Gender differences in cadmium and cotinine levels in prepubertal children.

Susceptibility to environmental stressors has been described for fetal and early childhood development. However, the possible susceptibility of the prepubertal period, characterized by the orchestration of the organism towards sexual maturation and adulthood has been poorly investigated and exposure data are scarce. In the current study levels of cadmium (Cd), cotinine and creatinine in urine were analyzed in a subsample 216 children from 12 European countries within the DEMOCOPHES project. The children were divided into six age-sex groups: boys (6-8 years, 9-10 years and 11 years old), and girls (6-7 years, 8-9 years, 10-11 years). The number of subjects per group was between 23 and 53. The cut off values were set at 0.1 µg/L for Cd, and 0.8 µg/L for cotinine defined according to the highest limit of quantification. The levels of Cd and cotinine were adjusted for creatinine level. In the total subsample group, the median level of Cd was 0.180 µg/L (range 0.10-0.69 µg/L), and for cotinine the median wet weight value was 1.50 µg/L (range 0.80-39.91 µg/L). There was no significant difference in creatinine and cotinine levels between genders and age groups. There was a significant correlation between levels of cadmium and creatinine in all children of both genders. This shows that even at such low levels the possible effect of cadmium on kidney function was present and measurable. An increase in Cd levels was evident with age. Cadmium levels were significantly different between 6-7 year old girls, 11 year old boys and 10-11 year old girls. As there was a balanced distribution in the number of subjects from countries included in the study, bias due to data clustering was not probable. The impact of low Cd levels on kidney function and gender differences in Cd levels needs further investigation.

Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries.

In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother-child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality and lifestyle. In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making.

[German Environmental Survey for Children (GerES IV) in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). First results]. / Kinder-Umwelt-Survey (KUS) im Rahmen des Kinder- und Jugendgesundheitssurveys (KiGGS). Erste Ergebnisse.

The German Environmental Survey for Children (GerES IV) is the environment-related module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) of the Robert Koch Institute and the fourth GerES of the Federal Environment Agency. The main objective of GerESs is to analyse and document the extent, distribution and determinants of exposure to environmental pollutants of the German general population. GerES IV was performed from 2003 to 2006. A total of 1.790 children aged 3-14 years from 150 sampling locations participated in GerES IV. Samples of blood, urine, tap water, house dust and indoor air were analysed. Hearing tests, measurements of traffic noise and interviews to get exposure-related information were conducted. First results indicate a clear decrease of the exposure to arsenic, lead and mercury. Cotinine concentrations in urine can be used to classify the exposure of children to environmental tobacco smoke. The examination of the tap water used in the subjects' households indicates that in some households the guideline values of the German Drinking Water Ordinance were not always met. This is the case for nickel, copper and lead which are used as pipe material for domestic plumbing.

German Environmental Survey (GerES): human biomonitoring as a tool to identify exposure pathways.

The German Environmental Survey (GerES) is a representative population study and has been repeatedly carried out since the mid-1980s. The currently run survey (GerES IV) is the first one solely targeted on children. The GerES IV Pilot Study resulted in first insights into major exposure pathways relevant to children. These insights were made possible by the determination of pollutant concentrations in blood and urine and the additional consideration of their occurrence in the indoor environment and by using questionnaire data. The results of the GerES IV Pilot Study are presented according to major exposure pathways such as house dust, food and environmental tobacco smoke (ETS). An overview on relevant pilot study results is given. The results of GerES IV will permit the verification and substantiation of the pilot study results.

[The Child Environment Survey]. / Kinder-Umwelt-Survey.

The German Environmental Survey (GerES) is a representative population study conducted in Germany since the mid-1980s. GerES IV is the first survey for children only; it will be conducted in close connection with the Health Survey for Children and Adolescents on a random sample of 1,800 children (3 to 14 years of age) taken from the study population of the Health Survey for Children and Adolescents. Various parameters will be analysed in blood, urine, house dust, indoor air and tap water. They include neurotoxins (PCBs, Pb, Hg), carcinogenic/cocarcinogenic substances (PAHs, benzene, halocarbons, Cd, As), substances that may cause irritation of the respiratory tract, allergies and asthma (VOC, formaldehyde, house dust mite, mould fungi, pet allergens) and substances that may have an effect on metabolism with potentially long-term consequences (such as DEHP). An additional part was devoted to the link between hearing ability, noise and stress. A one-year pilot study on 550 children and adolescents was conducted in 2001 to 2002 to collect information on parameters influencing the response rate and to test the suitability of the different instruments intended to be used for the main study.

Risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections.

BACKGROUND: Anesthesia for the child who presents for surgery with an upper respiratory infection (URI) presents a challenge for the anesthesiologist. The Current prospective study was designed to determine the incidence of and risk factors for adverse respiratory events in children with URTs undergoing elective surgical procedures. METHODS: The study population included 1,078 children aged 1 month to 18 yr who presented for an elective surgical procedure. Parents were given a short questionnaire detailing their child's demographics, medical history, and presence of any symptoms of a URT. Data regarding the incidence and severity of perioperative respiratory events were collected prospectively. Adverse respiratory events (any episode of laryngospasm, bronchospasm, breath holding > 15 s, oxygen saturation < 90%, or severe cough) were recorded. In addition, parents were contacted 1 and 7 days after surgery to determine the child's postoperative course. RESULTS: There were no differences between children with active URIs, recent URIs (within 4 weeks), and asymptomatic children with respect to the incidences of laryngospasm and bronchospasm. However, children with active and recent URIs had significantly more episodes of breath holding, major desaturation (oxygen saturation < 90%) events, and a greater incidence of overall adverse respiratory events than children with no URIs. Independent risk factors for adverse respiratory events in children with active URIs included use of an endotracheal tube (< 5 yr of age), history of prematurity, history of reactive airway disease, paternal smoking, surgery involving the airway, the presence of copious secretions, and nasal congestion. Although children with URIs had a greater incidence of adverse respiratory events, none were associated with any long-term adverse sequelae. CONCLUSIONS: The current study identified several risk factors for perioperative adverse respiratory events in children with lulls. Although children with acute and recent URIs are at greater risk for respiratory complications, these results suggest that most of these children can undergo elective procedures without significant increase in adverse anesthetic outcomes.