RESUMEN
Phytoestrogens have been associated with subtle hormonal changes, although effects on fecundity are unknown. Our objective was to evaluate the association between male and female urinary phytoestrogen (isoflavone and lignan) concentrations and time to pregnancy (TTP) in a population-based cohort of 501 couples desiring pregnancy and discontinuing contraception. Couples were followed for 12 mo or until pregnancy. Fecundability ORs (FORs) and 95% CIs were estimated after adjusting for age, body mass index, race, site, creatinine, supplement use, and physical activity in relation to female, male, and joint couple concentrations. Models included the phytoestrogen of interest and the sum of the remaining individual phytoestrogens. FORs <1 denote a longer TTP and FORs >1 a shorter TTP. Urinary lignan concentrations were higher, on average, among female partners of couples who became pregnant during the study compared with women who did not become pregnant (median enterodiol: 118 vs. 80 nmol/L; P < 0.10; median enterolactone: 990 vs. 412 nmol/L; P < 0.05) and were associated with significantly shorter TTP in models based on both individual and couples' concentrations (couples' models: enterodiol FOR, 1.13; 95% CI: 1.02, 1.26; enterolactone FOR, 1.11; 95% CI: 1.01, 1.21). Male lignan concentrations were not associated with TTP, nor were isoflavone concentrations. Sensitivity analyses showed that associations observed are unlikely to be explained by potential unmeasured confounding by lifestyle or other nutrients. Our results suggest that female urinary lignan concentrations at levels characteristic of the U.S. population are associated with a shorter TTP among couples who are attempting to conceive, highlighting the importance of dietary influences on fecundity.
Asunto(s)
Lignanos/orina , Fitoestrógenos/administración & dosificación , Tiempo para Quedar Embarazada/efectos de los fármacos , 4-Butirolactona/análogos & derivados , 4-Butirolactona/orina , Adolescente , Adulto , Índice de Masa Corporal , Dieta , Femenino , Humanos , Isoflavonas/administración & dosificación , Isoflavonas/orina , Lignanos/administración & dosificación , Masculino , Embarazo , Estudios Prospectivos , Factores Socioeconómicos , Tiempo para Quedar Embarazada/fisiología , Adulto JovenRESUMEN
BACKGROUND: The first step in evaluating potential geographic clusters of disease calls for an evaluation of the disease risk comparing the risk in a defined location to the risk in neighboring locations. Environmental exposures, however, represent continuous exposure levels across space not an exposure with a distinct boundary. The objectives of the current study were to adapt, apply and evaluate a geostatistical approach for identifying disease clusters. METHODS: The exceedance probability for very low birth weight (VLBW; < 1.5 kg) infants was mapped using an Intrinsic Conditional Autoregressive model. The data were applied to a 20 by 20 grid of 1 km2 pixels centered on each of the 13 National Priority List Superfund Sites in Harris County, Texas. RESULTS: Large clusters of VLBW were identified in close proximity to four of the 13 Superfund Sites. Three of the Superfund Sites, associated with disease clusters, were located close together in central Houston and these sites may have been surrounded by a single, confluent disease cluster. CONCLUSIONS: Geostatistical modeling of the exceedance probability for very low birth weights identified disease clusters of varying size, shape and statistical certainty near Superfund Sites in Harris County, Texas. The approach offers considerable potential as the first step for investigating potential disease clusters.
Asunto(s)
Sitios de Residuos Peligrosos , Recién Nacido de muy Bajo Peso , Modelos Teóricos , Análisis por Conglomerados , Exposición a Riesgos Ambientales/efectos adversos , Humanos , Recién Nacido , Probabilidad , Texas/epidemiologíaRESUMEN
The relationship between the environment and human fecundity and fertility remains virtually unstudied from a couple-based perspective in which longitudinal exposure data and biospecimens are captured across sensitive windows. In response, we completed the LIFE Study with methodology that intended to empirically evaluate a priori purported methodological challenges: implementation of population-based sampling frameworks suitable for recruiting couples planning pregnancy; obtaining environmental data across sensitive windows of reproduction and development; home-based biospecimen collection; and development of a data management system for hierarchical exposome data. We used two sampling frameworks (i.e., fish/wildlife licence registry and a direct marketing database) for 16 targeted counties with presumed environmental exposures to persistent organochlorine chemicals to recruit 501 couples planning pregnancies for prospective longitudinal follow-up while trying to conceive and throughout pregnancy. Enrolment rates varied from <1% of the targeted population (n = 424,423) to 42% of eligible couples who were successfully screened; 84% of the targeted population could not be reached, while 36% refused screening. Among enrolled couples, â¼ 85% completed daily journals while trying; 82% of pregnant women completed daily early pregnancy journals, and 80% completed monthly pregnancy journals. All couples provided baseline blood/urine samples; 94% of men provided one or more semen samples and 98% of women provided one or more saliva samples. Women successfully used urinary fertility monitors for identifying ovulation and home pregnancy test kits. Couples can be recruited for preconception cohorts and will comply with intensive data collection across sensitive windows. However, appropriately sized sampling frameworks are critical, given the small percentage of couples contacted found eligible and reportedly planning pregnancy at any point in time.
Asunto(s)
Exposición a Riesgos Ambientales/efectos adversos , Contaminantes Ambientales/sangre , Contaminantes Ambientales/orina , Exposición Materna/efectos adversos , Reproducción/efectos de los fármacos , Proyectos de Investigación , Adolescente , Adulto , Estudios de Cohortes , Métodos Epidemiológicos , Femenino , Desarrollo Fetal/efectos de los fármacos , Humanos , Hidrocarburos Clorados/sangre , Hidrocarburos Clorados/orina , Masculino , Persona de Mediana Edad , Embarazo , Estudios Prospectivos , Semen/química , Adulto JovenRESUMEN
Recent immigrants to the USA from Southeast Asia may be at higher risk of exposure to fish-borne contaminants including polychlorinated biphenyls (PCBs), p, p'-dichlorodiphenyldichloroethene (DDE) and methylmercury (MeHg) because of their propensity to engage in subsistence fishing. Exposure to contaminants was assessed in men and women of Hmong descent living in Green Bay, Wisconsin, where the Fox River and lower Green Bay are contaminated with PCBs, and to a lesser extent with mercury. Serum samples from 142 people were analyzed for PCBs and p,p'-DDE by capillary column gas chromatography with electron capture detection (ECD). Whole blood was analyzed for total mercury by cold vapor atomic absorption spectrometry and atomic fluorescence spectroscopy. Lipid-adjusted total PCB concentrations ranged from 8.7 to 3,091ng/g (full range of the data), with a geometric mean of 183.6ng/g (estimated after eliminating one outlier). DDE ranged from 0.3 to 7,083 (full range of the data) with a geometric mean of 449.8ng/g (estimated after eliminating two outliers). Men had higher PCB and DDE concentrations than women. Serum PCB concentrations were significantly correlated with fish consumption (r=0.43, p<0.0001), whereas DDE concentrations were not (r=0.09,p=0.29). Instead, serum DDE was strongly associated with the number of years spent in a Thai refugee camp before immigrating to the USA (r=0.60;p<0.0001). PCB congeners 138, 153, 118 and 180 accounted for a smaller percentage of the total PCBs than has been reported in other fish-eating populations, and several lightly chlorinated congeners were present in relatively large amounts. Mercury exposure was low in this population. In conclusion, Hmong immigrants in northeastern Wisconsin are at risk of elevated PCB exposure from consumption of locally caught fish. The pattern of exposure is somewhat different than patterns in other fish-eating populations, possibly due to use of Aroclor 1242 by the paper industry in this region.
Asunto(s)
Ingestión de Alimentos , Emigrantes e Inmigrantes , Peces , Contaminación de Alimentos , Contaminantes Químicos del Agua/análisis , Adolescente , Adulto , Animales , Asia Sudoriental/etnología , Diclorodifenil Dicloroetileno/análisis , Diclorodifenil Dicloroetileno/sangre , Diclorodifenil Dicloroetileno/química , Emigrantes e Inmigrantes/estadística & datos numéricos , Exposición a Riesgos Ambientales/análisis , Femenino , Peces/metabolismo , Humanos , Masculino , Mercurio/análisis , Mercurio/sangre , Mercurio/química , Persona de Mediana Edad , Bifenilos Policlorados/análisis , Bifenilos Policlorados/sangre , Bifenilos Policlorados/química , Factores Socioeconómicos , Contaminantes Químicos del Agua/sangre , Contaminantes Químicos del Agua/química , Wisconsin , Adulto JovenRESUMEN
Some evidence exists to support the hypothesis that elevated levels of circulating maternal estrogens during early pregnancy may increase risk of testicular germ cell cancer. However, the results from studies evaluating maternal factors have been mixed. We evaluated maternal factors, particularly those associated with excess estrogen levels, as risk factors for testicular cancer. We conducted a hospital-based case-control study at The University of Texas M. D. Anderson Cancer Center in Houston, Texas of 144 testicular cancer patients diagnosed between 1990 and 1996 and 86 friend controls matched to cases on age, race, and state of residence. Risk factor data about the mother, the son, and the pregnancy were obtained from the mothers by telephone interviews and from the sons by self-administered questionnaires. Extreme nausea during the first trimester of pregnancy was associated with an elevated risk of testicular cancer [odds ratio (OR) = 2.0; 95% confidence interval (CI) = 1.0-3.9]. Adjustment for potential confounders slightly lowered this risk (OR = 1.8; 95% CI = 0.9-3.8). Risks were modestly increased for other factors that are proxy measures for maternal estrogens, including preterm delivery (OR = 2.2; 95% CI = 0.4-12.9), birth weight <3000 g (OR = 2.4: 95% CI = 0.7-8.1), and birth weight >4000 g (OR = 1.7; 95% CI = 0.9-3.2), albeit nonsignificantly so. Our finding that severe nausea was associated with increased testicular cancer risk adds evidence to support the in utero estrogen exposure hypothesis because nausea early in pregnancy is related to rising levels of circulating estrogens. For other factors, which are less direct measures of maternal estrogens, the modest associations found indicate a suggestive pattern in support of the excess estrogen hypothesis.
Asunto(s)
Germinoma/epidemiología , Recién Nacido de Bajo Peso , Complicaciones del Embarazo/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Neoplasias Testiculares/epidemiología , Vómitos/epidemiología , Estudios de Casos y Controles , Causalidad , Intervalos de Confianza , Factores de Confusión Epidemiológicos , Criptorquidismo/epidemiología , Estrógenos/efectos adversos , Estrógenos/metabolismo , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Embarazo , Complicaciones del Embarazo/metabolismo , Primer Trimestre del Embarazo , Atención Prenatal , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
PURPOSE: This cohort study estimated the frequency of and risk factors for work injuries among migrant farmworker families over a two-year period. METHODS: The cohort consisted of 267 families. Bilingual interviewers asked mothers to respond for their family soliciting demographic, psychosocial, employment, and work-related injury information. Cox regression was used to examine risk factors for first injury events. RESULTS: Of the 267 families, nearly 60% migrated and 96% of these completed the follow-up interviews. These families represented about 310 individuals each year who had participated in farmwork on average 6 days a week, 10 hours a day, for 2.7 months in the past year. Twenty-five work-related injuries were reported with an overall rate of 12.5/100 FTE (95% C.I., 8.6-19.0). Working for a contractor increased the hazard ratio, and use of car seat belts and working for more than one employer during the season decreased it. CONCLUSIONS: If person-time at risk for injuries is taken into account the reported injuries are substantial. Because the injuries were quite diverse, specific interventions may have to focus on improved working conditions (physical and economic), ergonomic modifications, and enhanced enforcement of existing regulations.
Asunto(s)
Accidentes de Trabajo , Agricultura , Familia , Migrantes , Heridas y Lesiones/epidemiología , Estudios de Cohortes , Conductas Relacionadas con la Salud , Humanos , Factores de Riesgo , Texas/epidemiología , Migrantes/estadística & datos numéricosRESUMEN
BACKGROUND: The relation between persistent environmental chemicals and semen quality is evolving, although limited data exist for men recruited from general populations. OBJECTIVES: We examined the relation between perfluorinated chemicals (PFCs) and semen quality among 501 male partners of couples planning pregnancy. METHODS: Using population-based sampling strategies, we recruited 501 couples discontinuing contraception from two U.S. geographic regions from 2005 through 2009. Baseline interviews and anthropometric assessments were conducted, followed by blood collection for the quantification of seven serum PFCs (perfluorosulfonates, perfluorocarboxylates, and perfluorosulfonamides) using tandem mass spectrometry. Men collected a baseline semen sample and another approximately 1 month later. Semen samples were shipped with freezer packs, and analyses were performed on the day after collection. We used linear regression to estimate the difference in each semen parameter associated with a one unit increase in the natural log-transformed PFC concentration after adjusting for confounders and modeling repeated semen samples. Sensitivity analyses included optimal Box-Cox transformation of semen quality end points. RESULTS: Six PFCs [2-(N-methyl-perfluorooctane sulfonamido) acetate (Me-PFOSA-AcOH), perfluorodecanoate (PFDeA), perfluorononanoate (PFNA), perfluorooctane sulfonamide (PFOSA), perfluorooctane sulfonate (PFOS), and perfluorooctanoic acid (PFOA)] were associated with 17 semen quality end points before Box-Cox transformation. PFOSA was associated with smaller sperm head area and perimeter, a lower percentage of DNA stainability, and a higher percentage of bicephalic and immature sperm. PFDeA, PFNA, PFOA, and PFOS were associated with a lower percentage of sperm with coiled tails. CONCLUSIONS: Select PFCs were associated with certain semen end points, with the most significant associations observed for PFOSA but with results in varying directions.
Asunto(s)
Contaminantes Ambientales/toxicidad , Fluorocarburos/toxicidad , Análisis de Semen , Semen/efectos de los fármacos , Adulto , Exposición a Riesgos Ambientales , Humanos , Modelos Lineales , Masculino , Michigan , Espectrometría de Masas en Tándem , TexasRESUMEN
BACKGROUND: Persistent organic pollutants (POPs) are developmental toxicants, but the impact of both maternal and paternal exposures on offspring birth size is largely unexplored. OBJECTIVE: We examined associations between maternal and paternal serum concentrations of 63 POPs, comprising five major classes of pollutants, with birth size measures. METHODS: Parental serum concentrations of 9 organochlorine pesticides, 1 polybrominated biphenyl (PBB), 7 perfluoroalkyl chemicals (PFCs), 10 polybrominated diphenyl ethers (PBDEs), and 36 polychlorinated biphenyls (PCBs) were measured before conception for 234 couples. Differences in birth weight, length, head circumference, and ponderal index were estimated using multiple linear regression per 1-SD increase in natural log-transformed (ln-transformed) chemicals. Models were estimated separately for each parent and adjusted for maternal age, maternal prepregnancy body mass index (kilograms per meter squared) and other confounders, and all models included an interaction term between infant sex and each chemical. RESULTS: Among girls (n = 117), birth weight was significantly lower (range, 84-195 g) in association with a 1-SD increase in ln-transformed maternal serum concentrations of DDT, PBDE congeners 28 and 183, and paternal serum concentrations of PBDE-183 and PCB-167. Among boys (n = 113), maternal (PCBs 138, 153, 167, 170, 195, and 209 and perfluorooctane sulfonamide) and paternal (PCBs 172 and 195) serum concentrations of several POPs were statistically associated with lower birth weight (range, 98-170 g), whereas paternal concentrations of PBDEs (66, 99) were associated with higher birth weight. Differences in offspring head circumference, length, and ponderal index were also associated with parental exposures. CONCLUSIONS: Preconceptional maternal and paternal concentrations of several POPs were associated with statistically significant differences in birth size among offspring.
Asunto(s)
Peso al Nacer/efectos de los fármacos , Contaminantes Ambientales/toxicidad , Exposición Materna/efectos adversos , Exposición Paterna/efectos adversos , Adolescente , Adulto , Tamaño Corporal/efectos de los fármacos , Estudios de Cohortes , Exposición a Riesgos Ambientales/efectos adversos , Contaminantes Ambientales/sangre , Femenino , Humanos , Hidrocarburos Halogenados/sangre , Hidrocarburos Halogenados/toxicidad , Recién Nacido , Masculino , Exposición Materna/estadística & datos numéricos , Michigan , Persona de Mediana Edad , Exposición Paterna/estadística & datos numéricos , Plaguicidas/sangre , Plaguicidas/toxicidad , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , TexasRESUMEN
Consumption of sport-caught fish from the Great Lakes is a recognized source of human exposure to polychlorinated biphenyls (PCBs). Understanding temporal changes in PCB body burden is crucial for evaluating exposure levels and augmenting validity of studies investigating their relationship to adverse health effects. Using data collected from 1980 to 1995, we evaluated longitudinal changes in serum PCB levels among 179 fisheaters and non-fisheaters of the Michigan Fisheater Cohort. Participants identified as fisheaters in 1980 ate 26 lb or more of sport-caught fish per year, whereas non-fisheaters ate less than 6 lb per year. We found a monotonic decline in serum PCB levels among all participants from a mean value of 24 ppb in 1980 to 12 ppb in 1994. This was paralleled by an 83% decrease in mean fish consumption among all participants over the same period. We combined demographic, lifestyle, and fish consumption information with PCB data and evaluated the data using regression models to identify predictors of PCB body burden over a 16-year period. Results of the mixed-effects linear regression model suggest that consumption of Lake Michigan fish before 1980, amount of sport-caught fish eaten in the past year, age, and year of data collection were significant determinants of current PCB body burden over the 16-year study period. PCB levels were particularly elevated for males who were classified as fisheaters in 1980, which may reflect higher levels of sport-caught fish consumption compared with female fisheaters.
Asunto(s)
Exposición a Riesgos Ambientales , Contaminantes Ambientales/sangre , Peces , Contaminación de Alimentos , Modelos Teóricos , Bifenilos Policlorados/sangre , Adulto , Anciano , Animales , Estudios de Cohortes , Demografía , Dieta , Femenino , Great Lakes Region , Humanos , Estilo de Vida , Estudios Longitudinales , Masculino , Persona de Mediana EdadRESUMEN
The determinants of successful human reproduction and development may act as early as periconceptionally, underscoring the need to capture exposures during these critical windows when assessing potential toxicants. To identify such toxicants, couples must be studied longitudinally prior to conception without regard to a couple's ability to ascertain a clinically recognized pregnancy. We examined the utility and feasibility of prospective pregnancy study designs by conducting a systematic review of the literature to summarize relevant information regarding the planning, implementation, and success of previously published prospective pregnancy studies. Information concerning design elements and participation was abstracted from 15 eligible studies (from a total of 20 identified studies) using a standardized form. The primary author of each study was contacted to review our summary of their work and obtain missing information. Our findings confirm the ability to recruit women/couples from diverse populations using a variety of recruitment strategies. Among the studies we reviewed, 4-97% of eligible individuals were successfully contacted, with enrollment rates ranging from 42 to 100%. Length of follow-up varied from 3 to 12 months. A high percentage of women provided urine (57-98%) and blood (86-91%) specimens and most male partners (94-100%) provided semen samples. These data support the feasibility of this design.
Asunto(s)
Contaminantes Ambientales/envenenamiento , Embarazo , Adulto , Desarrollo Embrionario y Fetal , Femenino , Humanos , Cooperación del Paciente , Selección de Paciente , Efectos Tardíos de la Exposición Prenatal , Estudios Prospectivos , Reproducción , Proyectos de InvestigaciónRESUMEN
The scientific community is developing a compelling body of evidence that shows the importance of the in utero environment (including chemical and hormonal levels) to the ultimate health of the child and even of the aging adult. This article summarizes the evidence that shows this impact begins with conception. Only a full life-cycle evaluation will help us understand these impacts, and only such an understanding will produce logically prioritized mitigation strategies to address the greatest threats first. Clearly, the time for analysis begins when the next generation is but a twinkle in the eye.
Asunto(s)
Protección a la Infancia , Contaminantes Ambientales/envenenamiento , Fertilidad , Exposición Materna , Estado Nutricional , Exposición Paterna , Efectos Tardíos de la Exposición Prenatal , Adulto , Niño , Preescolar , Anomalías Congénitas/etiología , Desarrollo Embrionario y Fetal , Femenino , Fertilización , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Técnicas Reproductivas Asistidas , Semen/fisiologíaRESUMEN
OBJECTIVE: To assess the relationship between environmental chemicals and couple fecundity or time to pregnancy (TTP). DESIGN: Prospective cohort. SETTING: Communities of targeted populations with reported exposure. PATIENT(S): 501 couples recruited upon discontinuing contraception to become pregnant, 2005-2009. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Fecundability odds ratios (FORs) and 95% confidence intervals (CIs) estimated for each partner's chemical concentrations adjusted for age, body mass index, cotinine, creatinine, and research site while accounting for time off contraception. RESULT(S): Couples completed interviews and anthropometric assessments and provided the urine specimens for quantification of bisphenol A (BPA) and 14 phthalate metabolites, which were measured using high-performance liquid chromatography with electrospray triple-quadrupole mass spectrometer. Women recorded menstruation and pregnancy test results in daily journals. Couples were evaluated until a positive human-chorionic gonadotropin pregnancy test or 12 cycles without pregnancy. Neither female nor male BPA concentration was associated with TTP (FOR 0.98; 95% CI, 0.86, 1.13 and FOR 1.04; 95% CI, 0.91, 1.18, respectively). Men's urinary concentrations of monomethyl, mono-n-butyl, and monobenzyl phthalates were associated with a longer TTP (FOR 0.80; 95% CI, 0.70, 0.93; FOR 0.82, 95% CI, 0.70, 0.97; and FOR 0.77, 95% CI, 0.65 0.92, respectively). CONCLUSION(S): Select male but not female phthalate exposures were associated with an approximately 20% reduction in fecundity, underscoring the importance of assessing both partners' exposure to minimize erroneous conclusions.
Asunto(s)
Compuestos de Bencidrilo/orina , Contaminantes Ambientales/orina , Fertilidad/fisiología , Fenoles/orina , Ácidos Ftálicos/orina , Tiempo para Quedar Embarazada/fisiología , Adulto , Biomarcadores/orina , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Masculino , Embarazo , Estudios ProspectivosRESUMEN
BACKGROUND: Evidence suggesting that persistent environmental pollutants may be reproductive toxicants underscores the need for prospective studies of couples for whom exposures are measured. OBJECTIVES: We examined the relationship between selected persistent pollutants and couple fecundity as measured by time to pregnancy. METHODS: A cohort of 501 couples who discontinued contraception to become pregnant was prospectively followed for 12 months of trying to conceive or until a human chorionic gonadotrophin (hCG) test confirmed pregnancy. Couples completed daily journals on lifestyle and provided biospecimens for the quantification of 9 organochlorine pesticides, 1 polybrominated biphenyl, 10 polybrominated diphenyl ethers, 36 polychlorinated biphenyls (PCBs), and 7 perfluorochemicals (PFCs) in serum. Using Cox models for discrete time, we estimated fecundability odds ratios (FORs) and 95% CIs separately for each partner's concentrations adjusting for age, body mass index, serum cotinine, serum lipids (except for PFCs), and study site (Michigan or Texas); sensitivity models were further adjusted for left truncation or time off of contraception (≤ 2 months) before enrollment. RESULTS: The adjusted reduction in fecundability associated with standard deviation increases in log-transformed serum concentrations ranged between 18% and 21% for PCB congeners 118, 167, 209, and perfluorooctane sulfonamide in females; and between 17% and 29% for p,p´-DDE and PCB congeners 138, 156, 157, 167, 170, 172, and 209 in males. The strongest associations were observed for PCB 167 (FOR 0.79; 95% CI: 0.64, 0.97) in females and PCB 138 (FOR = 0.71; 95% CI: 0.52, 0.98) in males. CONCLUSIONS: In this couple-based prospective cohort study with preconception enrollment and quantification of exposures in both female and male partners, we observed that a subset of persistent environmental chemicals were associated with reduced fecundity.
Asunto(s)
Contaminantes Ambientales/toxicidad , Fertilidad , Hidrocarburos Clorados/toxicidad , Femenino , Humanos , Masculino , Embarazo , Parejas SexualesRESUMEN
The effect of heavy metals at environmentally relevant concentrations on couple fecundity has received limited study despite ubiquitous exposure. In 2005-2009, couples (n=501) desiring pregnancy and discontinuing contraception were recruited and asked to complete interviews and to provide blood specimens for the quantification of cadmium (µg L(-1)), lead (µg dL(-1)) and mercury (µg L(-1)) using inductively coupled plasma-mass spectrometry. Couples completed daily journals on lifestyle and intercourse along with menstruation and pregnancy testing for women. Couples were followed for 12 months or until pregnant. Fecundability odds ratios (FORs) and 95% confidence intervals (CIs) were estimated adjusting for age, body mass index, cotinine, and serum lipids in relation to female then male exposures. FORs <1 denote a longer time to pregnancy. In adjusted models, reduced FORs were observed for both female cadmium (0.78; 95% CI 0.63-0.97) and male lead (0.85; 95% CI 0.73-0.98) concentrations. When jointly modeling couples' exposures, only male lead concentration significantly reduced the FOR (0.82; 95% CI 0.68, 0.97), though the FOR remained <1 for female cadmium (0.80; 95% CI 0.64, 1.00). This prospective couple based cohort with longitudinal capture of time to pregnancy is suggestive of cadmium and lead's reproductive toxicity at environmentally relevant concentrations.
Asunto(s)
Contaminantes Ambientales/toxicidad , Fertilidad/efectos de los fármacos , Metales Pesados/toxicidad , Adolescente , Adulto , Índice de Masa Corporal , Cadmio/sangre , Estudios de Cohortes , Cotinina/análisis , Femenino , Humanos , Plomo/sangre , Lípidos/sangre , Estudios Longitudinales , Masculino , Espectrometría de Masas , Mercurio/sangre , Oportunidad Relativa , Embarazo , Adulto JovenRESUMEN
BACKGROUND: Since the early 1970s, the incidence of testicular germ cell tumors (TGCTs) in the United States has been increasing; however, potential environmental exposures accounting for this increase have not been identified. A previous study reported a significant association between frequent and long-term current marijuana users and TGCT risk. The purpose of this study was to evaluate the relation between marijuana use and TGCTs in a hospital-based case-control study. METHODS: TGCT patients diagnosed between January 1990 and October 1996 (n = 187) and male friend controls (n = 148) were enrolled in the study. All participants were between the ages of 18 and 50 at the time of diagnosis and resided in Texas, Louisiana, Arkansas, or Oklahoma. Associations of marijuana use and TGCTs were estimated using unconditional logistic regression, adjusting for age, race, prior cryptorchidism, cigarette smoking, and alcohol intake. RESULTS: Overall, patients with TGCTs were more likely to be frequent marijuana users (daily or greater) compared with controls (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.0-5.1). Histological-specific analyses revealed that patients with nonseminoma were significantly more likely than controls to be frequent users (OR, 3.1; 95% CI, 1.2-8.2) and long-term (≥ 10 years) users (OR, 2.4; 95% CI, 1.0-6.1). CONCLUSIONS: The finding of an association between frequent marijuana use and TGCTs, particularly among men with nonseminoma, was consistent with the findings of a previous report. Additional studies of marijuana use and TGCTs are warranted, especially studies evaluating the role of endocannabinoid signaling and cannabinoid receptors in TGCTs.
Asunto(s)
Fumar Marihuana/efectos adversos , Neoplasias de Células Germinales y Embrionarias/etiología , Neoplasias Testiculares/etiología , Adolescente , Adulto , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/patología , Factores de Riesgo , Neoplasias Testiculares/patologíaRESUMEN
The reproducibility of urinary phthalate metabolite concentrations has not been well characterized in non-pregnant women of reproductive age. Our primary study objectives were to describe the distribution of urinary phthalate metabolites concentrations among a population of Hmong women of reproductive age, and to evaluate intra- and inter-individual variability of phthalate metabolite concentrations. Ten phthalate metabolites were measured in first-morning urine samples collected from 45 women and 20 of their spouses, who were members of the Fox River Environment and Diet Study cohort in Green Bay, Wisconsin. Repeated first-morning urine samples were collected and analyzed from 25 women, who provided up to three samples over approximately 1 month. Measurement variability was assessed using intraclass correlations (ICCs) and surrogate category analysis. Linear mixed models were used to evaluate the associations between participant characteristics and phthalate metabolite concentrations. Nine of the 10 phthalate metabolites were detected in >80% of all analyzed samples, of which seven were detected in all samples. As a measure of reliability, ICCs were strongest for monobenzyl phthalate (0.64) and weakest for the metabolites of di(2-ethylhexyl)phthalate (DEHP) (ranging from 0.13 to 0.22). Similarly, surrogate category analysis suggested that a single urine sample characterized an average 1-month exposure with reasonable accuracy across low, medium and high tertiles for all metabolites, except the DEHP metabolites. Geometric mean concentrations of monoethyl phthalate increased with age, but patterns by education, income, body mass index, environmental tobacco smoke or season were not observed when measures were adjusted for urinary dilution. Our results suggest that the participant characteristics assessed in this study have limited influence on inter-individual variability of phthalate metabolite concentrations. With regard to intra-individual variability, our results suggest that urinary concentrations of some phthalate metabolites are more reproducible over time and are less subjected to exposure misclassification than others (e.g., metabolites of DEHP).
Asunto(s)
Asiático , Exposición a Riesgos Ambientales/análisis , Contaminantes Ambientales/metabolismo , Contaminantes Ambientales/orina , Edad Materna , Ácidos Ftálicos/metabolismo , Ácidos Ftálicos/orina , Adolescente , Adulto , Índice de Masa Corporal , Creatinina/metabolismo , Creatinina/orina , Dietilhexil Ftalato/metabolismo , Dietilhexil Ftalato/orina , Educación , Femenino , Humanos , Laos/etnología , Modelos Lineales , Masculino , Reproducibilidad de los Resultados , Estaciones del Año , Factores Socioeconómicos , Encuestas y Cuestionarios , Factores de Tiempo , Contaminación por Humo de Tabaco , Wisconsin , Adulto JovenRESUMEN
We describe the reproductive health and practices of Hmong immigrants before and after migration to the United States. Data were gathered as part of an ongoing study on the impact of perinatal exposure to environmental chemicals on children's health in Hmong residents of Green Bay, Wisconsin between August 1999 and May 2002. Of the 742 pregnancies reported by 141 reproductive-aged couples, 669 were live births. The Hmong have an average of 5.2 children (range 0-14) and the sex ratio differed by country of birth. Prenatal care began in the first trimester for 60% of US-born infants, up from 12% prior to immigration. Breastfeeding decreased from 94% and 88% in Laos and Thailand to only 11% for Hmong born in the US. Contraceptive use was reported by 25.5% of women; few reported smoking and alcohol consumption. The results suggest that Hmong immigrants may benefit from public health support targeting prenatal care and breastfeeding practices.
Asunto(s)
Características Culturales , Emigrantes e Inmigrantes/estadística & datos numéricos , Historia Reproductiva , Adolescente , Adulto , Anticoncepción/estadística & datos numéricos , Composición Familiar/etnología , Femenino , Conductas Relacionadas con la Salud , Humanos , Laos/etnología , Masculino , Persona de Mediana Edad , Embarazo , Resultado del Embarazo/etnología , Atención Prenatal/estadística & datos numéricos , Factores Socioeconómicos , Tailandia/etnología , Estados Unidos/epidemiologíaRESUMEN
The determination of critical windows of susceptibility to environmental chemical exposures and health has become a major public health focus. This study examined the association between early age at exposure to polybrominated biphenyls (PBBs) and subsequent birth weight and gestational length in offspring among females. The study population consisted of 1111 births that occurred among 560 women enrolled in the Michigan PBB Cohort from 1975 to 1994. Maternal age at exposure was categorized into three groups:<10 years (n = 64), 11-16 years (n = 149), and 17-42 years (n = 347). Overall serum PBB levels ranged from 0 to 1490 ppb, with a median of 2, 3, and 2 ppb in the three age groups, respectively. Separate mixed-effects linear regression models were used to evaluate the effect of age at exposure (years) and initial PBB level (ppb) on birth weight (grams) and gestational age (weeks), controlling for gestational age (weeks) (in the model examining effects on birth weight), BMI (kg/m(2)) and serum PCB level at enrollment (ppb), maternal age and paternal education at delivery, parity, infant gender, interval between the initial serum test and date of delivery (years), and the trimester in which prenatal care was initiated. Relative to the oldest age group, age<10 years at exposure was the most important predictor of increased birth weight (estimated regression coefficient = 225 g, P = 0.012). Infant birth weight increased approximately 16 g for every 10 ppb increase in serum PBBs (P=0.004). There was no association between initial PBB levels and gestational age, nor were initial serum PCB levels associated with either infant birth weight or gestational length. These results provide support for the hypothesis that early age at exposure may be an important determinant in subsequent health effects due to environmental chemical exposures.