Persistent organic pollutants exposure and risk of autism spectrum disorders: A systematic review and meta-analysis

IF 7.3 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES Environmental Pollution Pub Date : 2023-11-01 DOI:10.1016/j.envpol.2023.122439

Kexin Xu , Zhuoyan Li , Jianchao Qiao , Senzheng Wang , Pinpeng Xie , Zhiqiang Zong , Chengyang Hu

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Abstract

Accumulating number of epidemiological studies has recently proposed that improvement in the risk of autism spectrum disorders (ASD) is associated with persistent organic pollutants (POPs) exposure. However, evidence from current researches is limited and inconsistent. Thus, we conducted a systematic review and meta-analysis to investigate the potential associations comprehensively. We systematically and extensively searched two electronic databases (PubMed and EMBASE) from inception to July 3, 2022 and an updated search was performed before submission. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were derived from stratified random-effects meta-analyses by type of exposure and outcome. We also tested the potential heterogeneity across studies, conducted sensitivity analysis and evaluated publication bias. A total of 20 studies were finally included in our study. Meta-analytical effect estimates indicated a positive association between prenatal exposure to PCB-138, PCB-153 and PCB-170 and an increased risk of ASD, with OR of 1.89 (95% CI = 1.21–2.95, I² = 0%), 1.61 (95% CI = 1.05–2.47, I² = 0%) and 1.46 (95% CI = 1.03–2.06, I² = 0%) respectively. In contrast, PFDA was found inversely associated with the risk of ASD (OR = 0.70, 95% CI = 0.52–0.94, I² = 0%). The level of evidence supporting a link between ASD risk and exposure to PCB-138, PCB-153, PCB-170, and PFDA was respectively categorized as low, low, moderate, and low. In summary, this systematic review and meta-analysis suggest that exposure to PCB-138, PCB-153, and PCB-170 correlates with a heightened risk of ASD, with evidence levels rated as “low”, “low”, and “moderate”, respectively. In contrast, PFDA exposure appears to be inversely associated with ASD risk, with a “low” level of supporting evidence. However, due to the limited number of studies available for each exposure and outcome pairing, these results should be interpreted with caution. Sufficiently powered studies are needed to validate our findings.

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持久性有机污染物暴露与自闭症谱系障碍的风险：一项系统综述和荟萃分析。

最近，越来越多的流行病学研究表明，自闭症谱系障碍（ASD）风险的提高与持久性有机污染物（POP）的暴露有关。然而，目前研究的证据是有限的和不一致的。因此，我们进行了系统回顾和荟萃分析，以全面调查潜在的关联。从成立到2022年7月3日，我们系统而广泛地搜索了两个电子数据库（PubMed和EMBASE），并在提交前进行了更新搜索。汇总优势比（OR）和95%置信区间（CI）来自按暴露类型和结果进行的分层随机效应荟萃分析。我们还测试了研究之间的潜在异质性，进行了敏感性分析并评估了发表偏倚。我们的研究最终包括了20项研究。荟萃分析效应估计表明，产前接触PCB-138、PCB-153和PCB-170与ASD风险增加呈正相关，OR分别为1.89（95%CI=1.21-2.95，I2=0%）、1.61（95%CI=1.05-2.47，I2=0%）和1.46（95%CI=1.03-2.06，I2=0）。相反，PFDA与ASD风险呈负相关（OR=0.70，95%CI=0.52-0.94，I2=0%）。支持ASD风险与接触PCB-138、PCB-153、PCB-170和PFDA之间联系的证据水平分别分为低、低、中和低。总之，这项系统综述和荟萃分析表明，接触PCB-138、PCB-153和PCB-170与ASD风险增加相关，证据水平分别为“低”、“低”和“中等”。相比之下，全氟辛烷磺酸暴露似乎与ASD风险呈负相关，支持证据水平“较低”。然而，由于每次接触和结果配对的研究数量有限，应谨慎解读这些结果。需要足够有力的研究来验证我们的发现。

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来源期刊

Environmental Pollution 环境科学-环境科学

CiteScore

16.00

自引率

6.70%

发文量

2082

审稿时长

2.9 months

期刊介绍： Environmental Pollution is an international peer-reviewed journal that publishes high-quality research papers and review articles covering all aspects of environmental pollution and its impacts on ecosystems and human health. Subject areas include, but are not limited to: • Sources and occurrences of pollutants that are clearly defined and measured in environmental compartments, food and food-related items, and human bodies; • Interlinks between contaminant exposure and biological, ecological, and human health effects, including those of climate change; • Contaminants of emerging concerns (including but not limited to antibiotic resistant microorganisms or genes, microplastics/nanoplastics, electronic wastes, light, and noise) and/or their biological, ecological, or human health effects; • Laboratory and field studies on the remediation/mitigation of environmental pollution via new techniques and with clear links to biological, ecological, or human health effects; • Modeling of pollution processes, patterns, or trends that is of clear environmental and/or human health interest; • New techniques that measure and examine environmental occurrences, transport, behavior, and effects of pollutants within the environment or the laboratory, provided that they can be clearly used to address problems within regional or global environmental compartments.