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The Mount Sinai Journal of Medicine,... 2010Practitioners see a large number of children affected by environmental exposures each year. A national network of pediatric environmental health specialty units has been... (Review)
Review
BACKGROUND
Practitioners see a large number of children affected by environmental exposures each year. A national network of pediatric environmental health specialty units has been established to strengthen prevention capacity, yet the effectiveness of that translational resource has not been assessed.
METHODS
We supplemented a qualitative systematic review of previous assessments of healthcare provider capacity with a self-administered survey sent to the membership of the Michigan chapter of the American Academy of Pediatrics. We mailed surveys twice between October 2007 and January 2008 and obtained a 39.4% response rate.
RESULTS
Our systematic review identified 8 relevant studies, all of which relied on self-report questionnaires and surveys. Recognizing this methodological weakness, we found that national and state samples consistently identified significant gaps in self-efficacy and knowledge about environmental hazards across a broad range of child care providers. In the Michigan survey, respondents voiced high self-efficacy in dealing with lead and second-hand smoke, but confidence in managing pesticide, mercury, mold, polychlorinated biphenyl, and air pollution exposures was much lower (P < 0.0001). Pediatricians routinely referred affected patients to lead/toxicology clinics and allergist/immunologists but not to the regional pediatric environmental health specialty unit.
CONCLUSIONS
Gaps persist in practitioner knowledge about environmental health nationwide and across disciplines. Despite methodological weaknesses, educational opportunities and other efforts should be studied to determine best practices for enhancing the evaluation of environmental health concerns in children.
Topics: Asthma; Child; Developmental Disabilities; Diffusion of Innovation; Environmental Exposure; Environmental Health; Female; Health Care Surveys; Humans; Lead Poisoning; Male; Michigan; Middle Aged; Practice Patterns, Physicians'; Referral and Consultation; Self Efficacy; United States
PubMed: 20101722
DOI: 10.1002/msj.20158 -
Acta Neurobiologiae Experimentalis 2017The prevalence of neurodevelopmental disorders (NDs), including autism spectrum disorder, attention‑deficit/hyperactivity disorder, tic disorder,... (Review)
Review
The prevalence of neurodevelopmental disorders (NDs), including autism spectrum disorder, attention‑deficit/hyperactivity disorder, tic disorder, obsessive‑compulsive disorder, and emotional disturbances, has increased notably in the past few decades. To date, debate continues as to the origins of NDs. Increases in widespread exposure to and bioaccumulation of chemical neurotoxicants have paralleled the upsurge in NDs, and are suggested to be causal agents for NDs. One consistent aspect of NDs is the male preponderance. This review considers the issue of male preponderance by reviewing the gender‑specific neurotoxic effects of recognized neurotoxicant chemicals to assess their possible etiology in NDs. This investigation consisted of a systematic literature review of original studies published from 1970-2016 on suspected neurotoxicants, to examine whether they have a disproportionate adverse effect based on gender. Based on that review, the neurotoxicants exhibiting consistent gender‑specific effects, with exposed males being more affected (than similarly exposed females), were: lead, Thimerosal/ethylmercury, some organochlorine pesticides (e.g., dieldrin, endosulfan, and heptachlor), and air pollution. The next group identified were neurotoxicants exhibiting gender‑specific neurotoxic effects, with males being somewhat (but not consistently) more affected than females: mercury vapor, polychlorinated biphenyls (PCBs), and organophosphate pesticides. Finally, there was a group of studies in which the neurotoxicants exhibited apparent gender‑related neurotoxic effects but failed to show whether exposed males were consistently more affected than females: inorganic mercury salts, methylmercury species, and certain endocrine disruptors (e.g., phthalates and BPA). The overall conclusion from the studies reviewed was that the brain in males is more vulnerable to many toxic exposures than it is in females. Evidence suggests that the reasons for the male brain being more vulnerable include: (1) greater glutathione availability in females; (2) greater sulfate‑based detoxification capacity in females; (3) potentiating effects of co‑exposure to neurotoxicants and testosterone; (4) greater neuroinflammatory response in males; (5) reduced vulnerability to oxidative stress in females; and (6) neuroprotective effects of female hormones (estrogen and progesterone), especially in the reduction of inflammation and oxidative stress.
Topics: Brain; Developmental Disabilities; Female; Humans; Male; Neurotoxicity Syndromes; Neurotoxins; Sex Characteristics
PubMed: 29369294
DOI: No ID Found -
Environmental Research Sep 2020Environmental risks are responsible for one in five of all deaths worldwide. Persistent, bioaccumulative, and toxic substances are chemicals that can subsist for decades...
Environmental risks are responsible for one in five of all deaths worldwide. Persistent, bioaccumulative, and toxic substances are chemicals that can subsist for decades in human tissues and the environment. They include heavy metals, organochlorines, polychlorinated biphenyls, organobromines, organofluorines, and polycyclic aromatic hydrocarbons among others. Although humans are often exposed to multiple pollutants simultaneously, their negative effects on health have generally been studied for each one separately. Among the most severe of these harmful effects is cancer. Here, to compile and analyze the available evidence on the relationship between exposure to mixtures of persistent, bioaccumulative, and toxic chemicals and the risk of developing cancer in the general population, we provide a systematic review based on the main databases (Cochrane, PubMed and Embase), together with complementary sources, using the general methodology of the PRISMA Statement. The articles analyzed were selected by two researchers working independently and their quality was evaluated by reference to the Newcastle-Ottawa scale. The initial search yielded 2379 results from the main sources of information and 22 from the complementary ones. After the article selection process, 22 were included in the final review (21 case-control studies and one cohort study). Analysis of the selected studies revealed that most of the mixtures analyzed were positively associated with risk of cancer, especially that of the breast, colon-rectum or testis, and more strongly so than each contaminant alone. In view of the possible stronger association observed with the development of cancer for some mixtures of pollutants than when each one is present separately, exposure to mixtures should also be monitored and measured, preferably in cohort designs, to complement the traditional approach to persistent, bioaccumulative, and toxic chemicals. The results presented should be taken into account in public health policies in order to strengthen the regulatory framework for cancer prevention and control.
Topics: Case-Control Studies; Cohort Studies; Environmental Pollutants; Humans; Male; Neoplasms; Polychlorinated Biphenyls
PubMed: 32798941
DOI: 10.1016/j.envres.2020.109787 -
Frontiers in Endocrinology 2023There are conflicting reports on the association between environmental endocrine disruptors (EEDs) and thyroid cancer. This meta-analysis aimed to elucidate the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
There are conflicting reports on the association between environmental endocrine disruptors (EEDs) and thyroid cancer. This meta-analysis aimed to elucidate the relationship between EEDs and thyroid cancer.
METHODS
We searched for epidemiological studies on EEDs and thyroid cancer published in PubMed and Web of Science up to December 2022. We then screened the articles that could extract data on EEDs concentration levels in both thyroid cancer patients and healthy controls. We excluded articles that could not calculate effect sizes, focused on other thyroid diseases, or lacked controls. Standardized mean difference (SMD) was calculated to analyze the association between EEDs and thyroid cancer. We measured the heterogeneity among the included studies using I2, assessed publication bias by Egger's and Begg's test, and evaluated article quality using the Newcastle-Ottawa Quality Score (NOS). In the end, fifteen eligible case-control studies were included.
RESULTS
Our comprehensive analysis revealed that polychlorinated biphenyls (PCBs) were negatively associated with thyroid cancer{ SMD = -0.03, 95% confidence interval (CI) = (-0.05, -0.00), P = 0.03}, while polybrominated diphenyl ethers (PBDEs), phthalates (PAEs), and heavy metals were positively associated with thyroid cancer{PBDEs: SMD = 0.14, 95%CI = (0.04, 0.23), P = 0.007; PAEs: SMD = 0.30, 95%CI = (0.02, 0.58), P = 0.04; heavy metals: SMD = 0.21, 95%CI = (0.11, 0.32), P < 0.001}. We did not find a statistically significant relationship between bisphenol A (BPA) and thyroid cancer. Most of the included studies did not show publication bias, except for those on PCBs.
DISCUSSION
Our results indicate that exposure to certain EEDs, such as PBDEs, PAEs, and heavy metals, increases the risk of thyroid cancer. However, further large-scale epidemiological studies and mechanism studies are needed to verify these potential relationships and understand the underlying biological mechanisms.
Topics: Humans; Polychlorinated Biphenyls; Endocrine Disruptors; Halogenated Diphenyl Ethers; Thyroid Neoplasms; Metals, Heavy
PubMed: 38027118
DOI: 10.3389/fendo.2023.1283087 -
Reproductive Sciences (Thousand Oaks,... Apr 2024Endometriosis, characterized by endometrial-like mucosal tissue outside the uterine cavity, is a reproductive disorder afflicting about 10% of women within the... (Review)
Review
Endometriosis, characterized by endometrial-like mucosal tissue outside the uterine cavity, is a reproductive disorder afflicting about 10% of women within the reproductive age. The pathogenesis of endometriosis has been attributed to factors like genetics, environmental particles, and hormones. A comprehensive review of studies from July 2010 to July 2023 across multiple databases was done to aid in a better understanding of the same. The investigation focused on studies delineating the correlation between endocrine disruptors, microRNAs, and endometriosis. To optimize the search scope, keywords and subject headings were used as search terms. Then, two authors rigorously assessed studies using criteria, selecting 27 studies from various databases. Notably, dioxins, organochlorine pesticides, and polychlorinated biphenyls exhibited a solid connection for endometriosis, while bisphenol A and phthalates yielded conflicting results. The heightened presence of bisphenol A, polychlorinated biphenyls, and phthalates was linked to altered gene expression, including genes like AKR1B10, AKR1C3, and FAM49B. MicroRNAs like miRNA-31, miRNA-144, and miRNA-145 emerged as vital factors in the onset of endometriosis and progression. Furthermore, elevated expression of miR-1304-3p, miR-544, and miR-3684 and reduced expression of miR-3935 and miR-4427 exert substantial influence on signaling pathways like NF-κB, MAPK, and Wnt/β-catenin. Currently, literature shows an independent link between endocrine disruptor exposure and endometriosis and between microRNA dysregulation and endometriosis. However, research lacks the combination of all three factors. The review delves into the effects of endocrine disruptors and microRNAs on the pathogenesis of endometriosis to improve our understanding of the disorder and in finding therapies.
Topics: Humans; Female; MicroRNAs; Endometriosis; Endocrine Disruptors; Polychlorinated Biphenyls; Environmental Pollutants; Benzhydryl Compounds; Phenols
PubMed: 38036864
DOI: 10.1007/s43032-023-01412-8 -
Ecotoxicology and Environmental Safety Feb 2023Based on a systematic review and meta-analysis of articles published in PubMed, Embase, Cochrane, and Web of Science, we identified nine articles that provide evidence... (Meta-Analysis)
Meta-Analysis Review
Based on a systematic review and meta-analysis of articles published in PubMed, Embase, Cochrane, and Web of Science, we identified nine articles that provide evidence of the relationship between persistent organic pollutants and hyperuricemia. Our researchers assess the quality of the included studies and their risk of bias using the recommended method and tool. This study uses meta-analyses of the random effects of each exposure and outcome to estimate combined odds ratios (ORs) and 95% confidence intervals (CIs). We found that the risk of hyperuricemia was strongly associated with three perfluorinated compounds, PFNA, PFOA, and PFOS, with the OR(95%CI) of 1.26 (1.07-1.47), 1.44(1.15-1.79), and 1.23(1.01-1.50) respectively. We also found a weak association between two other perfluorinated compounds, PFDA and PFHxS. Other than that, the summary ORs (95% CIs) of incident hyperuricemia were 2.34 (1.79-3.08) for DDT, 3.25(2.40-4.39) for DDE, 2.57 (1.37-4.81) for PCBs and 3.05(2.22-4.19) in trans-nonanchlor. Therefore, DDT and its breakdown product, DDE, PCBs, and trans-nonanchlor have also been linked with an increased risk of hyperuricemia in humans. This study finds that persistent organic pollutant is a critical factor for hyperuricemia, and further studies in specific regions will be considered in the future.
Topics: Humans; Hyperuricemia; Persistent Organic Pollutants; Polychlorinated Biphenyls; DDT
PubMed: 36640578
DOI: 10.1016/j.ecoenv.2023.114525 -
Annals of Oncology : Official Journal... Feb 2009In overviews concerning environmental cancers, the definition of 'environmental' can vary considerably in terms of the list of exposures considered, due to differences... (Review)
Review
In overviews concerning environmental cancers, the definition of 'environmental' can vary considerably in terms of the list of exposures considered, due to differences in inclusion criteria, and the articles tend to focus mainly or exclusively on Western populations. International agencies such as World Health Organisation, that have had considerable success in fighting infectious diseases, seem to be weaker when considering the relevance of environmental carcinogens, particularly in developing countries, and in identifying the exposed populations. The purpose of this paper is to reexamine the issue with a specific focus on developing countries. There are good reasons to believe that the burden of environmental cancers in such countries is high and has been underestimated in previous analyses. We examine the most common pollutants (aflatoxins, arsenic, air pollutants, biomass fuel and coal, polychlorinated biphenyls and wastes). A systematic review was not possible given the sparse nature of the data, but we suggest that the burden of environmental exposures to carcinogens can be substantial in developing countries.
Topics: Developing Countries; Environmental Exposure; Environmental Monitoring; Environmental Pollutants; Epidemiological Monitoring; Humans; Neoplasms
PubMed: 18854551
DOI: 10.1093/annonc/mdn596 -
Reproductive Toxicology (Elmsford, N.Y.) Oct 2021The impact of environmental chemicals like persistent organic pollutants (POPs) on reproductive health is still poorly understood, despite the high societal and...
Associations between human internal chemical exposure to Persistent Organic Pollutants (POPs) and In Vitro Fertilization (IVF) outcomes: Systematic review and evidence map of human epidemiological evidence.
The impact of environmental chemicals like persistent organic pollutants (POPs) on reproductive health is still poorly understood, despite the high societal and economical costs. The aim of the present study was to systematically review and evaluate the human evidence on the associations between internal levels of POPs and in vitro Fertilization (IVF) outcomes among women. We applied a protocol based on the National Toxicology Program Office of Health Assessment and Translation's guidelines for the study search, selection and quality assessment. Fifteen studies were finally retained in the present work. The results showed that main families of POPs are still pervasive in follicular fluid and serum of women undergoing IVF treatments. Globally, we found inconsistent findings across studies for specific exposure-outcome dyads, suggesting that adverse effects of POPs on IVF outcomes cannot be ruled out. Specifically, there is evidence that POPs, notably some polychlorinated biphenyls and organochlorine pesticides, may impair embryo quality and pregnancy rates. Most studies have been performed in small cohorts (n<50) and focused on PCBs and OCPs, whereas major research gaps remain for emerging compounds (e.g. perfluoroalkylated substances) and the most clinically relevant outcome, live birth rate. The overall evidence presented 'serious' or 'very serious' risk of bias, mainly due to the lack of consideration of relevant confounding variables, low sample size or underreporting of methods. Globally, we judged the level of evidence being "low". Given the high economical and societal costs associated to infertility and IVF, further well-designed research is urged to fill the highlighted gaps.
Topics: Environmental Exposure; Female; Fertilization in Vitro; Humans; Persistent Organic Pollutants; Pregnancy; Treatment Outcome
PubMed: 34517099
DOI: 10.1016/j.reprotox.2021.09.005 -
Archives of Toxicology May 2004Experimental reproductive and developmental toxicity studies with polychlorinated biphenyls (PCBs) are reviewed in brief to determine their relevance for current... (Review)
Review
Experimental reproductive and developmental toxicity studies with polychlorinated biphenyls (PCBs) are reviewed in brief to determine their relevance for current environmental exposure of humans during the prenatal and postnatal developmental periods. Additional material is published in electronic form only, which contains graphic overviews on individual PCBs and various mixtures that are linked with the relevant citations. In this comprehensive article we focus on interactions of PCBs with biological substrates that could mediate adverse effects observed in experimental animals and in children, and the shortcomings of many of the animal studies available. A main point of criticism involves the relative lack of animal data on several of those persistent congeners, either as individual compounds or as environmentally relevant mixtures, which are currently used as a measure of human exposure. Experimental studies in animals are frequently conducted with commercial PCB mixtures, a test design that does not reflect the exposure situation in humans. Important improvements of animal experiments could be achieved by more complete reporting of litter data (pre- and post-natal losses, toxic signs in the dam and the offspring, birth weights and postnatal growth data), the inclusion of endpoints that have been found previously to be affected by PCBs, and measurements of internal exposure data.
Topics: Abnormalities, Drug-Induced; Androgen Antagonists; Androgens; Animals; Behavior, Animal; Environmental Pollutants; Estrogen Antagonists; Estrogens; Female; Hormones; Humans; Polychlorinated Biphenyls; Pregnancy; Prenatal Exposure Delayed Effects; Rodentia; Species Specificity; Thyroid Hormones
PubMed: 15064922
DOI: 10.1007/s00204-003-0519-y -
Revista Paulista de Pediatria : Orgao... 2022The aim of this study was to evaluate the influence of early exposure to agricultural pesticides and their relationship with autism spectrum disorder.
OBJECTIVE
The aim of this study was to evaluate the influence of early exposure to agricultural pesticides and their relationship with autism spectrum disorder.
DATA SOURCE
This systematic review was registered at PROSPERO as CRD42020204842. The subject was systematically analyzed on PubMed, Scopus, and Web of Science databases until April 2021. Only studies with humans with early exposure to agricultural pesticides and diagnosis of autism were included. Exclusion criteria were studies on pesticides for domestic or veterinary use and late exposure. There were no language and time restriction. The quality analysis of the studies used the Newcastle-Ottawa Scale.
DATA SYNTHESIS
Six case-control studies were included; three of them measured the route of exposure by maternal biomarkers and the others by the residence address. The studies had scores between moderate and high in the quality assessment tool. It was found high rates of association between early exposure to agricultural pesticides and autism and detection limit above the quantification for a sample of polychlorinated biphenyls, hexachlorobenzene, and dichlorodiphenyldichloroethylene.
CONCLUSIONS
There is evidence concerning the exposure to agricultural pesticides in early life and the development of the autism spectrum disorder; however, more studies are required to better understand their possible association.
Topics: Autism Spectrum Disorder; Autistic Disorder; Case-Control Studies; Humans; Pesticides; Polychlorinated Biphenyls
PubMed: 36102405
DOI: 10.1590/1984-0462/2023/41/2021360