Association between maternal smoking and child bone mineral density: a systematic review and meta-analysis.

Maternal smoking during pregnancy has detrimental effects on fetal development. The current review examined the differences in offspring's bone mineral density (BMD) between mothers smoked during pregnancy and those who did not. A systematic review and meta-analysis on the studies investigating the influence of maternal smoking during pregnancy on children or neonates' bone measures published up to October 30, 2018, was performed. BMD results measured at different body sites were pooled and then fixed or random effect models were used based on the presence of heterogeneity. The desired pooled effect size was the offspring's BMD mean difference with 95% confidence interval between smoker and non-smoker mothers. Sensitivity analysis was performed for birth weight and current weight, two important mediator/confounders causing heterogeneity. Overall, eight studies consisting of 17,931 participants aged from infancy to 18 years were included. According to the fixed effect model, the mean of BMD in offspring whose mothers smoked during pregnancy was 0.01 g/cm2 lower than those with non-smoker mothers (95% CI = - 0.02 to - 0.002). However, subgroup meta-analysis adjusted for birth weight and current weight demonstrated no significant mean difference between BMD of children with smoker and non-smoker mothers (d = 0.06, 95% CI = -0.04 to 0.16, p value = 0.25 and d = - 0.005, 95% CI = - 0.01 to 0.004, p value = 0.28, respectively). According to available studies, it is suggested that maternal smoking during pregnancy does not have direct effect on the offspring's BMD. Instead, this association might be confounded by other factors such as placental weight, birth weight, and current body size of children.

Evaluation of carcinogenic risks related to nitrate exposure in drinking water in Iran.

Nitrate is one of the most important contaminants that can release into the environment predominantly as a result of anthropogenic processes. Excessive intake of nitrates may increase the risk of certain types of cancer. The aim of this study was to investigate the concentration of nitrate in drinking water and its health to people in Iran. This cross-sectional study has performed in 2019. Nitrate concentrations in drinking water supplies were obtained from peer-reviewed publications. Monte Carlo stimulations and mathematical models were used to determine the excess cancer risk. Risk level for assessing the carcinogen risk was 10-5 (1 per 100,000 persons). Nitrate concentrations and cancer risk related to nitrate were classified by GIS software. According to the obtained results, the drinking water supplies of Tehran, Mashhad (Khorasan Razavi), Zahedan (Sistan and Baluchestan), Shiraz (Fars), Qom, Ardabil and Ahwaz (Khuzestan) have higher nitrate concentrations than the limit recommended by WHO and Institute of Standards and industrial Research of Iran (ISIRI). The estimated cancer risks for the provinces of Tehran, Mashhad (Khorasan Razavi), Zahedan (Sistan and Baluchestan), Shiraz (Fars), Qom, Ardabil and Ahwaz (Khuzestan) were in the no negligible range set by the Health Canada and WHO. The majority of Iran provinces that have impermissible level of nitrate in drinking water supplies had a significant association between cancer prevalence and nitrate exposure. •The findings demonstrated that carcinogen risk values of nitrate exposure through drinking water was 0.001%.•Results showed that Tehran, Mashhad (Khorasan Razavi), Zahedan (Sistan and Baluchestan), Shiraz (Fars), Qom, Ardabil and Ahwaz (Khuzestan) are more exposed to additional cancer risk related to nitrosamine.•The results of this study is considered as the comprehensive report that indicate the association between gastrointestinal cancer and nitrate exposure through drinking water.