Environmental Tobacco Smoke Exposure during Pregnancy and Child Neurodevelopment.

The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population consisted of 461 non-smoking pregnant women (saliva cotinine level <10 ng/mL). Maternal passive smoking was assessed based on the cotinine level in saliva analyzed by the use of high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS) and by questionnaire data. The cotinine cut-off value for passive smoking was established at 1.5 ng/mL (sensitivity 63%, specificity 71%). Psychomotor development was assessed in children at the age of one- and two-years using the Bayley Scales of Infant and Toddler Development. Approximately 30% of the women were exposed to ETS during pregnancy. The multivariate linear regression model indicated that ETS exposure in the 1st and the 2nd trimesters of pregnancy were associated with decreasing child language functions at the age of one (ß = -3.0, p = 0.03, and ß = -4.1, p = 0.008, respectively), and two years (ß = -3.8, p = 0.05, and ß = -6.3, p = 0.005, respectively). A negative association was found for cotinine level ≥1.5 ng/mL in the 2nd trimester of pregnancy and child cognition at the age of 2 (ß = -4.6, p = 0.05), as well as cotinine levels ≥1.5 ng/mL in all trimesters of pregnancy and child motor abilities at two years of age (ß = -3.9, p = 0.06, ß = -5.3, p = 0.02, and ß = -4.2, p = 0.05, for the 1st, the 2nd, and the 3rd trimester of pregnancy, respectively; for the 1st trimester the effect was of borderline statistical significance). This study confirmed that ETS exposure during pregnancy can have a negative impact on child psychomotor development within the first two years of life and underscore the importance of public health interventions aiming at reducing this exposure.

Estimation of Saliva Cotinine Cut-Off Points for Active and Passive Smoking during Pregnancy-Polish Mother and Child Cohort (REPRO_PL).

A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required.

Exposure to widespread environmental endocrine disrupting chemicals and human sperm sex ratio.

In recent years, a trend toward a declining proportion of male births has been noted in several, but not all, industrialized countries. The underlying reason for the drop in the sex ratio is unclear, but one theory states that widespread environmental endocrine disrupting chemicals affecting the male reproductive system in a negative manner could be part of the explanation. The present study was designed to investigate whether the urinary phthalate, pyrethroids and polycyclic aromatic hydrocarbons metabolites concentrations were associated with sperm Y:X ratio. The study population consisted of 194 men aged under 45 years of age who attended infertility clinic in Lodz, Poland for diagnostic purposes with normal semen concentration of 20-300 mln/ml or with slight oligozoospermia (semen concentration of 15-20 mln/ml) (WHO, 1999). The Y:X ratio was assessed by fluorescent in situ hybridization. Urinary concentrations of 1-hydroxypyrene were measured by high performance liquid chromatography, phthalate metabolites were analyzed using a procedure based on the LC-MS/MS methods and metabolites of synthetic pyrethroids were assessed by gas chromatography ion-tap mass spectrometry method. After adjustment for potential confounders (past diseases, age, abstinence, smoking, alcohol consumption, sperm concentration, motility, morphology) 5OH MEHP, CDCCA to TDCCA and 1-OHP was negatively related to Y:X sperm chromosome ratio (p = 0.033, p < 0.001, p = 0.047 respectively). As this is the first study to elucidate the association between the level of metabolites of widespread environmental endocrine disrupting chemicals (phthalates, synthetic pyrethroids, polycyclic aromatic hydrocarbons) on sex chromosome ratio in sperm therefore, these findings require further replication in other populations.

Urinary cotinine levels and environmental tobacco smoke in mothers and children of Romania, Portugal and Poland within the European human biomonitoring pilot study.

The aim of this study was to explore data from the DEMOCOPHES study population for Romania, Portugal and Poland, in order to assess smoking patterns and the extent of ETS exposure and compare the national study samples with reference to the respective anti-smoking laws. The subset of the DEMOCOPHES study sample consisted of 360 children and their mothers (120 in each of the three countries - Romania (RO), Portugal (PT) and Poland (PL). Smoking was assessed using a detailed questionnaire for the participants, which addresses both active and passive smoking. This assessment uses exposure-relevant questionnaire data, in particular on the home environment and residence, socio-demographic characteristics, lifestyle such as nutrition, smoking behavior, other exposure-relevant behavior and occupational history, as well as urinary cotinine and creatinine measurements. We performed general statistical analysis and innovative receiver operating characteristic (ROC) curve analyses. Smoking prevalence as evaluated by the questionnaire was generally high, and higher than official statistics, which suggests some under-reporting in the countries, particularly in Romania. Urinary cotinine levels provided biochemical confirmation of the high and similar smoking prevalence for the three countries. Concerning ETS exposure, Romania presented significantly higher levels, for children as well as for non-smoking mothers, with Portugal showing significantly lower levels. Compared to non-smoking mothers, the children showed relatively higher ETS exposure levels in all three countries. The established country-specific optimal cut-off values in urinary cotinine to distinguish smokers from non-smokers vary more than those to discriminate ETS exposure extent in non-smoking mothers and children. Although different between countries, these values are a valuable output to monitor effectiveness of both national antismoking laws and educational programs in the three countries. The findings of this study point to the urgent need for stronger, more effective and well enforced smoke-free legislation in the three countries.

Exposure determinants of cadmium in European mothers and their children.

The metal cadmium (Cd) is a widespread environmental pollutant with documented adverse effects on the kidneys and bones from long-term environmental exposure, but with insufficiently elucidated public health consequences such as risk of cardiovascular disease, hormone-related cancer in adults and developmental effects in children. This study is the first pan-European human biomonitoring project that succeeded in performing harmonized measurements of Cd in urine in a comparable way in mother-child couples from 16 European countries. The aim of the study was to evaluate the overall Cd exposure and significant determinants of Cd exposure. A study population of 1632 women (24-52 years of age), and 1689 children (5-12 years of age), from 32 rural and urban areas, was examined within a core period of 6 months in 2011-2012. Women were stratified as smokers and non-smokers. As expected, smoking mothers had higher geometric mean (gm) urinary cadmium (UCd; 0.24 µg/g crea; n=360) than non-smoking mothers (gm 0.18 µg/g crea; n=1272; p<0.0001), and children had lower UCd (gm 0.065 µg/g crea; n=1689) than their mothers at the country level. Non-smoking women exposed to environmental tobacco smoke (ETS) at home had 14% (95% CI 1-28%) higher UCd than those who were not exposed to ETS at home (p=0.04). No influence of ETS at home or other places on UCd levels was detected in children. Smoking women with primary education as the highest educational level of the household had 48% (95% CI 18-86%) higher UCd than those with tertiary education (p=0.0008). The same observation was seen in non-smoking women and in children; however they were not statistically significant. In children, living in a rural area was associated with 7% (95% CI 1-13%) higher UCd (p=0.03) compared to living in an urban area. Children, 9-12 years had 7% (95% CI 1-13%) higher UCd (p=0.04) than children 5-8 years. About 1% of the mothers, and 0.06% of the children, exceeded the tolerable weekly intake (TWI) appointed by EFSA, corresponding to 1.0 µg Cd/g crea in urine. Poland had the highest UCd in comparison between the 16 countries, while Denmark had the lowest. Whether the differences between countries are related to differences in the degree of environmental Cd contamination or to differences in lifestyle, socioeconomic status or dietary patterns is not clear.

Predictors of environmental lead exposure among pregnant women - a prospective cohort study in Poland.

Blood lead levels (BLL) in women of child-bearing age have been decreasing in recent decades, but still remains a concern for long-term effects of child psychomotor development. The aim of the study was to characterize lead exposure among Polish pregnant women and assess the relationship between BLL and selected socio-demographic, economic and lifestyle factors. The study population consisted of 594 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort Study (REPRO_PL). The women were interviewed three times during pregnancy (once in each trimester. Lead concentration in the blood collected during the second trimester of pregnancy was analyzed using graphite furnace atomic absorption spectrometry (GF-AAS), or inductively coupled plasma mass spectrometry (ICP-MS). Active and passive smoking was analyzed by the cotinine level in saliva using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The lead level in the blood ranged from 0.3 - 5.7 µg/dL, with a geometric mean (GM) of 1.1 µg/dL (GSD ±0.2 µg/dL). Statistically significant associations were found between BLL and factors such as maternal age (ß=0.01; p=0.02), education (ß=0.08; p=0.04) and prepregnancy BMI (ß=0.1; p=0.001). Additionally, BLL increased with increasing cotinine level in saliva (ß=0.02; p=0.06) and decreased with the increasing distance from the copper smelter (ß=-0.1; p=0.009). Public health interventions, especially in regions with a higher level of exposure to lead, among women with lower SES and among smokers, are still reasonable.

Lifestyle and semen quality: role of modifiable risk factors.

The relationship between exposure to lifestyle factors and adverse effects on human reproductive health is debated in the scientific literature and these controversies have increased public and regulatory attention. The aim of the study was to examine the association between modifiable lifestyle factors and main semen parameters, sperm morphology, and sperm chromatin structure. The study population consisted of 344 men who were attending an infertility clinic for diagnostic purposes with normal semen concentration of 20-300 M/ml or with slight oligozoospermia (semen total concentration of 15-20 M/ml) [WHO 1999]. Participants were interviewed and provided semen samples. The interview included questions about demographics, socio-economic status, medical history, lifestyle factors (consumption of alcohol, tobacco, coffee intake, cell phone and sauna usage), and physical activity. The results of the study suggest that lifestyle factors may affect semen quality. A negative association was found between increased body mass index (BMI) and semen volume (p = 0.03). Leisure time activity was positively associated with sperm concentration (p = 0.04) and coffee drinking with the percentage of motile sperm cells, and the percentage of sperm head and neck abnormalities (p = 0.01, p = 0.05, and p = 0.03, respectively). Drinking red wine 1-3 times per week was negatively related to sperm neck abnormalities (p = 0.01). Additionally, using a cell phone more than 10 years decreased the percentage of motile sperm cells (p = 0.02). Men who wore boxer shorts had a lower percentage of sperm neck abnormalities (p = 0.002) and percentage of sperm with DNA damage (p = 0.02). These findings may have important implications for semen quality and lifestyle.

Estimation of cutoff values of cotinine in urine and saliva for pregnant women in Poland.

Setting appropriate cutoff values and the use of a highly sensitive analytical method allow for correct classification of the smoking status. Urine-saliva pairs samples of pregnant women in the second and third trimester, and saliva only in the first trimester were collected. Offline SPE and LC-ESI-MS/MS method was developed in the broad concentration range (saliva 0.4-1000 ng/mL, urine 0.8-4000 ng/mL). The mean recoveries were 3.7 ± 7.6% for urine and 99.1 ± 2.6% for saliva. LOD for saliva was 0.12 ng/mL and for urine 0.05 ng/mL; LOQ was 0.4 ng/mL and 0.8 ng/mL, respectively. Intraday and interday precision equaled, respectively, 1.2% and 3.4% for urine, and 2.3% and 6.4% for saliva. There was a strong correlation between salivary cotinine and the uncorrected cotinine concentration in urine in the second and third trimesters of pregnancy. The cutoff values were established for saliva 12.9 ng/mL and urine 42.3 ng/mL or 53.1 µg/g creatinine with the ROC curve analysis. The developed analytical method was successfully applied to quantify cotinine, and a significant correlation between the urinary and salivary cotinine levels was found. The presented cut-off values for salivary and urinary cotinine ensure a categorization of the smoking status among pregnant women that is more accurate than self-reporting.

Developmental effects of exposures to environmental factors: the Polish Mother and Child Cohort Study.

This paper estimates the effects of exposure to environmental factors, including lead, mercury, environmental tobacco smoke (ETS), and polycyclic aromatic hydrocarbons (PAH), on child psychomotor development. The study population consists of mother-child pairs in the Polish Mother and Child Cohort Study. Prenatal and postnatal exposure to environmental factors was determined from biomarker measurements as follows: for lead exposure--cord blood lead level, for mercury--maternal hair mercury level, for ETS--cotinine level in saliva and urine, and for PAH--1-hydroxypyrene (1-HP) in urine. At the age of 12 (406 subjects) and 24 months (198 subjects) children were assessed using Bayley Scales of Infant and Toddler Development. There were no statistically significant effects of prenatal exposure to mercury or 1-HP on child psychomotor development. After adjusting for potential confounders, adverse effects of prenatal exposure to ETS on motor development ( ß = -2.6; P = 0.02) and postnatal exposure to ETS on cognitive ( ß = -0.2; P = 0.05) and motor functions ( ß = -0.5; P = 0.01) were found. The adverse effect of prenatal lead exposure on cognitive score was of borderline significance ( ß = -6.2; P = 0.06). The study underscores the importance of policies and public health interventions that aim to reduce prenatal and postnatal exposure to lead and ETS.

Human urinary phthalate metabolites level and main semen parameters, sperm chromatin structure, sperm aneuploidy and reproductive hormones.

The aim of the study was to assess the association of phthalate metabolites levels in urine with semen parameters (sperm concentration, motility, morphology, CASA parameters), sperm chromatin structure, sperm aneuploidy and reproductive hormones. The study population consisted of 269 men who were attending an infertility clinic and had normal semen concentration (20-300mln/ml) or slight oligozoospermia (15-20mln/ml). Participants were interviewed and provided a semen sample. The phthalate metabolites were analysed in the urine using a procedure based on the LC-MS/MS method. Urinary phthalate metabolites levels were significantly associated with a decrease in sperm motility (5OH MEHP, MEHP, MINP), CASA parameters (MBP), testosterone level (MEHP) and an increase sperm DNA damage (MBP) and sperm aneuploidy (MBzP, MBP, MEHP, MEP). In view of the importance of human reproductive health and the widespread usage of phthalates, it is important to further investigate these correlations.

[Biomarkers of occupational and environmental exposure to benzene and styrene determinated by LC-MS/MS]. / Oznaczanie biomarkerów narazenia zawodowego i srodowiskowego na benzen i styren z zastosowaniem techniki LC-MS/MS.

BACKGROUND: Based on the studies performed a sensitive and simple method for the determination of benzene and styrene metabolites in urine has been developed. The developed procedure can be used for biological monitoring of occupational and environmental exposure. MATERIAL AND METHODS: Urine samples for the determination of styrene metabolites (phenylglyoxylic acid--PGA and mandelic acid--MA) were only acidified with formic acid, while those for the determination of benzene metabolite (S-phenyl-mercapturic acid--S-PMA) were additionally extracted with ethyl acetate. The measurement was performed by high performance liquid chromatography--tandem mass spectrometry (HPLC-MS/MS). The quality of our analysis was verified using internal and external quality control. RESULTS: Limit of detection for S-PMA was 0.33 microg/l, for MA--60 microg/l and for PGA--40 microg/l; precision was 2-3% and recovery 94-98%. CONCLUSIONS: The method for the quantification of benzene and styrene metabolites can be used for biological monitoring of occupational and environmental exposure.

[Occupational exposure to pesticides among farmers of the Lódz' voivodeship agricultural area]. / Zawodowa ekspozycja na wybrane pestycydy rolników z terenów rolniczych województwa Lódzkiego.

BACKGROUND: Pesticides are widely used in agriculture for the crop protection. Despite advanced mechanization of the agricultural production, the population's exposure to these chemicals is still significant. The objective of the study was to evaluate farmers' occupational exposure to two most frequently used pesticides: MCPA and 2,4-D. MATERIAL AND METHODS: Pesticide exposure was assessed in 24 farmers, living in the Lódz voivodeship agriculture area, for 71 sprayings performed on their arable areas. The exposure assessment methods were used to estimate workers' exposure to selected pesticides (MCPA and 2,4-D). The analysis covered the biological material (urine) collected on the day of pesticides spraying: in the morning before spraying (Sample A), in the evening after spraying (Sample B) and on the next day (Sample C). RESULTS: The level of pesticides found in farmers' urine was growing from sample A to sample C. The highest level of pesticides was found in sample C and the lowest in sample A. The predictors of the pesticide level were: sample collection time (urine concentration of pesticides in sample C compared with sample B) (p = 0.002), concentration of pesticides in sample A (p = 0.012) and the amount of products used during spraying (p = 0.021). 'The use of protective equipment was at the border of statistical significance (p = 0.059). The differences in exposure between farmers can be only partly explained by the analyzed exposure predictors. CONCLUSIONS: The study not only confirmed the presence of occupational exposure but also showed the level of exposure among farmers under study. This is very important because in Poland the level of exposure among farmers is unknown and studies using the biological monitoring are very rare.

Predictors of environmental exposure to polycyclic aromatic hydrocarbons among pregnant women--prospective cohort study in Poland.

OBJECTIVES: The aim of the study was to characterize the PAH exposure level based on 1-hydroxypyrene (1-HP) in urine of Polish pregnant women and to assess the relationship between PAH and factors such as smoking, environmental tobacco smoke exposure, place of residence, heating and cooking method. MATERIALS AND METHODS: The study population included in this analysis consisted of 449 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort study performed in 8 regions of Poland. The women were interviewed three times during pregnancy (once in each trimester). 1-HP concentration in urine was chosen as the biomarker of exposure to PAH. The urine sample was analysed using high performance liquid chromatography (HPLC). The active and passive smoking exposure was verified by saliva cotinine, analysed by high performance liquid chromatography coupled with tandem mass spectrometry (LC-MSMS) and isotope dilution method. RESULTS: 1-HP concentration in urine ranged from 0.02 to 10.2 µg/g creatinine with the geometric mean (GM) 0.4 µg/g creatinine. The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection (GM ratio: 1.1; p = 0.01), among smokers (GM ratio: 1.7; p < 0.001) and for the women living in big cities (GM ratio: 1.3; p = 0.001). CONCLUSIONS: The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection, among smokers and those living in big cities.

Exposure to polycyclic aromatic hydrocarbons and newborn biometric indicators.

OBJECTIVES: The aim of the study was to examine the impact of polycyclic aromatic hydrocarbons (PAH) on foetal growth. MATERIALS AND METHODS: The prospective Polish Mother and Child Cohort study was performed in 8 regions of Poland. The study population consisted of 449 mother-child pairs All women were interviewed three times during pregnancy (once in each trimester). 1-hydroxypyrene (1-HP) concentration in urine was chosen as the biomarker of exposure to PAH. The urine sample collected from the participant women between 20-24 weeks of pregnancy was analysed using high performance liquid chromatography (HPLC). The active and passive smoking exposure was verified by determination of saliva cotinine level using high performance liquid chromatography coupled with tandem mass spectrometry/positive electrospray ionisation (LC-ESI+MS/MS) and isotope dilution method. RESULTS: The exposure to PAH measured by 1-HP level in urine of pregnant women was significantly associated with child birth weight (ß = -158.3; p = 0.01), chest circumference (ß = -0.7; p = 0.02) and cephalisation index (ß = 4.2; p = 0.01) after adjustment for gestational age, child gender, pregnant woman marital status, educational level, season of last menstruation period (LMP), prepregnancy body mass index (BMI), and weight gain in pregnancy. After inclusion salivary cotinine levels into the analysis, the results were not statistically significant. CONCLUSIONS: Prenatal exposures to PAH adversely influence foetal development including child weight, length, head and chest circumference. Tobacco smoking is the important source of PAH. After controlling for active and passive smoking, the observed associations were not statistically significant.

[Impact of prenatal environmental tobacco smoke exposure on birth parameters]. / Wplyw prenatalnej ekspozycji na dym tytoniowy na parametry urodzeniowe noworodka.

The aim of the study was to analyze the association between prenatal environmental tobacco smoke exposure (ETS) and child anthropometric parameters at birth such birth weight, length, head and chest circumference. The study population consisted of 107 pregnant women from Lodz district as the part of Polish Mother and Child Cohort study. The child prenatal ETS exposure was assessed based on questionnaire with mothers and cotinine level in saliva collected three times in pregnancy. The level of cotinine in biological samples was analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS ESI+). About 35% of the children were prenatally exposed to ETS. The birth weight of the children prenatally exposed to ETS was 335 g lower than the birth weight of non-exposed newborns p < 0.001 after adjustment for: maternal educational level, marital status, prepregnancy weight, child gender, and gestational age. The same refers to child length and chest circumference (coef. -1.1 cm; p = 0.03 and coef. -1.3 cm; p = 0.002 respectively). Taking into account the negative effect of prenatal exposure to ETS, more efforts need to be taken to eliminate child ETS exposure.

[Exposure to environmental tobacco smoke and psychomotor development of children]. / Narazenie na srodowiskowy dym tytoniowy a rozwój psychoruchowy dzieci.

BACKGROUND: In Poland, prenatal exposure to tobacco smoke is observed in about 30 percent of children and postnatal in over 50 percent of children. This exposure has serious health consequences, including the negative effect on child neurodevelopment. The aim of the study was to assess the effect of environmental tobacco smoke (ETS) exposure on child psychomotor development. MATERIAL AND METHODS: The study population consisted of 63 children with well assessed prenatal ETS exposure (a threefold analysis of cotinine level in saliva of pregnant women). To assess ETS exposure in infants within one year after birth a questionnaire-based interview was conducted with mothers. The Bayley Scale for Infant and Toddler Development (BESID-III) was used for the evaluation of child neurodevelopment. RESULTS: Multivariate analysis (including gender, birth order of the child and parental educational status) indicated the statistically significant association between prenatal exposure to ETS and cognitive child development (b = -4.0; p = 0.04). ETS exposure has also a negative impact on motor (b = -2.7; p = 0.2) and language (b = -3.4; p = 0.08) abilities of the child although the results were not statistically significant. CONCLUSIONS: Maternal smoking was found to be related to a decrease in child neurodevelopment, however, it was impossible to separate the prenatal from postnatal exposure. A lot of effort should be made to eliminate ETS exposure of children.

[Exposure of smoking pregnant women to polycyclic aromatic hydrocarbons]. / Narazenie palacych kobiet ciezarnych na wielopierscieniowe weglowodory aromatyczne.

BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are compounds that are formed as a result of incomplete combustion of organic matter. The most common sources of PAHs are cigarette smoke, coal-fired utilities, steel plants, coke-oven plants, graphite electrode manufacturing plant, Söderberg aluminum electrolysis plant, vehicle exhaust, wood-burning ovens and fireplaces, and charcoal-grilled and smoked food. The aim of the study was to assess the exposure of smoking pregnant women to PAHs. MATERIAL AND METHODS: The study population consisted of 189 pregnant women from the Lódz voivodeship (province). Smoking status was assessed based on saliva cotinine level analyzed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The cutoff point 10 ng/ml was adopted for saliva cotinine level. 1-hydroxypyrene (1-HP) concentration in urine sample was chosen as the biomarker of exposure to PAHs. RESULTS AND CONCLUSIONS: The mean concentration of 1-HP in urine of nonsmoking woman was 0.60 microg/g creatinine, whereas in smoking one 1.35 microg/g creatinine. Among the women with saliva cotinine level higher than 10 ng/ml, the mean concentration of 1-HP in urine was over twofold higher than that in women with cotinine level lower than 10 ng/ml after adjustment for the day of urine ample collection (ratio of geometric mean 2.3; 95% CI 1.7-3.0). The study confirmed a higher risk of exposure to PAHs in the group of women who smoke cigarettes during pregnancy as compared to nonsmoking women. It should be stressed that cigarette smoking is not the only source of exposure to PAHs.

Polish mother and child cohort study--defining the problem, the aim of the study and methodological assumption.

OBJECTIVES: Exposures during prenatal period have implications for pregnancy outcome as well as for children's health, morbidity and mortality. Prospective cohort study design allows for the identification of exposures that may influence pregnancy outcome and children's health, verification of such exposures by biomarker measurements and notification of any changes in exposure level. MATERIALS AND METHODS: Polish Mother and Child Cohort Study (REPRO_PL) is multicenter prospective cohort study conducted in 8 different regions of Poland. The final cohort is intended to comprise 1300 mother-child pairs to be recruited within 4-year period (2007-2011). The recruitment and all scheduled visits are conducted in maternity units or clinics in the districts included in the study. The women are followed-up 3 times in pregnancy (once in each trimester) and after delivery for the notification of pregnancy outcome. During each visit, detailed questionnaire and biological samples are collected including saliva, urine, hair, maternal blood and cord blood. About 6 weeks postpartum, breast milk from part of the women is collected. The study concentrates on the identification and evaluation of the effects of prenatal environmental exposure on pregnancy outcome and children's health. Specific research hypotheses refer to the role of heavy metals, exposure to polycyclic aromatic hydrocarbons (PAHs) and environmental tobacco smoke (ETS) in the aetiology of small-for-gestational-age (SGA) and preterm delivery (PD). The role of oxidative stress putative mechanism and pregnant women nutritional status will be investigated. Based on questionnaire data, the impact of occupational exposures and stressful situations will be evaluated. RESULTS: The results of the study will become available within the next few years and will help to determine levels of child prenatal exposure in several areas of Poland and its impact on course and outcome of pregnancy.

[Prenatal and postnatal child exposure to environmental tobacco smoke]. / Prenatalna i postnatalna ekspozycja dzieci na srodowiskowy dym tytoniowy.

The aim of the study was to evaluate the prenatal and postnatal child exposure to environmental tobacco smoke. The study population consisted of 83 women from Lodz, Poland among which detail questionnaire was conducted three times during pregnancy period. From all women included into the study the saliva sample was collected to verify smoking status in pregnancy. One year after delivery the second questionnaire was performed and urine sample from all children was collected. The cotinine level in saliva and urine was analyzed using Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS ESI+). About 22% of the children were expose to ETS during prenatal and 46% in postnatal period. Cotinine level in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 11.4 ng/ml; 95% CI 7.1-18.3) and exposed homes (GM 7.3 ng/ml; 95% CI 3.6-15.0) compared with non-exposed homes (GM 1.3 ng/ml; 95% CI 0.9-1.7) (p < 0.001). Children should be more protected from ETS exposure in prenatal and postnatal period.

[Dermal exposure to pesticides among women working in Polish greenhouses using cotton patches]. / Ekspozycja dermalna na pestycydy kobiet pracujacych w gospodarstwach ogrodniczych--wyniki badan z wykorzystaniem próbników bawelnianych.

BACKGROUND: The work in greenhouses might involve indirect exposure to pesticides, resulting from the contact with previously pesticide-treated flowers and vegetables. The objective of the study was to assess the exposure to selected pesticides of workers tending and harvesting greenhouse cultivations after the restricted-entry intervals expired using cotton patches. MATERIAL AND METHODS: Pesticide exposure was assessed among women (n=19) tending and harvesting vegetables in one of the vegetable production greenhouse in Poland. The exposure assessment methods were used to estimate workers' exposure to selected pesticides (hexythiazoks, azoksystrobin, imazalil) after the restricted-entry intervals expired. Cotton gloves and patches on chest and arms were used during the whole workshift in the greenhouse. RESULTS: All the three kinds of pesticides were found on cotton patches and gloves. The concentration of the examined active ingredients was higher on gloves than on patches. Their concentration on patches and gloves between sprayings was proportional to the concentration of active ingredients used during sprayings. CONCLUSION: Dermal exposure of women to pesticides during work in a greenhouse takes place even when employees are not directly engaged in the process of spraying. Therefore, it is nececarry to ensure that this occupational group is provided with the efficient personal protective equipment.