animal models and cell lines. Future research is needed to understand how prenatal PFAS exposure and maternal oxidative stress may affect fetal development.
Collapse
Affiliation(s)
- Kaitlin R Taibl
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Max T Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Amy Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sarah Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Ginger L Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joshua F Robinson
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| |
Collapse
|
35
|
Abrahamsson D, Siddharth A, Robinson JF, Soshilov A, Elmore S, Cogliano V, Ng C, Khan E, Ashton R, Chiu WA, Fung J, Zeise L, Woodruff TJ. Modeling the transplacental transfer of small molecules using machine learning: a case study on per- and polyfluorinated substances (PFAS). J Expo Sci Environ Epidemiol 2022; 32:808-819. [PMID: 36207486 PMCID: PMC9742309 DOI: 10.1038/s41370-022-00481-2] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Despite their large numbers and widespread use, very little is known about the extent to which per- and polyfluoroalkyl substances (PFAS) can cross the placenta and expose the developing fetus. OBJECTIVE The aim of our study is to develop a computational approach that can be used to evaluate the of extend to which small molecules, and in particular PFAS, can cross to cross the placenta and partition to cord blood. METHODS We collected experimental values of the concentration ratio between cord and maternal blood (RCM) for 260 chemical compounds and calculated their physicochemical descriptors using the cheminformatics package Mordred. We used the compiled database to, train and test an artificial neural network (ANN). And then applied the best performing model to predict RCM for a large dataset of PFAS chemicals (n = 7982). We, finally, examined the calculated physicochemical descriptors of the chemicals to identify which properties correlated significantly with RCM. RESULTS We determined that 7855 compounds were within the applicability domain and 127 compounds are outside the applicability domain of our model. Our predictions of RCM for PFAS suggested that 3623 compounds had a log RCM > 0 indicating preferable partitioning to cord blood. Some examples of these compounds were bisphenol AF, 2,2-bis(4-aminophenyl)hexafluoropropane, and nonafluoro-tert-butyl 3-methylbutyrate. SIGNIFICANCE These observations have important public health implications as many PFAS have been shown to interfere with fetal development. In addition, as these compounds are highly persistent and many of them can readily cross the placenta, they are expected to remain in the population for a long time as they are being passed from parent to offspring. IMPACT Understanding the behavior of chemicals in the human body during pregnancy is critical in preventing harmful exposures during critical periods of development. Many chemicals can cross the placenta and expose the fetus, however, the mechanism by which this transport occurs is not well understood. In our study, we developed a machine learning model that describes the transplacental transfer of chemicals as a function of their physicochemical properties. The model was then used to make predictions for a set of 7982 per- and polyfluorinated alkyl substances that are listed on EPA's CompTox Chemicals Dashboard. The model can be applied to make predictions for other chemical categories of interest, such as plasticizers and pesticides. Accurate predictions of RCM can help scientists and regulators to prioritize chemicals that have the potential to cause harm by exposing the fetus.
Collapse
Affiliation(s)
- Dimitri Abrahamsson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, USA.
| | - Adi Siddharth
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, USA
| | - Joshua F Robinson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, USA
| | - Anatoly Soshilov
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1001 I St, Sacramento, CA, 95814, USA
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1515 Clay St, Oakland, CA, 94612, USA
| | - Sarah Elmore
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1001 I St, Sacramento, CA, 95814, USA
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1515 Clay St, Oakland, CA, 94612, USA
| | - Vincent Cogliano
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1001 I St, Sacramento, CA, 95814, USA
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1515 Clay St, Oakland, CA, 94612, USA
| | - Carla Ng
- Department of Civil and Environmental Engineering, University of Pittsburgh, 3700 O'Hara St, Pittsburgh, PA, 15261, USA
| | - Elaine Khan
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1001 I St, Sacramento, CA, 95814, USA
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1515 Clay St, Oakland, CA, 94612, USA
| | - Randolph Ashton
- Wisconsin Institute for Discovery, University of Wisconsin, Madison, 330 N Orchard St, Madison, WI, 53715, USA
- The Stem Cell and Regenerative Medicine Center, University of Wisconsin, Madison, 1111 Highland Avenue, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin - Madison, 1550 Engineering Drive, Madison, WI, 53706, USA
| | - Weihsueh A Chiu
- Department of Veterinary Physiology and Pharmacology, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Jennifer Fung
- Department of Obstetrics, Gynecology, and Reproductive Science and the Center of Reproductive Science, University of California, San Francisco, San Francisco, CA, 94143-2240, USA
| | - Lauren Zeise
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1001 I St, Sacramento, CA, 95814, USA
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, 1515 Clay St, Oakland, CA, 94612, USA
| | - Tracey J Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, USA.
| |
Collapse
|
36
|
Choi G, Kuiper JR, Bennett DH, Barrett ES, Bastain TM, Breton CV, Chinthakindi S, Dunlop AL, Farzan SF, Herbstman JB, Karagas MR, Marsit CJ, Meeker JD, Morello-Frosch R, O'Connor TG, Pellizzari ED, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Watkins DJ, Zhu H, Kannan K, Buckley JP, Woodruff TJ. Exposure to melamine and its derivatives and aromatic amines among pregnant women in the United States: The ECHO Program. Chemosphere 2022; 307:135599. [PMID: 36055588 PMCID: PMC9748524 DOI: 10.1016/j.chemosphere.2022.135599] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/24/2022] [Accepted: 07/01/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Melamine, melamine derivatives, and aromatic amines are nitrogen-containing compounds with known toxicity and widespread commercial uses. Nevertheless, biomonitoring of these chemicals is lacking, particularly during pregnancy, a period of increased susceptibility to adverse health effects. OBJECTIVES We aimed to measure melamine, melamine derivatives, and aromatic amine exposure in pregnant women across the United States (U.S.) and evaluate associations with participant and urine sample collection characteristics. METHODS We measured 43 analytes, representing 45 chemicals (i.e., melamine, three melamine derivatives, and 41 aromatic amines), in urine from pregnant women in nine diverse ECHO cohorts during 2008-2020 (N = 171). To assess relations with participant and urine sample collection characteristics, we used generalized estimating equations to estimate prevalence ratios (PRs) for analytes dichotomized at the detection limit, % differences (%Δ) for continuous analytes, and 95% confidence intervals. Multivariable models included age, race/ethnicity, marital status, urinary cotinine, and year of sample collection. RESULTS Twelve chemicals were detected in >60% of samples, with near ubiquitous detection of cyanuric acid, melamine, aniline, 4,4'-methylenedianiline, and a composite of o-toluidine and m-toluidine (99-100%). In multivariable adjusted models, most chemicals were associated with higher exposures among Hispanic and non-Hispanic Black participants. For example, concentrations of 3,4-dichloroaniline were higher among Hispanic (%Δ: +149, 95% CI: +17, +431) and non-Hispanic Black (%Δ: +136, 95% CI: +35, +311) women compared with non-Hispanic White women. We observed similar results for ammelide, o-/m-toluidine, 4,4'-methylenedianiline, and 4-chloroaniline. Most chemicals were positively associated with urinary cotinine, with strongest associations observed for o-/m-toluidine (%Δ: +23; 95% CI: +16, +31) and 3,4-dichloroaniline (%Δ: +25; 95% CI: +17, +33). Some chemicals exhibited annual trends (e.g., %Δ in melamine per year: -11; 95% CI: -19, -1) or time of day, seasonal, and geographic variability. DISCUSSION Exposure to melamine, cyanuric acid, and some aromatic amines was ubiquitous in this first investigation of these analytes in pregnant women. Future research should expand biomonitoring, identify sources of exposure disparities by race/ethnicity, and evaluate potential adverse health effects.
Collapse
Affiliation(s)
- Giehae Choi
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jordan R Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sridhar Chinthakindi
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, CA, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | | | - Megan E Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Hongkai Zhu
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Tracey J Woodruff
- Department of Obstetrics, Gynecology, and Reproductive Sciences and the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
37
|
Eick SM, Cushing L, Goin DE, Padula AM, Andrade A, DeMicco E, Woodruff TJ, Morello-Frosch R. Neighborhood conditions and birth outcomes: Understanding the role of perceived and extrinsic measures of neighborhood quality. Environ Epidemiol 2022; 6:e224. [PMID: 36249266 PMCID: PMC9555921 DOI: 10.1097/ee9.0000000000000224] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022] Open
Abstract
Living in a disadvantaged neighborhood has been associated with adverse birth outcomes. Most prior studies have conceptualized neighborhoods using census boundaries and few have examined the role of neighborhood perceptions, which may better capture the neighborhood environment. In the present study, we examined associations between extrinsic and perceived neighborhood quality measures and adverse birth outcomes. Methods Participants resided in the San Francisco Bay Area of California and were enrolled in Chemicals in Our Bodies, a prospective birth cohort (N = 817). The Index of Concentration at the Extremes (ICE) for income, Area Deprivation Index (ADI), and the Urban Displacement Project's measure of gentrification were included as census block group-level extrinsic neighborhood quality measures. Poor perceived neighborhood quality was assessed using an interview questionnaire. Linear regression models were utilized to examine associations between extrinsic and perceived neighborhood quality measures, and gestational age and birthweight for gestational age z-scores. Covariates in adjusted models were chosen via a directed acyclic graph (DAG) and included maternal age, education, and marital status. Results In adjusted models, having poor perceived neighborhood quality was associated with higher birthweight z-scores, relative to those who did not perceive their neighborhood as poor quality (β = 0.21, 95% confidence intervals = 0.01, 0.42). Relative to the least disadvantaged tertile, the upper tertile of the ADI was associated with a modest reduction in gestational age (β = -0.35, 95% confidence intervals = -0.67, -0.02). Conclusions In the Chemicals in Our Bodies study population, extrinsic and perceived neighborhood quality measures were inconsistently associated with adverse birth outcomes.
Collapse
Affiliation(s)
- Stephanie M. Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, California
| | - Dana E. Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Amy M. Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Aileen Andrade
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, California
| |
Collapse
|
38
|
Rayasam S, Koman PD, Axelrad DA, Woodruff TJ, Chartres N. Toxic Substances Control Act (TSCA) Implementation: How the Amended Law Has Failed to Protect Vulnerable Populations from Toxic Chemicals in the United States. Environ Sci Technol 2022; 56:11969-11982. [PMID: 35980084 PMCID: PMC9454241 DOI: 10.1021/acs.est.2c02079] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Indexed: 05/03/2023]
Abstract
Exposures to industrial chemicals are widespread and can increase the risk of adverse health effects such as cancer, developmental disorders, respiratory effects, diabetes, and reproductive problems. The amended Toxic Substances Control Act (amended TSCA) requires the U.S. Environmental Protection Agency (EPA) to evaluate risks of chemicals in commerce, account for risk to potentially exposed and susceptible populations, and mitigate risks for chemicals determined to pose an unreasonable risk to human health and the environment. This analysis compares EPA's first 10 chemical risk evaluations under amended TSCA to best scientific practices for conducting risk assessments. We find EPA's risk evaluations underestimated human health risks of chemical exposures by excluding conditions of use and exposure pathways; not considering aggregate exposure and cumulative risk; not identifying all potentially exposed or susceptible subpopulations, and not quantifying differences in risk for susceptible groups; not addressing data gaps; and using flawed systematic review approaches to identify and evaluate the relevant evidence. We present specific recommendations for improving the implementation of amended TSCA using the best available science to ensure equitable, socially just safeguards to public health. Failing to remedy these shortcomings will result in continued systematic underestimation of risk for all chemicals evaluated under amended TSCA.
Collapse
Affiliation(s)
- Swati
D.G. Rayasam
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
| | - Patricia D. Koman
- Environmental
Health Sciences, University of Michigan
School of Public Health, Ann Arbor, Michigan 48109, United States
| | | | - Tracey J. Woodruff
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
- Environmental
Research and Translation for Health, Department of Obstetrics, Gynecology
and Reproductive Sciences, University of
California San Francisco School of Medicine, San Francisco, California 94143, United States
| | - Nicholas Chartres
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco School of Medicine, San Francisco, California 94143, United States
| |
Collapse
|
39
|
Oksas C, Brody JG, Brown P, Boronow KE, DeMicco E, Charlesworth A, Juarez M, Geiger S, Schantz SL, Woodruff TJ, Morello-Frosch R, Padula AM. Perspectives of peripartum people on opportunities for personal and collective action to reduce exposure to everyday chemicals: Focus groups to inform exposure report-back. Environ Res 2022; 212:113173. [PMID: 35351450 PMCID: PMC9244766 DOI: 10.1016/j.envres.2022.113173] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/16/2021] [Revised: 02/15/2022] [Accepted: 03/22/2022] [Indexed: 05/30/2023]
Abstract
Participants in biomonitoring studies who receive personal exposure reports seek information to reduce exposures. Many chemical exposures are driven by systems-level policies rather than individual actions; therefore, change requires engagement in collective action. Participants' perceptions of collective action and use of report-back to support engagement remain unclear. We conducted virtual focus groups during summer 2020 in a diverse group of peripartum people from cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program (N = 18). We assessed baseline exposure and collective action experience, and report-back preferences. Participants were motivated to protect the health of their families and communities despite significant time and cognitive burdens. They requested time-conscious tactics and accessible information to enable action to reduce individual and collective exposures. Participant input informed the design of digital report-back in the cohorts. This study highlights opportunities to shift responsibility from individuals to policymakers to reduce chemical exposures at the systems level.
Collapse
Affiliation(s)
- Catherine Oksas
- University of California San Francisco School of Medicine, San Francisco, CA, USA.
| | | | - Phil Brown
- Department of Sociology and Anthropology and Department of Health Sciences, Northeastern University, Boston, MA, USA.
| | | | - Erin DeMicco
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Annemarie Charlesworth
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Maribel Juarez
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Sarah Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Tracey J Woodruff
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Rachel Morello-Frosch
- School of Public Health and Department of Environmental Science, Policy and Management University of California Berkeley, Berkeley, CA, USA.
| | - Amy M Padula
- Program for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
40
|
Eick SM, Geiger SD, Alshawabkeh A, Aung M, Barrett E, Bush NR, Cordero JF, Ferguson KK, Meeker JD, Milne GL, Nguyen RHN, Padula AM, Sathyanarayana S, Welch BM, Schantz SL, Woodruff TJ, Morello-Frosch R. Associations between social, biologic, and behavioral factors and biomarkers of oxidative stress during pregnancy: Findings from four ECHO cohorts. Sci Total Environ 2022; 835:155596. [PMID: 35490822 PMCID: PMC9177811 DOI: 10.1016/j.scitotenv.2022.155596] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 02/10/2022] [Revised: 04/01/2022] [Accepted: 04/25/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Lower socioeconomic status (SES) and elevated psychosocial stress are known contributors to adverse pregnancy outcomes; however, biological mechanisms linking these factors to adverse pregnancy outcomes are not well-characterized. Oxidative stress may be an important, yet understudied mechanistic pathway. We used a pooled study design to examine biological, behavioral, and social factors as predictors of prenatal oxidative stress biomarkers. METHODS Leveraging four pregnancy cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program spanning multiple geographic regions across the United States (U.S.) (N = 2082), we measured biomarkers of oxidative stress in urine samples at up to three time points during pregnancy, including 8-isoprostane-prostaglandin F2α (8-isoPGF2α), its major metabolite, 2,3-dinor-5,6-dihydro-15-F2t-isoprostane, and prostaglandin F2α (PGF2α). Maternal age, pre-pregnancy body mass index, marital/partnered status, parity, and smoking status were included as biological and behavioral factors while race/ethnicity, maternal education, and stressful life events were considered social factors. We examined associations between each individual biological, behavioral, and social factor with oxidative stress biomarkers using multivariable-adjusted linear mixed models. RESULTS Numerous biological, behavioral, and social factors were associated with elevated levels of 8-isoPGF2α, its major metabolite, and PGF2α. Pregnant people who were current smokers relative to non-smokers or had less than a high school education relative to a college degree had 11.04% (95% confidence interval [CI] = -1.97%, 25.77%) and 9.13% (95% CI = -1.02%, 20.32%) higher levels of 8-isoPGF2α, respectively. CONCLUSIONS Oxidative stress biomarkers are elevated among pregnant people with higher socioeconomic disadvantage and may represent one pathway linking biological, behavioral, and social factors to adverse pregnancy and child health outcomes, which should be explored in future work.
Collapse
Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA.
| | - Sarah Dee Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA 02115, USA
| | - Max Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Emily Barrett
- Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA 30606, USA
| | - Kelly K Ferguson
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC 27709, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Ginger L Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Ruby H N Nguyen
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - Barrett M Welch
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC 27709, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA 94143, USA; Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA
| |
Collapse
|
41
|
Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Bastain TM, Breton CV, Dabelea D, Habre R, Magzamen S, Padula AM, Him DA, Camargo CA, Cowell W, Croen LA, Deoni S, Everson TM, Hartert TV, Hipwell AE, McEvoy CT, Morello-Frosch R, O'Connor TG, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Associations between combined exposure to environmental hazards and social stressors at the neighborhood level and individual perinatal outcomes in the ECHO-wide cohort. Health Place 2022; 76:102858. [PMID: 35872389 PMCID: PMC9661655 DOI: 10.1016/j.healthplace.2022.102858] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
Limited studies examine how prenatal environmental and social exposures jointly impact perinatal health. Here we investigated relationships between a neighborhood-level combined exposure (CE) index assessed during pregnancy and perinatal outcomes, including birthweight, gestational age, and preterm birth. Across all participants, higher CE index scores were associated with small decreases in birthweight and gestational age. We also observed effect modification by race; infants born to Black pregnant people had a greater risk of preterm birth for higher CE values compared to White infants. Overall, our results suggest that neighborhood social and environmental exposures have a small but measurable joint effect on neonatal indicators of health.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Dana Dabelea
- University of Colorado Anschutz Medical Campus, USA
| | | | | | | | | | | | | | - Lisa A Croen
- Kaiser Permanente Northern California Division of Research, USA
| | | | - Todd M Everson
- Rollins School of Public Health at Emory University, USA
| | | | | | | | | | | | - Michael Petriello
- Wayne State University, Institute of Environmental Health Sciences, USA
| | | | - Joseph B Stanford
- University of Utah, Departments of Family and Preventive Medicine and Pediatrics, USA
| | | | | | | |
Collapse
|
42
|
Rayasam SDG, Aung MT, Cooper C, Kwiatkowski C, Germolec DR, Rooney AA, Walker VR, Forte C, Woodruff TJ, Chartres N. Identifying environmental factors that influence immune response to SARS-CoV-2: Systematic evidence map protocol. Environ Int 2022; 164:107230. [PMID: 35447423 PMCID: PMC8989740 DOI: 10.1016/j.envint.2022.107230] [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: 11/18/2021] [Revised: 02/25/2022] [Accepted: 04/05/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND Widespread environmental contamination can directly interact with human immune system functions. Environmental effects on the immune system may influence human susceptibility to respiratory infections as well as the severity of infectious diseases, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, the efficacy of vaccines to respiratory diseases may be impacted by environmental exposures through immune perturbations. Given the quick pace of research about COVID-19 and associated risk factors, it is critical to identify and curate the streams of evidence quickly and effectively. OBJECTIVE We developed this systematic evidence map protocol to identify and organize existing human and animal literature on high-priority environmental chemical classes (Per- and polyfluoroalkyl substances, pesticides, phthalates, quaternary ammonium compounds, and air pollutants) and their potential to influence three key outcomes: (1) susceptibility to respiratory infection, including SARS-CoV-2 (2) severity of the resultant disease progression, and (3) impact on vaccine efficacy. The result of this project will be an online, interactive database which will show what evidence is currently available between involuntary exposures to select environmental chemicals and immune health effects, data gaps that require further research, and data rich areas that may support further analysis. SEARCH AND STUDY ELIGIBILITY We will search PubMed for epidemiological or toxicological literature on select toxicants from each of the chemical classes and each of the three outcomes listed above. STUDY APPRAISAL AND SYNTHESIS OF METHODS For each study, two independent reviewers will conduct title and abstract screening as well as full text review for data extraction of study characteristics. Study quality will not be evaluated in this evidence mapping. The main findings from the systematic evidence map will be visualized using a publicly available and interactive database hosted on Tableau Public.
Collapse
Affiliation(s)
- Swati D G Rayasam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Max T Aung
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Courtney Cooper
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Carol Kwiatkowski
- Department of Biological Sciences, North Carolina State University, 112 Derieux Place, Room 3510 Thomas Hall, CB 7614, Raleigh, NC 27695, United States
| | - Dori R Germolec
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Research Triangle Park, NC, 27560, United States.
| | - Andrew A Rooney
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Research Triangle Park, NC, 27560, United States.
| | - Vickie R Walker
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Research Triangle Park, NC, 27560, United States.
| | - Chanese Forte
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| |
Collapse
|
43
|
Buckley J, Kuiper JR, Bennett DH, Barrett ES, Bastain T, Breton CV, Chinthakindi S, Dunlop AL, Farzan SF, Herbstman JB, Karagas MR, Marsit CJ, Meeker JD, Morello-Frosch R, O’Connor TG, Romano ME, Schantz S, Schmidt RJ, Watkins DJ, Zhu H, Pellizzari ED, Kannan K, Woodruff TJ. Exposure to Contemporary and Emerging Chemicals in Commerce among Pregnant Women in the United States: The Environmental influences on Child Health Outcome (ECHO) Program. Environ Sci Technol 2022; 56:6560-6573. [PMID: 35536918 PMCID: PMC9118548 DOI: 10.1021/acs.est.1c08942] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [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: 12/30/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 05/10/2023]
Abstract
Prenatal chemical exposures can influence maternal and child health; however, few industrial chemicals are routinely biomonitored. We assessed an extensive panel of contemporary and emerging chemicals in 171 pregnant women across the United States (U.S.) and Puerto Rico in the Environmental influences on Child Health Outcomes (ECHO) Program. We simultaneously measured urinary concentrations of 89 analytes (103 total chemicals representing 73 parent compounds) in nine chemical groups: bactericides, benzophenones, bisphenols, fungicides and herbicides, insecticides, organophosphate esters (OPEs), parabens, phthalates/alternative plasticizers, and polycyclic aromatic hydrocarbons (PAHs). We estimated associations of creatinine-adjusted concentrations with sociodemographic and specimen characteristics. Among our diverse prenatal population (60% non-Hispanic Black or Hispanic), we detected 73 of 89 analytes in ≥1 participant and 36 in >50% of participants. Five analytes not currently included in the U.S. biomonitoring were detected in ≥90% of samples: benzophenone-1, thiamethoxam, mono-2-(propyl-6-carboxy-hexyl) phthalate, monocarboxy isooctyl phthalate, and monohydroxy-iso-decyl phthalate. Many analyte concentrations were higher among women of Hispanic ethnicity compared to those of non-Hispanic White women. Concentrations of certain chemicals decreased with the calendar year, whereas concentrations of their replacements increased. Our largest study to date identified widespread exposures to prevalent and understudied chemicals in a diverse sample of pregnant women in the U.S.
Collapse
Affiliation(s)
- Jessie
P. Buckley
- Department
of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21218, United States
| | - Jordan R. Kuiper
- Department
of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21218, United States
| | - Deborah H. Bennett
- Department
of Public Health Sciences, University of California Davis, Davis, California 95616, United States
| | - Emily S. Barrett
- Department
of Biostatistics and Epidemiology, Rutgers
School of Public Health, Piscataway, New Jersey 08854, United States
| | - Tracy Bastain
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Carrie V. Breton
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Sridhar Chinthakindi
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Anne L. Dunlop
- Department
of Gynecology and Obstetrics, Emory University
School of Medicine, Atlanta, Georgia 30322, United States
| | - Shohreh F. Farzan
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Julie B. Herbstman
- Department
of Environmental Health Sciences, Columbia, New York, NY 10032, United States
| | - Margaret R. Karagas
- Department
of Epidemiology, Dartmouth Geisel School
of Medicine, Lebanon, New Hampshire 03756, United States
| | - Carmen J. Marsit
- Department
of Environmental Health, Rollins School
of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - John D. Meeker
- Department
of Environmental Health Sciences, University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Rachel Morello-Frosch
- Department
of Environmental Science, Policy and Management and School of Public
Health, University of California, Berkeley California 94720, United States
| | - Thomas G. O’Connor
- Department
of Psychiatry, University of Rochester, Rochester, New York 14627, United States
| | - Megan E. Romano
- Department
of Epidemiology, Dartmouth Geisel School
of Medicine, Lebanon, New Hampshire 03756, United States
| | - Susan Schantz
- Beckman
Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Rebecca J. Schmidt
- Department
of Public Health Sciences, University of California Davis, Davis, California 95616, United States
| | - Deborah J. Watkins
- Department
of Environmental Health Sciences, University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Hongkai Zhu
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Edo D. Pellizzari
- RTI International, Research Triangle
Park, North Carolina 27709, United States
| | - Kurunthachalam Kannan
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Tracey J. Woodruff
- Department
of Obstetrics, Gynecology, and Reproductive Sciences and the Philip
R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California 94143, United States
| |
Collapse
|
44
|
Eick SM, Goin DE, Lam J, Woodruff TJ, Chartres N. Correction: Authors' rebuttal to Integrated Risk Information System (IRIS) response to "Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools". Syst Rev 2022; 11:86. [PMID: 35513846 PMCID: PMC9074178 DOI: 10.1186/s13643-022-01967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.,Department of Public Health, California State University, East Bay, Hayward, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
45
|
Eick SM, Enright EA, Padula AM, Aung M, Geiger SD, Cushing L, Trowbridge J, Keil AP, Gee Baek H, Smith S, Park JS, DeMicco E, Schantz SL, Woodruff TJ, Morello-Frosch R. Prenatal PFAS and psychosocial stress exposures in relation to fetal growth in two pregnancy cohorts: Applying environmental mixture methods to chemical and non-chemical stressors. Environ Int 2022; 163:107238. [PMID: 35436721 PMCID: PMC9202828 DOI: 10.1016/j.envint.2022.107238] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 11/16/2021] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Prenatal exposure to individual per‑ and poly‑fluoroalkyl substances (PFAS) and psychosocial stressors have been associated with reductions in fetal growth. Studies suggest cumulative or joint effects of chemical and non-chemical stressors on fetal growth. However, few studies have examined PFAS and non-chemical stressors together as a mixture, which better reflects real life exposure patterns. We examined joint associations between PFAS, perceived stress, and depression, and fetal growth using two approaches developed for exposure mixtures. METHODS Pregnant participants were enrolled in the Chemicals in Our Bodies cohort and Illinois Kids Development Study, which together make up the ECHO.CA.IL cohort. Seven PFAS were previously measured in 2nd trimester maternal serum samples and were natural log transformed for analyses. Perceived stress and depression were assessed using self-reported validated questionnaires, which were converted to t-scores using validated methods. Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to assess joint associations between PFAS, perceived stress and depression t-scores and birthweight z-scores (N = 876). RESULTS Individual PFAS, depression and perceived stress t-scores were negatively correlated with birthweight z-scores. Using quantile g-computation, a simultaneous one quartile increase in all PFAS, perceived stress and depression t-scores was associated with a slight reduction in birthweight z-scores (mean change per quartile increase = -0.09, 95% confidence interval = -0.21,0.03). BKMR similarly indicated that cumulative PFAS and stress t-scores were modestly associated with lower birthweight z-scores. Across both methods, the joint association appeared to be distributed across multiple exposures rather than due to a single exposure. CONCLUSIONS Our study is one of the first to examine the joint effects of chemical and non-chemical stressors on fetal growth using mixture methods. We found that PFAS, perceived stress, and depression in combination were modestly associated were lower birthweight z-scores, which supports prior studies indicating that chemical and non-chemical stressors are jointly associated with adverse health outcomes.
Collapse
Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Elizabeth A Enright
- Department of Psychology, St. Mary's College of Maryland, St. Mary's City, MD, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Max Aung
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Sarah D Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Jessica Trowbridge
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hyoung Gee Baek
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, CA, USA.
| |
Collapse
|
46
|
Koman PD, Gilden R, Chartres N, Woodruff TJ. Toxic Substances Control Act (TSCA) Implementation: New Ways to Promote Occupational Justice and Prevent Worker Exposures From Hazardous Chemicals. Workplace Health Saf 2022; 70:224. [PMID: 35321606 PMCID: PMC9909441 DOI: 10.1177/21650799221078553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
47
|
Eick SM, Goin DE, Lam J, Woodruff TJ, Chartres N. Authors' rebuttal to Integrated Risk Information System (IRIS) response to "Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools". Syst Rev 2022; 11:53. [PMID: 35321722 PMCID: PMC8944042 DOI: 10.1186/s13643-022-01894-8] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
This letter responds to the US Environmental Protection Agency's Integrated Risk Information System (IRIS) program letter by Radke et al. (2021) that was published in response to the application of the IRIS risk of bias tool in our recent study "Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools." Their letter stated that we misrepresented the IRIS approach. Here, we respond to their three points raised and how we did not misrepresent their tool and also identified areas for improvement: (1) why it should be expected that different reviewers could reach different conclusions with the IRIS tool, as ratings are subject to reviewer judgment; (2) why our interpretation that "low" or "uninformative" studies could be excluded from a body of evidence was reasonable; and (3) why we believe the use of a rating system that generates an overall rating based on an individual domain or a combination of identified deficiencies essentially acts as a score and assumes that we know empirically how much each risk of bias domain should contribute to the overall rating for that study. We have elaborated on these points in our letter.
Collapse
Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.,Department of Public Health, California State University, East Bay, Hayward, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
48
|
Pega F, Momen NC, Gagliardi D, Bero LA, Boccuni F, Chartres N, Descatha A, Dzhambov AM, Godderis L, Loney T, Mandrioli D, Modenese A, van der Molen HF, Morgan RL, Neupane S, Pachito D, Paulo MS, Prakash KC, Scheepers PTJ, Teixeira L, Tenkate T, Woodruff TJ, Norris SL. Assessing the quality of evidence in studies estimating prevalence of exposure to occupational risk factors: The QoE-SPEO approach applied in the systematic reviews from the WHO/ILO Joint Estimates of the Work-related burden of disease and Injury. Environ Int 2022; 161:107136. [PMID: 35182944 PMCID: PMC8885428 DOI: 10.1016/j.envint.2022.107136] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 01/05/2022] [Accepted: 02/04/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) have produced the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). For these, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors have been conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methodology is to assess the quality of evidence across studies. In this article, we present the approach applied in these WHO/ILO systematic reviews for performing such assessments on studies of prevalence of exposure. It is called the Quality of Evidence in Studies estimating Prevalence of Exposure to Occupational risk factors (QoE-SPEO) approach. We describe QoE-SPEO's development to date, demonstrate its feasibility reporting results from pilot testing and case studies, note its strengths and limitations, and suggest how QoE-SPEO should be tested and developed further. METHODS Following a comprehensive literature review, and using expert opinion, selected existing quality of evidence assessment approaches used in environmental and occupational health were reviewed and analysed for their relevance to prevalence studies. Relevant steps and components from the existing approaches were adopted or adapted for QoE-SPEO. New steps and components were developed. We elicited feedback from other systematic review methodologists and exposure scientists and reached consensus on the QoE-SPEO approach. Ten individual experts pilot-tested QoE-SPEO. To assess inter-rater agreement, we counted ratings of expected (actual and non-spurious) heterogeneity and quality of evidence and calculated a raw measure of agreement (Pi) between individual raters and rater teams for the downgrade domains. Pi ranged between 0.00 (no two pilot testers selected the same rating) and 1.00 (all pilot testers selected the same rating). Case studies were conducted of experiences of QoE-SPEO's use in two WHO/ILO systematic reviews. RESULTS We found no existing quality of evidence assessment approach for occupational exposure prevalence studies. We identified three relevant, existing approaches for environmental and occupational health studies of the effect of exposures. Assessments using QoE-SPEO comprise three steps: (1) judge the level of expected heterogeneity (defined as non-spurious variability that can be expected in exposure prevalence, within or between individual persons, because exposure may change over space and/or time), (2) assess downgrade domains, and (3) reach a final rating on the quality of evidence. Assessments are conducted using the same five downgrade domains as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach: (a) risk of bias, (b) indirectness, (c) inconsistency, (d) imprecision, and (e) publication bias. For downgrade domains (c) and (d), the assessment varies depending on the level of expected heterogeneity. There are no upgrade domains. The QoE-SPEO's ratings are "very low", "low", "moderate", and "high". To arrive at a final decision on the overall quality of evidence, the assessor starts at "high" quality of evidence and for each domain downgrades by one or two levels for serious concerns or very serious concerns, respectively. In pilot tests, there was reasonable agreement in ratings for expected heterogeneity; 70% of raters selected the same rating. Inter-rater agreement ranged considerably between downgrade domains, both for individual rater pairs (range Pi: 0.36-1.00) and rater teams (0.20-1.00). Sparse data prevented rigorous assessment of inter-rater agreement in quality of evidence ratings. CONCLUSIONS We present QoE-SPEO as an approach for assessing quality of evidence in prevalence studies of exposure to occupational risk factors. It has been developed to its current version (as presented here), has undergone pilot testing, and was applied in the systematic reviews for the WHO/ILO Joint Estimates. While the approach requires further testing and development, it makes steps towards filling an identified gap, and progress made so far can be used to inform future work in this area.
Collapse
Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, Australia; General Internal Medicine/Public Health/Center for Bioethics and Humanities, University of Colorado-Anschutz Medical Campus, Denver, CO, United States
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France /Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, CAPTV CDC, Angers, France
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Daniela Pachito
- Evidence-based Health, Universidade Federal de São Paulo, Sao Paulo, Brazil; Cochrane Brazil, Sao Paulo, Brazil
| | - Marilia S Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Liliane Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Susan L Norris
- Oregon Health & Science University, Portland, OR, United States; Department of Quality Assurance, Norms and Standards, World Health Organization, Geneva, Switzerland
| |
Collapse
|
49
|
Corbett GA, Lee S, Woodruff TJ, Hanson M, Hod M, Charlesworth AM, Giudice L, Conry J, McAuliffe FM. Nutritional interventions to ameliorate the effect of endocrine disruptors on human reproductive health: A semi-structured review from FIGO. Int J Gynaecol Obstet 2022; 157:489-501. [PMID: 35122246 PMCID: PMC9305939 DOI: 10.1002/ijgo.14126] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/02/2022] [Indexed: 11/09/2022]
Abstract
Background Endocrine disrupting chemicals have harmful effects on reproductive, perinatal, and obstetric outcomes. Objective To analyze the evidence on nutritional interventions to reduce the negative effects of endocrine disruptors on reproductive, perinatal, and obstetric outcomes. Search strategy A search of MEDLINE (PubMed), Allied Health Literature (CINAHL), EMBASE, Web of Science, and the Cochrane Database was conducted from inception to May 2021. Selection criteria Experimental studies on human populations. Data collection and analysis Data were collected from eligible studies. Risk of bias assessment was completed using the Cochrane risk of bias tool and the ROBINS‐I Tool. Results Database searches yielded 15 362 articles. Removing 11 181 duplicates, 4181 articles underwent abstract screening, 26 articles were eligible for full manuscript review, and 16 met full inclusion criteria. Several interventions were found to be effective in reducing exposure to endocrine disruptors: avoidance of plastic containers, bottles, and packaging; avoidance of canned food/beverages; consumption of fresh and organic food; avoidance of fast/processed foods; and supplementation with vitamin C, iodine, and folic acid. There were some interventional studies examining therapies to improve clinical outcomes related to endocrine disruptors. Conclusion Dietary alterations can reduce exposure to endocrine disruptors, with limited data on interventions to improve endocrine‐disruptor–related clinical outcomes. This review provides useful instruction to women, their families, healthcare providers, and regulatory bodies. Nutritional interventions shown to reduce exposure to endocrine disruptors include avoidance of canned/processed or plastic‐packaged foods. Consumption of fresh/organic foods and vitamin C, iodine, and folic acid also reduce exposure.
Collapse
Affiliation(s)
- Gillian A Corbett
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sadhbh Lee
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Tracey J Woodruff
- Program on Reproductive Health and Environment, Department of Obstetrics and Gynecology, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Mark Hanson
- International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health.,Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and NIHR Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Moshe Hod
- International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health.,Mor Comprehensive Women's Health Care Centre, Tel Aviv, Israel
| | - Anne Marie Charlesworth
- Program on Reproductive Health and Environment, Department of Obstetrics and Gynecology, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Linda Giudice
- International Federation of Gynecology and Obstetrics (FIGO) Committee on Climate Change and Toxic Environmental Exposures.,Centre for Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Jeanne Conry
- Environmental Health and Leadership Foundation, United States
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, UCD School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,International Federation of Gynaecology and Obstetrics (FIGO) Committee on Impact of Pregnancy on Long-term Health
| | | |
Collapse
|
50
|
Eick SM, Goin DE, Cushing L, DeMicco E, Smith S, Park JS, Padula AM, Woodruff TJ, Morello-Frosch R. Joint effects of prenatal exposure to per- and poly-fluoroalkyl substances and psychosocial stressors on corticotropin-releasing hormone during pregnancy. J Expo Sci Environ Epidemiol 2022; 32:27-36. [PMID: 33824413 PMCID: PMC8492777 DOI: 10.1038/s41370-021-00322-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and psychosocial stressors has been associated with adverse pregnancy outcomes, including preterm birth. Previous studies have suggested that joint exposure to environmental chemical and social stressors may be contributing to disparities observed in preterm birth. Elevated corticotropin-releasing hormone (CRH) during mid-gestation may represent one biologic mechanism linking chemical and nonchemical stress exposures to preterm birth. METHODS Using data from a prospective birth cohort (N = 497), we examined the cross-sectional associations between five individual PFAS (ng/mL; PFNA, PFOA, PFOS, PFHxS, and Me-PFOSA-AcOH) and CRH (pg/mL) using linear regression. PFAS and CRH were measured during the second trimester in serum and plasma, respectively. Coefficients were standardized to reflect change in CRH associated with an interquartile range (IQR) increase in natural log-transformed PFAS. We additionally examined if the relationship between PFAS and CRH was modified by psychosocial stress using stratified models. Self-reported depression, stressful life events, perceived stress, food insecurity, and financial strain were assessed using validated questionnaires during the second trimester and included as binary indicators of psychosocial stress. RESULTS An IQR increase in PFNA was associated with elevated CRH (β = 5.17, 95% confidence interval [CI] = 1.79, 8.55). Increased concentrations of PFOA were also moderately associated with CRH (β = 3.62, 95% CI = -0.42, 7.66). The relationship between PFNA and CRH was stronger among women who experienced stressful life events, depression, food insecurity, and financial strain compared to women who did not experience these stressors. CONCLUSIONS This cross-sectional study is the first to examine the relationship between PFAS exposure and CRH levels in mid-gestation. We found that these associations were stronger among women who experienced stress, which aligns with previous findings that chemical and nonchemical stressor exposures can have joint effects on health outcomes.
Collapse
Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| |
Collapse
|