Exposure to p,p´-DDE during early pregnancy, anthropometry, and gestational age at birth, in a flower-growing region of Mexico.

Prenatal exposure to dichlorodiphenyldichloroethylene (p,p´-DDE) may interfere with fetal development; however, studies evaluating anthropometry and gestational age at birth show inconsistent results. Typically, p,p´-DDE exposure has been measured during the third trimester and missed the key early pregnancy period. We evaluated the association between p,p´-DDE exposure before week 18 of pregnancy and anthropometry at birth, as well as gestational length, in 170 mother-child pairs from a cohort study in a flower-growing mexican region. Maternal serum p,p´-DDE concentrations were determined by gas chromatography. The associations between p,p´-DDE and z-scores of birth weight, birth length, and gestational age were evaluated by linear multiple regression models. Logistic regression models were used for low birth weight and small size for gestational age. Effect modification by child's sex was explored. The average gestational age at the blood sample extraction was 10.6 weeks. p,p'-DDE was detected in 64.7% of mothers, at a geometric mean of 0.24 ng/mL. Prenatal p,p´-DDE exposure was not associated with the birth outcomes in the whole sample. However, a high p,p´-DDE exposure was marginally associated with greater small for gestational age risk in male newborns (OR≥0.076ng/mL vs <0.076 ng/mL = 3.09, 95% CI: 0.61; 15.58), but not in female (p for interaction = 0.08).Even though, we found no reductions in anthropometric measurements or gestational length associated with early prenatal p,p´-DDE exposure, the potential effect modification by infant's sex in terms of small for the gestational age risk deserves future studies.

Endocrine disrupting-chemicals and biochemical recurrence of prostate cancer after prostatectomy: A cohort study in Guadeloupe (French West Indies).

Previous studies have suggested that exposure to environmental chemicals with hormonal properties, also called endocrine disrupting chemicals, may be involved in the occurrence of prostate cancer (PCa). Such exposure may also influence the treatment outcome as it is still present at the time of diagnosis, the beginning of therapy, and beyond. We followed 326 men in Guadeloupe (French West Indies) who underwent radical prostatectomy as primary treatment of localized PCa. We analyzed the relationship between exposure to the estrogenic chlordecone, the antiandrogenic dichlorodiphenyldichloroethylene (DDE, the main metabolite of the insecticide DDT), and the nondioxin-like polychlorinated biphenyl congener 153 (PCB-153) with mixed estrogenic/antiestrogenic properties and the risk of biochemical recurrence (BCR) after surgery. After a median follow-up of 6.1 years after surgery, we found a significant increase in the risk of BCR, with increasing plasma chlordecone concentration (adjusted hazard ratio = 2.51; 95% confidence interval: 1.39-4.56 for the highest vs. lowest quartile of exposure; p trend = 0.002). We found no associations for DDE or PCB-135. These results shown that exposure to environmental estrogens may negatively influence the outcome of PCa treatment.

Prenatal p,p'-DDE exposure and establishment of lateralization and spatial orientation in Mexican preschooler.

BACKGROUND: Prenatal exposure to p,p'-DDE is associated with impairments in motor development during the first year of life, with no related repercussions on mental or motor development at 12-30 months and with impairments in cognitive areas, but not in perceptual and motor areas at preschool age. However, its association with particular psychomotor factors, such as establishment of lateralization and spatial orientation, essential elements to the overall learning and specifically reading, writing and spelling in preschoolers, has not been independently evaluated, since cognitive and motor areas have only been explored globally. OBJECTIVE: To determine the association between prenatal exposure to p,p'-DDE and the establishment of lateralization and spatial orientation in children 5 years of age. MATERIALS AND METHODS: Establishment of lateralization and spatial orientation was evaluated using the McCarthy Scale of Children's Abilities, with 167 children 5 years of age who participated in a birth cohort in the state of Morelos, Mexico. The information available for each child included: serum concentrations of p,p'-DDE of the mother during at least one trimester of pregnancy, mothers' intelligence quotients, stimulation at home and anthropometry. A logistic regression model was used to calculate the association between prenatal exposure to p,p'-DDE and lateralization and a multiple linear regression model was used for the association with spatial orientation. RESULTS: A two-fold increase in p,p'-DDE in lipid base during the second trimester of pregnancy was associated with a significant reduction, -0.18 points (95% CI -0.41; 0.04, in the spatial orientation index, with no impairment in the establishment of hemispheric dominance. Attending preschool and the maternal intelligence quotient were the main determinants of spatial orientation and the establishment of hemispheric dominance. CONCLUSIONS: Prenatal exposure to p,p'-DDE may affect the 5 year old's ability to identify spatial orientation of oneself and surrounding objects. Given the observed role of attending preschool in the functions studied, early attendance in formal education might serve as a stimulation strategy for preschoolers. These preliminary results should be verified and expanded in further prospective studies with DDE.

Prenatal exposure to p,p'-DDE and p,p'-DDT in relation to lower respiratory tract infections in boys from a highly exposed area of Mexico.

BACKGROUND: Prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE), the major breakdown product of DDT, has been associated with recurrent lower respiratory tract infections (LRTIs) in infants. However, epidemiological investigations are limited. OBJECTIVE: To assess the association of prenatal exposure to p,p'-DDE and p,p'-DDT with the occurrence of LRTI in boys from Chiapas, a highly exposed area of Mexico. METHODS: We analyzed data from 747 singleton boys whose prenatal exposure to p,p'-DDE and p,p'-DDT was determined in maternal serum drawn at delivery (2002-2003). LRTI (i.e., pneumonia, bronchiolitis, and other illness of the bronchi) experienced by the children were reported by their mothers during in-person interviews. The median age of the children when they were last seen was 21.4 months (quartiles 19.1 and 25.3 months). RESULTS: Median exposure to p,p'-DDE in this population was higher (2.7 µg/g lipid) than recent U.S. levels (0.20 µg/g). There were 0.19 episodes of LRTI per child-year. After adjusting for potential confounders, children in the highest category of p,p'-DDE (>9.00 µg/g) exposure compared to those in the lowest (≤ 3.00 µg/g) had an adjusted incidence rate ratio (aIRR) of LRTI of 0.77 (95% confidence interval [CI], 0.41-1.46). The corresponding aIRR for p,p'-DDT (≥ 2.00 µg/g compared to ≤ 0.25 µg/g) was 0.65 (95% CI: 0.30-1.39). CONCLUSION: An association of prenatal exposure to p,p'-DDE and p,p'-DDT with LRTI during childhood was not supported in this population with relatively high levels of exposure.

Chlordecone exposure, length of gestation, and risk of preterm birth.

Persistent organic pollutants have not been conclusively associated with length of gestation or with preterm birth. Chlordecone is an organochlorine pesticide that has been extensively used to control the banana root borer population in the French West Indies. Data from the Timoun Mother-Child Cohort Study conducted in Guadeloupe between 2004 and 2007 were used to examine the associations of chlordecone concentrations in maternal plasma with the length of gestation and the rate preterm birth in 818 pregnant women. Data were analyzed using multivariate linear regression for length of gestation and a Cox model for preterm birth. The median plasma chlordecone concentration was 0.39 µg/L (interquartile range, 0.18-0.83). No correlation was observed with plasma concentrations of p,p'-dichlorodiphenyl dichloroethene (ρ = 0.017) or polychlorinated biphenyl 153 (ρ = -0.016), the other main organochlorine compounds detected. A 1-log10 increase in chlordecone concentration was associated with a decreased length of gestation (-0.27 weeks; 95% confidence interval: -0.50, -0.03) and an increased risk of preterm birth (60%; 95% confidence interval: 10, 130). These associations may result from the estrogen-like and progestin-like properties of chlordecone. These results are of public health relevance because of the prolonged persistence of chlordecone in the environment and the high background rate of preterm births in this population.

[Human health effects and p,p'-DDE and p,p'-DDT exposure: the case of Mexico]. / Efectos a la salud y exposición a p,p'-DDT y p,p'-DDE: el caso de México.

Based on the systematic revision of 32 articles published in PubMed-Medline until January of 2006 and using like key words DDT exposure, human, milk and Mexico; this study analyzes the situation about the exposure of difenildicloroetano (DDT) and its main metabolite p,p,'-DDE in Mexico, as well as, their possible repercussion on the human health. Even though, the use of the DDT in Mexico was banned in 1999, the evaluated studies report significant levels of p, p'-DDE, in biological samples of serum, adipose tissue and maternal milk of populations not occupationally exposed. Also, there are evidences on damages to the health, specially related to the reproductive area, and more recently damages at cellular level, as well as, alteration in the psychomotor development of children exposed in uterus. Even though many gaps exist concerning the other adverse effects on health, relating to DDT exposure and its metabolites, experience accumulated at this point, must be taken into account in Mexico and the rest from Latin America, so that following this precautionary principle they should legislate against DDT and other persistent organic contaminants with characteristics similar to those of DDT and its metabolites.

In utero exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment among young Mexican American children.

OBJECTIVE: We investigated the relationship between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment of Mexican farm-workers' children in California. METHODS: Participants from the Center for the Health Assessment of Mothers and Children of Salinas study, a birth cohort study, included 360 singletons with maternal serum measures of p,p'-DDT, o,p'-DDT, and p,p'-DDE. Psychomotor development and mental development were assessed with the Bayley Scales of Infant Development at 6, 12, and 24 months. RESULTS: We found a approximately 2-point decrease in Psychomotor Developmental Index scores with each 10-fold increase in p,p'-DDT levels at 6 and 12 months (but not 24 months) and p,p'-DDE levels at 6 months only. We found no association with mental development at 6 months but a 2- to 3-point decrease in Mental Developmental Index scores for p,p'-DDT and o,p'-DDT at 12 and 24 months, corresponding to 7- to 10-point decreases across the exposure range. Even when mothers had substantial exposure, breastfeeding was usually associated positively with Bayley scale scores. CONCLUSIONS: Prenatal exposure to DDT, and to a lesser extent DDE, was associated with neurodevelopmental delays during early childhood, although breastfeeding was found to be beneficial even among women with high levels of exposure. Countries considering the use of DDT should weigh its benefit in eradicating malaria against the negative associations found in this first report on DDT and human neurodevelopment.

Persistent organochlorine pesticide levels in bovine fat from Mexico.

Organochlorine pesticides have been used in Mexico in agriculture as a seed dresser, in sanitation, in malaria control programmes and in livestock to combat ectoparasites. The pesticides applied drift to areas where cattle graze and plants grow. Because of their chemical stability, they accumulate in the lipid-rich tissues of the body. In the body, they circulate throughout all compartments and accumulate in adipose fat. The aim was to monitor the organochlorine pesticide levels in bovine muscle fat and kidney fat from cows living in an endemic malaria zone, where the environmental contamination can be suspected as being higher. Two hundred samples (100 muscle fat, 100 kidney fat) were analysed by gas chromatography. From the pesticides, only hexachlorobenzene (HCB), beta-hexachlorocyclohexane (HCH), gamma-HCH, pp'-1.1.1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT), op'-DDT and pp'-DDE, were detected frequently and at levels above the detection limits. The HCB mean level was low at 0.009 mg kg(-1) on a fat basis. From the HCH isomers, beta-HCH mean concentration was 0.039 mg kg(-1) and gamma-HCH was 0.025 mg kg(-1) on a fat basis. Among DDTs, pp'-DDT was the major constituent (0.032 mg kg(-1) on a fat basis) followed by pp'-DDE (0.025 mg kg(-1) on a fat basis) and op'-DDT (0.023 mg kg(-1) on a fat basis). The DDT total (sigma DDT) level was 0.067 mg kg(-1) on a fat basis. Comparing the previous study (1994) and the present one (2002-03), organochlorine pesticide levels were decreased. HCB decreased 3.7 times from 0.033 to 0.009 mg kg(-1) on a fat basis; beta-HCH decreased 3.8 times from 0.149 to 0.039 mg kg(-1) on a fat basis; pp'-DDE did not reveal a significant difference at 0.026 versus 0.025 mg kg(-1) on a fat basis. However, pp'-DDT decreased substantially, 6.7 times from 0.215 to 0.032 mg kg(-1) on a fat basis. The DDT total decreased 3.5 times from 0.236 to 0.067 mg kg(-1) on a fat basis. The tendency for reduced concentrations in organochlorine pesticide levels in Mexican cows is caused by their substitution with pyrethroids used in agriculture and by the Mexican Ministry of Health in sanitary programmes.

Preterm birth in relation to maternal organochlorine serum levels.

PURPOSE: To evaluate the associations of serum levels of p,pacute;-DDE and two other persistent organochlorine pesticides, beta-HCH and HCB, in relation to preterm birth. METHODS: During 1995 we performed a case-cohort study and 233 mothers were recruited at three large maternity hospitals in Mexico City. Serum levels were obtained shortly after delivery. RESULTS: A non-significant increased risk of preterm birth in relation to serum p,p'-DDE levels was observed. There was also a suggestion of an increased risk of preterm birth among women in the highest tertile of beta-HCH (adjusted odds ratio 1.85, 95% CI = 0.94-3.66, p value for test of trend p = 0.08) compared with the lowest tertile. No association was found between HCB serum levels and preterm births. CONCLUSIONS: These findings suggest that p,pacute;-DDE and other organochlorine pesticides may pose a risk to preterm birth in countries that continue to use such insecticides for malaria control.

Breast cancer, lactation history, and serum organochlorines.

The authors analyzed the relation between lactation history, organochlorine serum levels-in particular, 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane (DDT) and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE)-and the risk of breast cancer within a subsampe from a larger breast cancer case-control study conducted among women living in Mexico City, Mexico, between 1990 and 1995. From the original study, they selected a random sample of 260 subjects (1:1 case/control ratio). Analysis was restricted to 120 cases and 126 controls who had given birth to at least one child and had complete information on all key variables. Serum DDE levels were higher among cases (mean = 3.84 microg/g lipids, standard deviation = 5.98) than among controls (mean = 2.51 microg/g lipids, standard deviation = 1.97). After adjustment for age, age at menarche, duration of lactation, Quetelet index, and serum DDT levels, serum DDE levels were positively related to the risk of breast cancer (adjusted odds ratio (OR)Q1-Q2 = 1.24, 95% confidence interval (CI): 0.50, 3.06; ORQ1-Q3 = 2.31, 95% CI: 0.92, 5.86; ORQ1-Q4 = 3.81, 95% CI: 1.14, 12.80; test of trend, p = 0.02). The increased risk associated with higher serum DDE levels was more apparent among postmenopausal women (ORQ1-Q4 = 5.26, 95% CI: 0.80, 34.30; test of trend p = 0.03). A longer period of lactation was associated with a slightly decreased risk of breast cancer independently of serum DDE levels (OR = 0.91, 95% CI: 0.85, 0.99 change in risk per 10 months of lactation). Serum DDT level was not related to the risk of breast cancer. The data suggest that high levels of exposure to DDE may increase women's risk of breast cancer, particularly among postmenopausal women.

Organochlorines and breast cancer: a case-control study in Brazil.

Breast cancer is an important cause of morbidity and mortality in Brazil. Some studies have analyzed the potential role of organochlorine compounds in breast cancer etiology. These chemical compounds have been widely used in agriculture and in vector-control programs in Brazil. A case-control study was carried out in the main cancer hospital of the Instituto Nacional de Câncer in Rio de Janeiro to investigate exposure to organochlorinated pesticides as a risk factor for breast cancer. We investigated 177 cases of invasive breast cancer at the hospital, between May 1995 and July 1996, and 350 controls selected among female visitors at the same hospital. In addition to information obtained from interviews, blood samples were taken, to analyze residual amounts of organochlorine by gas chromatography using an electron capture detector. [1,1-Dichloro-2, 2-bis(p-chlorophenyl)ethylene] (DDE) was determined in sera of 457 women from a total of 493 participants who had serum samples available. Residues of hexachlorobenzene were found in 11 women only. No statistically significant association was found between breast cancer risk and serum level of DDE or history of exposure to pesticides. Serum levels of DDE (ng/ml) were similar in patients (median = 3.1, mean = 5.1) and controls (median = 3.1, mean = 4.8) (p = 0.93). The age-adjusted odds ratio of breast cancer for women in the upper quintile compared with those in the lowest quintile was 0.90 (95% confidence interval 0.47-1.73). When adjusted for other variables, the risk remained not statistically significant (upper quintile odds ratio = 0.79, 95% confidence interval 0.39-1.60). In our hands, exposure to organochlorinated pesticides measured by history or serum analysis was thus not a risk factor for breast cancer.

DDE and shortened duration of lactation in a northern Mexican town.

OBJECTIVES: Worldwide declines in the duration of lactation are cause for public health concern. Higher levels of dichlorodiphenyl dichloroethene (DDE) have been associated with shorter durations of lactation in the United States. This study examined whether this relationship would hold in an agricultural town in northern Mexico. METHODS: Two hundred twenty-nine women were followed every 2 months from childbirth until weaning or until the child reached 18 months of age. DDE was measured in breast milk samples taken at birth, and women were followed to see how long they lactated. RESULTS: Median duration was 7.5 months in the lowest DDE group and 3 months in the highest. The effect was confined to those who had lactated previously, and it persisted after statistical adjustment for other factors. These results are not due to overtly sick children being weaned earlier. Previous lactation lowers DDE levels, which produces an artifactual association, but simulations using best estimates show that an effect as large as that found here would arise through this mechanism only 6% of the time. CONCLUSIONS: DDE may affect women's ability to lactate. This exposure may be contributing to lactation failure throughout the world.

Development after exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene transplacentally and through human milk.

OBJECTIVE: To determine whether exposure to polychlorinated biphenyls (PCBs) or dichlorodiphenyl dichloroethene (DDE), either transplacentally or through breast feeding, affected scores on the Bayley Scales of Infant Development at 6 or 12 months of age. DESIGN: Cohort followed from birth to 1 year of age. SETTING: General community. PARTICIPANTS: Volunteer sample of 858 infants, of whom 802 had Bayley scores available at either 6 months or 12 months or both. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Bayley scales and chemical measurements were done independently. Higher transplacental exposure to PCBs was associated with lower psychomotor scores at both 6 and 12 months of age; the difference between the mean scores in the lowest and highest PCB groups was 7 points at 6 months and 8 points at 12 months. Higher transplacental exposure to DDE was associated with higher mental scores at 6 months of age (the difference between the mean scores in the lowest and highest DDE groups was 6 points), but no relationship was seen at 12 months. Exposure to either chemical through breast feeding was apparently unrelated to Bayley scores. CONCLUSIONS: Transplacental exposure to PCBs was associated with lower psychomotor scores. No deleterious effects were associated with breast feeding.

Neonatal effects of transplacental exposure to PCBs and DDE.

Neonatal effects of transplacental exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) were examined in a study of 912 infants. Birth weight, head circumference, and neonatal jaundice showed no relationship to PCBs or DDE. We also administered the Brazelton Neonatal Behavioral Assessment Scales, which are psychologic and neurologic tests designed for use in newborn infants. The results of these tests showed that higher PCB levels were associated with hypotonicity and hyporeflexia and that higher DDE levels were associated with hyporeflexia.