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Cancer incidence in Swedish oil refinery workers exposed to benzene 接触苯的瑞典炼油厂工人的癌症发病率。
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-07-04 DOI: 10.1016/j.ijheh.2024.114420
E.M. Andersson , L. Barregard , M. Akerstrom , G. Sallsten , B. Järvholm , R.I. Nilsson

Background

Oil refinery workers are exposed to benzene, which is a well-known cause of leukaemia, but results on leukaemia in oil refinery workers have been mixed, and the data on workers’ exposure is limited. Oil refinery workers are also exposed to asbestos and several studies have shown increased risk of mesothelioma.

Aim

The objective was to investigate cancer incidence, especially leukaemia, at low to moderate exposure to benzene in an update of a previous study of employees at three Swedish oil refineries.

Methods

Cancer incidence was followed up in 2264 men (1548 refinery operators) employed at three oil refineries in Sweden for at least one year. Job types and employment times were collected from complete company files. A retrospective assessment of the benzene exposure was performed by occupational hygienists in collaboration with the refineries using historic measurements as well as detailed information on changes in the industrial hygiene and technological developments. Cases of cancer were retrieved by a linkage with the Swedish Cancer Register through 35–47 years of follow-up and standardized incidence ratios (SIR) with 95% confidence intervals (CI) were calculated.

Results

In total, 258 tumors had occurred versus 240 expected (SIR 1.07; 95% CI 0.95–1.21). There were 10 cases of leukaemia, all in refinery operators (SIR 2.4; 95% CI 1.18–4.51). There were three cases of pleural mesothelioma, two of which in refinery operators. The mean estimated cumulative benzene exposure for the cases of leukaemia was 7.9 ppm-years (median 4.9, range 0.1–31.1).

Discussion

The study suggests that low to moderate average cumulative benzene exposure increases the risk of leukaemia. Limitations include the modest number of cases and potential misclassification of exposure.

Conclusion

The present study indicated an increased risk of leukaemia in male oil refinery workers with low to moderate exposure to benzene.

背景:炼油厂工人接触苯,而苯是众所周知的白血病病因,但炼油厂工人白血病的研究结果不一,有关工人接触苯的数据也很有限。炼油厂工人也会接触石棉,一些研究显示间皮瘤的风险会增加。目的:研究目的是调查中低度接触苯的癌症发病率,尤其是白血病,这是对之前对瑞典三家炼油厂的员工进行的研究的更新:对在瑞典三家炼油厂工作至少一年的 2264 名男性(1548 名炼油厂操作工)的癌症发病率进行了跟踪调查。从完整的公司档案中收集了工作类型和工作时间。职业卫生学家与炼油厂合作,利用历史测量数据以及有关工业卫生和技术发展变化的详细信息,对苯接触情况进行了回顾性评估。通过与瑞典癌症登记册的连接,对 35-47 年的跟踪调查结果进行了癌症病例检索,并计算了标准化发病率(SIR)和 95% 的置信区间(CI):总共有 258 例肿瘤发生,而预期为 240 例(SIR 1.07;95% CI 0.95-1.21)。白血病病例有 10 例,均为炼油厂操作工(SIR 2.4;95% CI 1.18-4.51)。胸膜间皮瘤有 3 例,其中 2 例为炼油厂操作工。据估计,白血病病例的平均累积苯暴露量为 7.9 ppm-年(中位数为 4.9,范围为 0.1-31.1):讨论:这项研究表明,中低水平的平均累积苯暴露量会增加白血病的风险。结论:本研究表明,中低浓度的平均累积苯暴露会增加患白血病的风险:本研究表明,男性炼油厂工人接触中低浓度苯会增加患白血病的风险。
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引用次数: 0
Outbreak of cholera due to contaminated pond water utilisation in a rural area of West Bengal, India, 2021 2021 年,印度西孟加拉邦农村地区因使用受污染的池塘水而爆发霍乱。
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-28 DOI: 10.1016/j.ijheh.2024.114409
Dhiraj Roy , Tanima Roy Mondal , Pallavi Indwar

Background

On March 31, 2021, an outbreak of diarrhoeal disease was reported in Dangapara village of Purba Bardhaman district, West Bengal, India. The outbreak was investigated to estimate the magnitude, identify aetiological agents and source of infection, and guide prevention control measures.

Methods

We did an active search for case patients at Dangapara village. We excluded children under five years of age from the epidemiological analysis. We described the outbreak by time, place, and person. We conducted a case control study with 133 controls and 65 cases. Water samples from different sources and rectal swabs from case patients were collected and sent for laboratory investigations.

Results

We identified 95 case patients among 330 residents of Dangapara village (attack rate 29 %). Three stool samples were positive for Vibrio cholerae, and two pond water samples were contaminated with coliform organisms. Washing utensils [adjusted odds ratio (AOR): 69.8, (95% confidence interval (CI) 6.5–749.5)] and taking a bath in pond water [AOR: 3.4, (95% CI 1.2–9)] were associated with increased risk of illness. About 97% of cases were attributed to washing utensils in pond water. Washing hands before taking food was associated with a lower risk of developing disease with AOR: 0.1 (95% CI 0.03–0.33).

Conclusion

A cholera outbreak occurred among residents of Dangapara village due to theuse of contaminated pond water for washing utensils and bathing. Prompt management of cases and immediate discontinuation of pond water use stopped the outbreak.

背景:2021 年 3 月 31 日,印度西孟加拉邦 Purba Bardhaman 区 Dangapara 村爆发了腹泻病。我们对疫情进行了调查,以估计疫情的严重程度,确定病原体和感染源,并指导预防控制措施:我们在 Dangapara 村积极寻找病例患者。我们在流行病学分析中排除了五岁以下儿童。我们按时间、地点和人员对疫情进行了描述。我们进行了病例对照研究,其中有 133 名对照者和 65 名病例。我们收集了不同来源的水样和病例患者的直肠拭子,并将其送往实验室进行化验:我们在 Dangapara 村的 330 名居民中发现了 95 名病例患者(发病率为 29%)。三份粪便样本霍乱弧菌呈阳性,两份池塘水样本受到大肠菌群污染。清洗餐具[调整后的几率比(AOR):69.8,(95% 置信区间(CI)6.5-749.5)]和在池塘水中洗澡[AOR:3.4,(95% 置信区间(CI)1.2-9)]与患病风险增加有关。约 97% 的病例与在池塘水中清洗餐具有关。结论:结论:由于使用受污染的池塘水清洗餐具和洗澡,Dangapara 村居民中爆发了霍乱。对病例的及时处理和立即停止使用池塘水阻止了疫情的爆发。
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引用次数: 0
Association of metals with early postnatal gut microbiota among infants admitted to the neonatal intensive care unit 新生儿重症监护室收治的婴儿中金属与产后早期肠道微生物群的关系。
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-25 DOI: 10.1016/j.ijheh.2024.114410
Shi-ting Xiang , Changci Zhou , Kunyan Zhao , Ye Ma , Ruiwen Huang , Yunlong Peng , Yan Tang , Fei Yang , Jun Qiu

The gut microbiota is closely related to infant health. However, the impact of environmental factors on the gut microbiota has not been widely investigated, particularly in vulnerable populations such as infants admitted to the neonatal intensive care unit (NICU). This study investigated the association between exposure to 12 metals and the composition of the gut microbiota in infants admitted to the NICU. Metal concentrations were determined in serum samples obtained from 107 infants admitted to the NICU at Hunan Children's hospital, China. Gut microbiota data were derived from 16S rRNA sequencing using stool samples. Generalized linear regression (GLR) models and Bayesian kernel machine regression (BKMR) analyses were used to estimate the associations between metals and both alpha-diversity indices and bacterial taxa. The GLR models showed that tin correlated negatively with the Shannon index (β = −0.55, 95% conficence interval [CI]: −0.79, −0.30, PFDR< 0.001) and positively with the Simpson index (β = 0.26, 95% CI: 0.13, 0.39, PFDR< 0.001). The BKMR analysis yielded similar results, showing that tin had the largest posterior inclusion probability for both the Shannon (0.986) and the Simpson (0.796) indices. Tin, cadmium, mercury, lead, and thallium were associated with changes in one or more taxa at the genus level. The BKMR analysis also revealed a negative correlation between metal mixtures and Clostridium_sensu_stricto, and tin contibuted mostly to the negative correlation. Early postnatal exposure to metals were associated with differences in the microbiome among infants admitted to the NICU. However, as the study was cross-sectional, these relationships must be confirmed in further studies.

肠道微生物群与婴儿健康密切相关。然而,环境因素对肠道微生物群的影响尚未得到广泛研究,尤其是在易感人群中,如新生儿重症监护室(NICU)收治的婴儿。本研究调查了新生儿重症监护室婴儿接触 12 种金属与肠道微生物群组成之间的关系。研究人员测定了中国湖南省儿童医院新生儿重症监护室 107 名婴儿血清样本中的金属浓度。肠道微生物群数据来自粪便样本的 16S rRNA 测序。使用广义线性回归(GLR)模型和贝叶斯核机器回归(BKMR)分析来估计金属与α-多样性指数和细菌分类群之间的关系。GLR 模型显示,锡与香农指数呈负相关(β = -0.55,95% 置信区间 [CI]:-0.79,-0.30,PFDR< 0.001),与辛普森指数呈正相关(β = 0.26,95% 置信区间:0.13,0.39,PFDR< 0.001)。BKMR 分析也得出了类似的结果,显示锡在香农指数(0.986)和辛普森指数(0.796)中的后纳入概率最大。锡、镉、汞、铅和铊与一个或多个类群在属一级的变化有关。BKMR 分析还显示,金属混合物与梭状芽孢杆菌之间存在负相关关系,而锡在负相关关系中占绝大部分。产后早期接触金属与新生儿重症监护室婴儿微生物组的差异有关。然而,由于该研究是横断面研究,这些关系必须在进一步的研究中得到证实。
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引用次数: 0
Prenatal and childhood exposure to bisphenols and bone mineral density in 7-year-old children from the Odense Child Cohort 欧登塞儿童队列中 7 岁儿童的产前和童年双酚暴露与骨矿物质密度
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-18 DOI: 10.1016/j.ijheh.2024.114408
Annika Sigvaldsen , Hanne Frederiksen , Frederik Damsgaard Højsager , Anna-Maria Andersson , Anders Juul , Henriette Boye , Marianne Skovsager Andersen , Tina Kold Jensen

Background

Bisphenol A (BPA) is a well-known endocrine disrupter used in several consumer products. Restricted use of BPA has led to increased use of bisphenol F (BPF) and bisphenol S (BPS). While previous studies found no associations between prenatal BPA and BPF exposure and bone mineral density (BMD), two recent cohort studies found that prenatal BPS exposure was negatively associated with bone mineral density in the offspring.

Aim

To determine possible associations between maternal and child urinary bisphenol concentrations, BMD and bone mineral content (BMC) in 7-year-old healthy children.

Methods

Pregnant women were recruited in 2010–2012 to participate in the Odense Child Cohort (OCC), Denmark. Maternal urine samples were collected in gestational week 28 and urinary BPA concentration was measured by isotope diluted LC-MS/MS. The children delivered a urine sample at age 7 years in which BPA, BPF and BPS were measured by an extended LS-MS/MS method based on the original method. At age 7 years DXA scans were performed and BMC and Z-score for BMD calculated. Associations between osmolality adjusted urinary maternal BPA and child BPA, BPF and BPS concentrations and BMC and BMD Z-score were examined by multiple linear regression analysis adjusted for potential confounders. Additionally, a combined effect of the bisphenols were evaluated by including the sum of child urinary BPA, BPF and BPS concentrations in the statistical analyses.

Results

A total of 546 mothers and 453 children aged 7 years participated. BPA was detected in 84% and 96% of the maternal and child urine samples, respectively. We found no significant association between maternal urinary BPA concentration during pregnancy and BMC and BMD Z-score in 7-year-old children. In addition, no association between current bisphenol exposure in tertiles and bone density was found, interestingly, current BPA and summed bisphenol exposure in the highest 10% was associated with lower BMD Z-score at age 7-years, statistically significant for boys.

Conclusion

In these low exposed children we found no association between prenatal or current bisphenol exposure in tertiles and BMD in healthy children, however, the highest 10% exposed children had lower BMD, significant for boys, suggesting a negative impact with high bisphenol exposure. The short half-lives of bisphenols and the cross-sectional nature of the child exposure prompt more longitudinal studies to further clarify this topic.

背景双酚 A(BPA)是一种众所周知的内分泌干扰物,被用于多种消费品中。限制双酚 A 的使用导致双酚 F(BPF)和双酚 S(BPS)的使用增加。尽管之前的研究发现产前双酚 A 和双酚 F 暴露与骨矿物质密度 (BMD) 之间没有关联,但最近的两项队列研究发现产前双酚 S 暴露与后代的骨矿物质密度呈负相关。在孕 28 周时收集母体尿样,并通过同位素稀释 LC-MS/MS 方法测量尿液中的双酚 A 浓度。孩子们在 7 岁时采集尿样,在原有方法的基础上采用扩展的 LS-MS/MS 方法测量双酚 A、双酚 F 和双酚 S。7 岁时进行 DXA 扫描,并计算 BMC 和 BMD 的 Z 值。经渗透压调整的母体双酚 A 和儿童双酚 A、BPF 和 BPS 尿液浓度与 BMC 和 BMD Z 评分之间的关系通过多元线性回归分析进行了研究,并对潜在的混杂因素进行了调整。此外,通过将儿童尿液中双酚 A、双酚 F 和双酚 S 的浓度总和纳入统计分析,评估了双酚的综合影响。分别有 84% 和 96% 的母亲和儿童尿液样本中检测到双酚 A。我们发现,孕期母体尿液中的双酚 A 浓度与 7 岁儿童的 BMC 和 BMD Z 分数之间没有明显关联。结论 在这些低暴露儿童中,我们没有发现产前或当前双酚暴露量级与健康儿童的骨密度之间有任何关联,但是,暴露量最高的 10%儿童的骨密度较低,男孩的骨密度较低,这表明高双酚暴露量会产生负面影响。由于双酚的半衰期较短,而且儿童接触双酚的情况是横断面的,因此需要进行更多的纵向研究来进一步澄清这一问题。
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引用次数: 0
Prenatal exposure to polycyclic aromatic hydrocarbons and executive functions at school age: Results from a combined cohort study 产前接触多环芳烃与学龄时的执行功能:一项合并队列研究的结果
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-15 DOI: 10.1016/j.ijheh.2024.114407
Yu Ni , Adam A. Szpiro , Christine T. Loftus , Tomomi Workman , Alexis Sullivan , Erin R. Wallace , Anne M. Riederer , Drew B. Day , Laura E. Murphy , Ruby H.N. Nguyen , Sheela Sathyanarayana , Emily S. Barrett , Qi Zhao , Daniel A. Enquobahrie , Christopher Simpson , Shaikh I. Ahmad , Jessica A. Arizaga , Brent R. Collett , Karen J. Derefinko , Kurunthachalam Kannan , Catherine J. Karr

Background

Executive functions develop rapidly in childhood, enabling problem-solving, focused attention, and planning. Exposures to environmental toxicants in pregnancy may impair healthy executive function development in children. There is increasing concern regarding polycyclic aromatic hydrocarbons (PAHs) given their ability to transfer across the placenta and the fetal blood-brain barrier, yet evidence from epidemiological studies is limited.

Methods

We examined associations between prenatal PAH exposure and executive functions in 814 children of non-smoking mothers from two U.S. cohorts in the ECHO-PATHWAYS Consortium. Seven mono-hydroxylated PAH metabolites were measured in mid-pregnancy urine and analyzed individually and as mixtures. Three executive function domains were measured at age 8–9: cognitive flexibility, working memory, and inhibitory control. A composite score quantifying overall performance was further calculated. We fitted linear regressions adjusted for socio-demographics, maternal health behaviors, and psychological measures, and examined modification by child sex and stressful life events in pregnancy. Bayesian kernel machine regression was performed to estimate the interactive and overall effects of the PAH mixture.

Results

The results from primary analysis of linear regressions were generally null, and no modification by child sex or maternal stress was indicated. Mixture analyses suggested several pairwise interactions between individual PAH metabolites in varied directions on working memory, particularly interactions between 2/3/9-FLUO and other PAH metabolites, but no overall or individual effects were evident.

Conclusion

We conducted a novel exploration of PAH-executive functions association in a large, combined sample from two cohorts. Although findings were predominantly null, the study carries important implications for future research and contributes to evolving science regarding developmental origins of diseases.

背景执行功能在儿童时期发展迅速,能够帮助儿童解决问题、集中注意力和制定计划。孕期接触环境有毒物质可能会损害儿童执行功能的健康发展。由于多环芳烃(PAHs)能穿过胎盘和胎儿血脑屏障,因此人们越来越关注多环芳烃,但流行病学研究的证据却很有限。方法我们研究了ECHO-PATHWAYS联合会两个美国队列中814名非吸烟母亲所生子女的产前多环芳烃暴露与执行功能之间的关系。对孕中期尿液中的七种单羟基多环芳烃代谢物进行了测定,并对其进行了单独分析和混合物分析。在 8-9 岁时测量了三个执行功能领域:认知灵活性、工作记忆和抑制控制。我们进一步计算了量化总体表现的综合得分。我们根据社会人口统计学、母亲健康行为和心理测量结果进行了线性回归,并研究了儿童性别和孕期生活压力事件的影响。我们进行了贝叶斯核机器回归,以估计多环芳烃混合物的交互效应和总体效应。结果线性回归的主要分析结果一般为空,没有发现儿童性别或母亲压力对其有任何影响。混合物分析表明,单个 PAH 代谢物之间在不同方向上对工作记忆有几种成对的交互作用,尤其是 2/3/9-FLUO 与其他 PAH 代谢物之间的交互作用,但总体或单个效应并不明显。尽管研究结果主要为空,但该研究对未来研究具有重要意义,并有助于发展有关疾病发育起源的科学。
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引用次数: 0
Occupational noise and genetic variants in stress hormone biosynthesis-based genes and rates of blood lipid changes in China: A five-year longitudinal study 中国的职业噪声和基于应激激素生物合成的基因的遗传变异与血脂变化率:五年纵向研究
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-14 DOI: 10.1016/j.ijheh.2024.114404
Xiayun Dai , Fan Wang , Lei Ni, Jinfeng Jiang, Jiaojun Liang, Tian Xu, Zhiteng Min, Siqi Chen, Yong Yao, Guilin Yi, Yongbin Luo, Zhiwei Pan, Zhenlong Chen

Lipid profiles are influenced by both noise and genetic variants. However, little is known about the associations of occupational noise and genetic variants with age-related changes in blood lipids, a crucial event in the initiation and evolution of atherosclerotic cardiovascular diseases. We aimed to evaluate the associations of blood lipid change rates with occupational noise and genetic variants in stress hormone biosynthesis-based genes. This cohort was established in 2012 and 2013 and was followed up until 2017. A total of 952 participants were included in the final analysis and all of them were categorized to two groups, the exposed group and control group, according to the exposed noise levels in their working area. Single nucleotide polymorphisms (SNPs) in stress hormone biosynthesis-based genes were genotyped. Five physical examinations were conducted from 2012 to 2017 and lipid measurements were repeated five times. The estimated annual changes (EACs) of blood lipid were calculated as the difference in blood lipid levels between any 2 adjacent examinations divided by their time interval (year). The generalized estimating equations for repeated measures analyses with exchangeable correlation structures were used to evaluate the influence of exposing to noise (versus being a control) and the SNPs mentioned above on the EACs of blood lipids. We found that the participants experienced accelerated age-related decline in high-density lipoprotein cholesterol (HDL-C) levels as they were exposed to noise (β = −0.38, 95% confidence interval (CI), −0.66 to −0.10, P = 0.007), after adjusting for work duration, gender, smoking, alcohol consumption, and pack-years. This trend was only found in participants with COMT-rs165815 TT genotype (β = −1.19, 95% CI, −1.80 to −0.58, P < 0.001), but not in those with the CC or CT genotypes. The interaction of noise exposure and rs165815 was marginally significant (Pinteraction = 0.010) after multiple adjustments. Compared with DDC-rs11978267 AA genotype carriers, participants carrying rs11978267 GG genotype had decreased EAC of triglycerides (TG) (β = −5.06, 95% CI, −9.07 to −1.05, P = 0.013). Participants carrying DBH-rs4740203 CC genotype had increased EAC of total cholesterol (TC) (β = 1.19, 95% CI, 0.06 to 2.33, P = 0.039). However, these findings were not statistically significant after multiple adjustments. These results indicated that Occupational noise exposure was associated with accelerated age-related decreases in HDL-C levels, and the COMT-rs165815 genotype appeared to modify the effect of noise exposure on HDL-C changes among the occupational population.

血脂特征受噪声和遗传变异的影响。然而,人们对职业噪声和遗传变异与血脂年龄相关变化的关系知之甚少,而血脂年龄相关变化是动脉粥样硬化性心血管疾病发生和发展的关键因素。我们的目的是评估血脂变化率与职业噪声和基于应激激素生物合成基因的遗传变异之间的关系。该队列于 2012 年和 2013 年建立,并一直随访至 2017 年。共有952名参与者被纳入最终分析,所有参与者根据其工作区域的暴露噪声水平被分为两组,即暴露组和对照组。对基于应激激素生物合成基因的单核苷酸多态性(SNPs)进行了基因分型。从2012年至2017年进行了五次体检,并重复进行了五次血脂测量。血脂的估计年度变化(EACs)计算方法为任意两次相邻体检之间血脂水平的差值除以其时间间隔(年)。我们使用具有可交换相关结构的重复测量分析的广义估计方程来评估暴露于噪声(相对于作为对照)和上述 SNPs 对血脂 EACs 的影响。我们发现,在对工作时间、性别、吸烟、饮酒量和包年进行调整后,暴露于噪声的参与者的高密度脂蛋白胆固醇(HDL-C)水平会随着年龄的增长而加速下降(β = -0.38,95% 置信区间 (CI),-0.66 至 -0.10,P = 0.007)。只有 COMT-rs165815 TT 基因型的参与者(β = -1.19, 95% CI, -1.80 to -0.58,P <0.001)有这种趋势,而 CC 或 CT 基因型的参与者则没有这种趋势。经多重调整后,噪声暴露与 rs165815 的交互作用略有显著性(Pinteraction = 0.010)。与 DDC-rs11978267 AA 基因型携带者相比,携带 rs11978267 GG 基因型的参与者甘油三酯(TG)的 EAC 值降低(β = -5.06,95% CI,-9.07 至 -1.05,P = 0.013)。携带 DBH-rs4740203 CC 基因型的参与者总胆固醇(TC)的 EAC 增加(β = 1.19,95% CI,0.06 至 2.33,P = 0.039)。然而,经过多次调整后,这些结果在统计学上并不显著。这些结果表明,职业噪声暴露与高密度脂蛋白胆固醇水平随年龄增长而加速下降有关,而 COMT-rs165815 基因型似乎可以改变噪声暴露对职业人群高密度脂蛋白胆固醇变化的影响。
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引用次数: 0
Associations between mycoestrogen exposure and sex steroid hormone concentrations in maternal serum and cord blood in the UPSIDE pregnancy cohort UPSIDE 妊娠队列中雌激素暴露与母体血清和脐带血中性激素浓度之间的关系
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-14 DOI: 10.1016/j.ijheh.2024.114405
Carolyn W. Kinkade , Lauren M. Aleksunes , Anita Brinker , Brian Buckley , Jessica Brunner , Christina Wang , Richard K. Miller , Thomas G. O'Connor , Zorimar Rivera-Núñez , Emily S. Barrett

Zearalenone (ZEN) is a fungal-derived toxin found in global food supplies including cereal grains and processed foods, impacting populations worldwide through diet. Because the chemical structure of ZEN and metabolites closely resembles 17β-estradiol (E2), they interact with estrogen receptors α/β earning their designation as ‘mycoestrogens’. In animal models, gestational exposure to mycoestrogens disrupts estrogen activity and impairs fetal growth. Here, our objective was to evaluate relationships between mycoestrogen exposure and sex steroid hormone concentrations in maternal circulation and cord blood for the first time in humans. In each trimester, pregnant participants in the UPSIDE study (n = 297) provided urine for mycoestrogen analysis and serum for hormone analysis. At birth, placental mycoestrogens and cord steroids were measured. We fitted longitudinal models examining log-transformed mycoestrogen concentrations in relation to log-transformed hormones, adjusting for covariates. Secondarily, multivariable linear models examined associations at each time point (1st, 2nd, 3rd trimesters, delivery). We additionally considered effect modification by fetal sex. ZEN and its metabolite, α-zearalenol (α-ZOL), were detected in >93% and >75% of urine samples; >80% of placentas had detectable mycoestrogens. Longitudinal models from the full cohort exhibited few significant associations. In sex-stratified analyses, in pregnancies with male fetuses, estrone (E1) and free testosterone (fT) were inversely associated with ZEN (E1 %Δ: −6.68 95%CI: −12.34, −0.65; fT %Δ: −3.22 95%CI: −5.68, −0.70); while α-ZOL was positively associated with E2 (%Δ: 5.61 95%CI: −1.54, 9.85) in pregnancies with female fetuses. In analysis with cord hormones, urinary mycoestrogens were inversely associated with androstenedione (%Δ: 9.15 95%CI: 14.64, −3.30) in both sexes, and placental mycoestrogens were positively associated with cord fT (%Δ: 37.13, 95%CI: 4.86, 79.34) amongst male offspring. Findings support the hypothesis that mycoestrogens act as endocrine disruptors in humans, as in animal models and livestock. Additional work is needed to understand impacts on maternal and child health.

玉米赤霉烯酮(ZEN)是一种从真菌中提取的毒素,存在于包括谷物和加工食品在内的全球食品供应中,通过饮食影响着全球人口。由于玉米赤霉烯酮及其代谢物的化学结构与 17β-estradiol (E2) 非常相似,因此它们会与雌激素受体 α/β 发生作用,从而被称为 "雌激素"。在动物模型中,妊娠期接触肌醇雌激素会破坏雌激素活性并损害胎儿生长。在这里,我们的目的是首次在人类中评估暴露于霉变雌激素与母体循环和脐带血中性激素浓度之间的关系。在每个孕期,UPSIDE 研究中的孕妇(n = 297)都会提供尿液进行雌激素分析,并提供血清进行激素分析。胎儿出生时,胎盘中的肌醇雌激素和脐带类固醇也被测定。我们建立了纵向模型,在对协变因素进行调整的基础上,检验对数变换后的肌醇浓度与对数变换后的激素的关系。其次,多变量线性模型检验了每个时间点(第一、第二、第三孕期,分娩)的相关性。此外,我们还考虑了胎儿性别对效果的影响。93%的尿样和75%的尿样中检测到ZEN及其代谢物α-玉米赤霉烯醇(α-ZOL);80%的胎盘中检测到肌醇。整个队列的纵向模型几乎没有显示出明显的关联。在性别分层分析中,在男性胎儿妊娠中,雌酮(E1)和游离睾酮(fT)与ZEN成反比(E1 %Δ:-6.68 95%CI:-12.34,-0.65;fT %Δ:-3.22 95%CI:-5.68,-0.70);而在女性胎儿妊娠中,α-ZOL与E2成正比(%Δ:5.61 95%CI:-1.54,9.85)。在对脐带激素进行分析时,男女胎儿尿中的绵雌激素与雄烯二酮呈反向关系(%Δ:9.15 95%CI:14.64,-3.30),而在男性胎儿中,胎盘绵雌激素与脐带绒毛膜促性腺激素呈正向关系(%Δ:37.13,95%CI:4.86,79.34)。研究结果支持这样的假设:与动物模型和家畜一样,霉变雌激素在人体内也起着干扰内分泌的作用。要了解其对母婴健康的影响,还需要做更多的工作。
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引用次数: 0
Cyclophosphamide exposure factors in family caregivers for pediatric cancer patients 儿科癌症患者家庭护理人员接触环磷酰胺的因素
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-12 DOI: 10.1016/j.ijheh.2024.114402
Yuko Noda , Yuhki Koga , Kenichiro Yamamura , Junko Miyata , Yuko Hamada , Shouichi Ohga

The exposure of family caregivers to anticancer drugs for pediatric patients with malignancy is a potential health risk that needs to be minimized. We monitored the amount of cyclophosphamide (CPM) that had adhered to the undershirts of patients and the personal protective equipment (PPE) of family caregivers as well as the caregivers' urine levels of CPM within the first three days after the first and second courses of high-dose CPM therapy. Liquid chromatography/mass spectrometry (LC/MS/MS) detected >0.03 ng/ml of CPM in 26% (23/88) of urine samples from 8 of 11 (72.7%) patients’ family caregivers, with a peak of 0.7 ng/ml from 24 to 48 h after administration. Since urine CPM concentrations in family caregivers varied after the first and second courses, the exposure risk factors were analyzed by scoring the PPE-wearing time index (caring minutes × PPE points from wearing masks, gloves, and/or gowns) and CPM adhesion of PPE items with the caring patterns of diaper change, washing body care, oral care, eating assistance, emotional support, and co-sleeping. The closest association was observed for CPM adhesion between oral care gloves and undershirts (correlation coefficient 0.67, p = 0.001). The mixed-effect model analysis indicated only a significant correlation between the PPE-wearing time index and emotional care (playing, cuddling, and physical contact) (p = 0.016). These results suggest that prolonged emotional support results in poor PPE protection, which increases the risk of exposure in family caregivers. Strict PPE care within 48 h after high-dose CPM controls the exposure to high-risk anticancer drugs in caregivers of pediatric patients.

家庭护理人员接触儿科恶性肿瘤患者的抗癌药物是一种潜在的健康风险,需要将这种风险降至最低。我们监测了患者衬衣和家庭护理人员个人防护设备(PPE)上附着的环磷酰胺(CPM)量,以及护理人员在第一和第二疗程大剂量环磷酰胺治疗后三天内尿液中的环磷酰胺含量。液相色谱/质谱法(LC/MS/MS)在 11 位患者家属护理人员中的 8 位(72.7%)26%(23/88)的尿样中检测到了 0.03 纳克/毫升的 CPM,用药后 24 至 48 小时内达到峰值 0.7 纳克/毫升。由于家庭护理人员尿液中的 CPM 浓度在第一和第二个疗程后有所不同,因此通过对 PPE 佩戴时间指数(护理分钟数 × 佩戴口罩、手套和/或病号服的 PPE 分数)和 PPE 物品的 CPM 附着情况与换尿布、清洗身体、口腔护理、协助进食、情感支持和同床共枕等护理模式进行评分,分析了暴露风险因素。口腔护理手套和内衣之间的 CPM 附着力关系最为密切(相关系数 0.67,p = 0.001)。混合效应模型分析表明,仅个人防护设备穿戴时间指数与情感关怀(玩耍、拥抱和身体接触)之间存在显著相关性(p = 0.016)。这些结果表明,长时间的情感支持会导致 PPE 保护效果不佳,从而增加家庭护理人员的暴露风险。大剂量 CPM 后 48 小时内严格的 PPE 护理可控制儿科患者护理人员接触高风险抗癌药物的风险。
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引用次数: 0
Analysis of chemical exposures in racial populations in Canada: An investigation based on the Canadian health measures survey 加拿大种族人口接触化学品情况分析:基于加拿大健康措施调查的一项研究
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-08 DOI: 10.1016/j.ijheh.2024.114406
Subramanian Karthikeyan, Tyler Pollock, Mike Walker, Cheryl Khoury, Annie St-Amand

Despite demonstrated disparities in environmental chemical exposures by racial identity, no Canadian study has systematically assessed the feasibility of using a nationally representative dataset to examine differences in chemical concentrations by race. We assessed the feasibility and constraints of analysing chemical exposures in racial populations, including visible minorities and populations of Indigenous identity, using biomonitoring data collected through the Canadian Health Measures Survey (CHMS). Our primary objectives were to assess the ability to 1) generate geometric means and percentiles of chemical concentrations for racial populations by age or sex, 2) statistically compare concentrations among racial populations, and 3) calculate time trends of concentrations by race. We conducted these analyses for several priority chemicals: lead, cadmium, benzene, bisphenol A (BPA), and di(2-ethylhexyl) phthalate (DEHP). Survey participants self-identified as one of the following: White, Black, East and Southeast Asian, South Asian, Middle Eastern, Latin American, First Nations, Metis, and Inuit. Analyses were conducted for individual and combined cycles of the CHMS. Using data from the latest CHMS cycle in which each chemical was measured, we observed that sample sizes were sufficient to report geometric mean concentrations for all races except Inuit. Due to privacy considerations associated with small sample sizes, the 5th and 95th percentile concentrations could not be consistently reported for all racial populations in this analysis. While we were able to statistically compare concentrations among racial populations, the analysis was constrained by the limited number of statistical degrees of freedom available in a single CHMS cycle. Both of these constraints were alleviated by combining multiple cycles of data. The analysis of time trends was less subject to privacy and statistical limitations; we were able to calculate time trends of chemical concentrations for all racial populations. Our findings provide an important baseline for follow-up investigations of descriptive and etiological analyses of environmental chemical exposures and race in the CHMS.

尽管按种族身份划分的环境化学品暴露存在差异,但还没有一项加拿大研究系统地评估了使用具有全国代表性的数据集来检查按种族划分的化学品浓度差异的可行性。我们利用加拿大健康措施调查(CHMS)收集的生物监测数据,评估了分析种族人群(包括有色人种和土著人群)化学物质暴露的可行性和限制因素。我们的主要目标是评估以下能力:1)按年龄或性别生成种族人群化学物质浓度的几何平均数和百分位数;2)统计比较种族人群之间的浓度;3)计算按种族划分的浓度时间趋势。我们对以下几种重点化学品进行了分析:铅、镉、苯、双酚 A (BPA) 和邻苯二甲酸二(2-乙基己基)酯 (DEHP)。调查参与者自我认同为以下人群之一:白人、黑人、东亚和东南亚人、南亚人、中东人、拉丁美洲人、原住民、梅蒂斯人和因纽特人。对 CHMS 的单个周期和合并周期进行了分析。使用最近一次测量每种化学品的 CHMS 周期的数据,我们发现样本量足以报告除因努伊特人以外的所有种族的几何平均浓度。由于样本量较小,考虑到隐私问题,在本分析中无法一致地报告所有种族人群的第 5 百分位数和第 95 百分位数浓度。虽然我们能够对不同种族人群的浓度进行统计比较,但由于单个 CHMS 周期的统计自由度有限,因此分析受到了限制。通过合并多个周期的数据,这两个限制因素都得到了缓解。对时间趋势的分析较少受到隐私和统计方面的限制;我们能够计算出所有种族人群的化学物质浓度的时间趋势。我们的研究结果为后续调查 CHMS 中环境化学暴露和种族的描述性分析和病因分析提供了重要的基础。
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引用次数: 0
Investigating the relationship between extreme weather and cryptosporidiosis and giardiasis in Colorado: A multi-decade study using distributed-lag nonlinear models 调查科罗拉多州极端天气与隐孢子虫病和贾第虫病之间的关系:使用分布式滞后非线性模型的十年研究
IF 6 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-06-02 DOI: 10.1016/j.ijheh.2024.114403
Elise N. Grover , James L. Crooks , Elizabeth J. Carlton , Sara H. Paull , William B. Allshouse , Rachel H. Jervis , Katherine A. James

Environmentally-mediated protozoan diseases like cryptosporidiosis and giardiasis are likely to be highly impacted by extreme weather, as climate-related conditions like temperature and precipitation have been linked to their survival, distribution, and overall transmission success. Our aim was to investigate the relationship between extreme temperature and precipitation and cryptosporidiosis and giardiasis infection using monthly weather data and case reports from Colorado counties over a twenty-one year period. Data on reportable diseases and weather among Colorado counties were collected using the Colorado Electronic Disease Reporting System (CEDRS) and the Daily Surface Weather and Climatological Summaries (Daymet) Version 3 dataset, respectively. We used a conditional Poisson distributed-lag nonlinear modeling approach to estimate the lagged association (between 0 and 12-months) between relative temperature and precipitation extremes and the risk of cryptosporidiosis and giardiasis infection in Colorado counties between 1997 and 2017, relative to the risk found at average values of temperature and precipitation for a given county and month. We found distinctly different patterns in the associations between temperature extremes and cryptosporidiosis, versus temperature extremes and giardiasis. When maximum or minimum temperatures were high (90th percentile) or very high (95th percentile), we found a significant increase in cryptosporidiosis risk, but a significant decrease in giardiasis risk, relative to risk at the county and calendar-month mean. Conversely, we found very similar relationships between precipitation extremes and both cryptosporidiosis and giardiasis, which highlighted the prominent role of long-term (>8 months) lags. Our study presents novel insights on the influence that extreme temperature and precipitation can have on parasitic disease transmission in real-world settings. Additionally, we present preliminary evidence that the standard lag periods that are typically used in epidemiological studies to assess the impacts of extreme weather on cryptosporidiosis and giardiasis may not be capturing the entire relevant period.

环境介导的隐孢子虫病和贾第虫病等原生动物疾病很可能受到极端天气的严重影响,因为温度和降水等气候相关条件与这些疾病的生存、分布和总体传播成功率有关。我们的目的是利用科罗拉多州各县二十一年间的月度天气数据和病例报告,研究极端气温和降水与隐孢子虫病和贾第鞭毛虫病感染之间的关系。科罗拉多州各县的可报告疾病和天气数据分别通过科罗拉多州疾病电子报告系统(CEDRS)和每日地表天气和气候学摘要(Daymet)第 3 版数据集收集。我们采用条件泊松分布-滞后非线性建模方法,估算了 1997 年至 2017 年科罗拉多州各县相对极端气温和极端降水与隐孢子虫病和贾第鞭毛虫病感染风险之间的滞后关联(0 至 12 个月),与特定县和月份的平均气温和降水值的风险相比。我们发现,极端气温与隐孢子虫病、极端气温与贾第虫病之间的关联模式截然不同。当最高或最低气温较高(第 90 百分位数)或很高(第 95 百分位数)时,我们发现相对于县和历月平均气温而言,隐孢子虫病的风险显著增加,而贾第虫病的风险则显著降低。相反,我们发现极端降水量与隐孢子虫病和贾第虫病之间的关系非常相似,这凸显了长期(大于 8 个月)滞后的突出作用。我们的研究就极端气温和降水在现实环境中对寄生虫病传播的影响提出了新的见解。此外,我们还提出了初步证据,证明流行病学研究中通常用于评估极端天气对隐孢子虫病和贾第虫病影响的标准滞后期可能无法捕捉到整个相关时期。
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International journal of hygiene and environmental health
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