Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder.

BACKGROUND: Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations, creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder (ADHD). Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream, and the severity of their symptoms correlates with the heavy metal levels measured in their blood. Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education. AIM: To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake. METHODS: The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD. Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test (n = 11) or control (n = 11) group. The test group participated in the six-week online nutritional epigenetics tutorial, while the control group did not. The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods. Diet intake scores were derived for both ultra-processed and whole/organic foods. Paired sample t-tests were conducted to determine any differences in mean diet scores within each group. RESULTS: There was a significant difference in the diet scores of the test group between the pre- and post-intervention periods. The parents in the test group significantly reduced their intake of ultra-processed foods with a pre-intervention diet score of 70 (mean = 5.385, SD = 2.534) and a post-intervention diet score of 113 (mean = 8.692, SD = 1.750) and the paired t-test analysis showing a significance of P < 0.001. The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100 (mean = 5.882, SD = 2.472) and post-intervention diet score of 121 (mean = 7.118, SD = 2.390) and the paired t-test analysis showing a significance of P < 0.05. CONCLUSION: Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.

Fish consumption and omega-3 polyunsaturated fatty acids from diet are positively associated with cognitive function in older adults even in the presence of exposure to lead, cadmium, selenium, and methylmercury: a cross-sectional study using NHANES 2011-2014 data.

BACKGROUND: Long-chain omega-3 polyunsaturated fatty acids (ω-3 PUFAs) are reported to be beneficial for cognition, but limited consumption of some fish is recommended due to high concentrations of heavy metals and persistent organics. OBJECTIVE: We aimed to determine whether dietary ω-3 PUFAs from fish consumption are associated with higher cognitive scores in older adults and explored the associations of mixtures of ω-3 PUFAs and blood concentrations of lead, cadmium, selenium, and methylmercury on cognitive performance. METHODS: We conducted a cross-sectional study with data from the NHANES 2011-2014, assessing cognitive scores of immediate recall, delayed recall, and executive function in adults ≥60 y (n = 3123). We performed multivariate linear regressions and mixture models utilizing the quantile-based g-computation method to identify associations between monthly fish consumption or dietary ω-3 PUFAs with blood concentrations of lead, cadmium, methyl mercury, and selenium on cognitive scores. RESULTS: Fish consumption had significant positive associations with all 3 cognitive scores, whereas dietary ω-3 PUFAs were only significantly associated with the Digit Symbol Substitution Test (DSST) scores. Mixture analysis showed significant positive associations with DSST scores for fish consumption (ß: 0.88; 95% CI: 0.48, 1.29) and dietary ω-3 PUFAs (ß: 0.41; 95% CI: 0.03, 0.78) with positive component weights for fish consumption, dietary ω-3 PUFAs, and blood selenium and negative component weight for blood cadmium concentrations. CONCLUSIONS: Our findings support dietary recommendations for older adults to consume fish to maintain cognitive function, likely due to biomolecular actions of ω-3 PUFAs that increase neuronal membrane fluidity, have antioxidation activity, and restore cell damage. The combination of selenium and fish consumption or ω-3 PUFAs was associated with reduced decline in cognitive scores and less negative associations from exposures to lead, cadmium, and mercury compounds.

Different volatile organic compounds in local point source air pollution pose distinctive elevated risks for respiratory disease-associated emergency room visits.

Air pollution increases risk of respiratory disease but prior research has focused on particulate matter and criteria air pollutants, and there are few studies on respiratory effects of volatile organic compounds (VOC). We examined zip code level relationships between emergency room (ER) visits for respiratory illness and VOC pollution in New York State from 2010 to 2018. Detailed information on VOC pollution was derived from the National Emissions Inventory, which provides point source information on VOC emissions at the zip code level. We considered four respiratory diseases: asthma, acute upper respiratory infections, chronic obstructive pulmonary disease (COPD), and lower respiratory disease, using mixed effects regression with a random intercept to account for county level variability in single pollutant models, and Random Forest Regression (RFR) to assess relative importance of VOC exposures when considered together in multipollutant models. Single pollutant models show associations between respiratory-related ER visits with all pollutants of interest across all study years, even after adjusting for poverty and smoking by zip code. The largest relative single pollutant effect sizes considered included benzene, ethylbenzene, and total (summed) VOCs. Results from RFR including all VOC exposures indicate that ethylbenzene has the greatest variable importance for asthma, acute upper respiratory infections, and COPD, with toluene and benzene most important for lower respiratory ailments. RFR results also demonstrate presence of pairwise interactive effects between VOC pollutants. Our findings show that local VOC pollution may offer a significant contribution to the risk of respiratory disease-related ER visits, and that effects vary by illness and by VOC compound. ER visit rates for respiratory illness were elevated in high poverty zip codes, although this may be attributable to the fact that the poor lack basic access to health care and use ERs more frequently for routine care.

Effects of mixtures of polychlorinated biphenyls (PCBs) and three organochlorine pesticides on cognitive function differ between older Mohawks at Akwesasne and older adults in NHANES.

BACKGROUND: Akwesasne Mohawks has been exposed to high concentrations of polychlorinated biphenyls (PCBs) and background levels of organochlorine pesticides, hexachlorobenzene (HCB), dichlorodiphenyl dichloroethylene (DDE), and mirex. We have previously reported relative contributions to the mixture of low- and high-chlorinated PCBs, HCB, and DDE on cognitive decrements in Mohawks of various ages. OBJECTIVE: This study examines differences in the mixture effects of PCB congener groups, HCB, DDE, and mirex on cognitive function in older Mohawks and less PCB-exposed older adults from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 cycles. METHODS: We used Bayesian kernel machine regression (BKMR) to evaluate the mixture effects of different PCB congener groups, HCB, DDE, and mirex on cognitive function in both populations. Models were adjusted for age, sex, education levels, and race/ethnicity focusing on individuals 60 years and older. RESULTS: Older Mohawks had 3-fold higher mean total PCB concentrations and 1.8-fold higher mirex, but slightly lower mean DDE and HCB levels than NHANES older adults. Higher mixture concentrations were significantly associated with greater cognitive decline. In older Mohawks, low- and high-chlorinated PCBs, HCB, and DDE contributed to the cognitive score decline. In contrast, score decline in older NHANES adults were primarily from high-chlorinated PCBs and DDE with a threshold dose of approximately 2.08-2.27 ng/g and 2.02-2.40 ng/g, respectively. CONCLUSION: Mixtures of PCBs and organochlorine pesticides increase the risk of cognitive decline in both older Mohawks and NHANES older adults. However, contributions to these mixture effects show significant differences. In older Mohawks, high- and low-chlorinated PCBs, DDE, and HCB are the primary contributors, while high-chlorinated PCBs and DDE are important contributors in NHANES older adults. Due to chronic heavy exposures to PCBs, older Mohawks had a significantly increased risk of cognitive decline compared to general older adults from NHANES.

Patterns of Emergency Room Visits for Respiratory Diseases in New York State in Relation to Air Pollution, Poverty and Smoking.

We have explored differences in rates of emergency room (ER) visits for respiratory diseases in the counties of New York State (NYS) in relation to levels of air pollution, poverty, and smoking. Air pollution information was derived from the National Emissions Inventory, which provides information on road, non-road, point, and non-point sources of 12 different air pollutants. This information is only available at the county level. Four types of respiratory diseases were considered: asthma, chronic obstructive pulmonary disease (COPD), acute lower respiratory diseases, and acute upper respiratory diseases. Asthma ER visits were elevated in counties with greater total air pollution. All forms of respiratory diseases were elevated in counties with a greater rate of poverty, although this may reflect the fact that poor people often use ERs for routine care. There was a very strong association between rates of smoking for COPD and acute lower respiratory diseases. There was an apparent negative association between smoking and asthma ER visits, but this must reflect the fact that smoking was much more common in upstate counties while asthma was more common in the New York City area, where air pollution is high. Air pollution was much greater in urban than in rural areas. Our evidence indicates that air pollution is the greatest risk factor for asthma attacks, whereas smoking is the greatest risk factor for chronic obstructive pulmonary disease (COPD) and lower respiratory disease. Poor people are more vulnerable to all forms of respiratory diseases.

Fine particulate matter and its chemical constituents' levels: A troubling environmental and human health situation in Karachi, Pakistan.

Like many urban centers in developing countries, the effect of air pollution in Karachi is understudied. The goal of this study was to determine the chemical characterization, temporal and seasonal variability, sources, and health impacts of fine particulate matter (PM2.5) in Karachi, Pakistan. Daily samples of PM2.5 were collected using a low-volume air sampler at two different sites (Makro and Karachi University) over the four seasons between October 2009 and August 2010. Samples were analyzed for black carbon (BC), trace metals, and water-soluble ions. Results showed that the annual average concentrations of PM2.5 at Makro and Karachi University were 114 ± 115 and 71.7 ± 56.4 µg m-3, respectively, about 22.8 and 14.3-fold higher than the World Health Organization annual guideline of 5 µg m-3. BC concentrations were 3.39 ± 1.97 and 2.70 ± 2.06 µg m-3, respectively. The concentrations of PM2.5, BC, trace metals, and ions at the two sites showed clear seasonal trends, with higher concentrations in winter and lower concentrations in summer. The trace metals and ionic species with the highest concentrations were Pb, S, Zn, Ca, Si, Cl, Fe, and SO42-. The air quality index in the fall and winter at both sites was about 68 %, which is "unhealthy" for the general population. Positive Matrix Factorization revealed the overall contribution to PM2.5 at the Makro site came from three major sources - industrial emissions (13.3 %), vehicular emissions (59.1 %), and oil combustion (23.3 %). The estimates of expected number of deaths due to short-term exposure to PM2.5 were high in the fall and winter at both sites, with an annual mean estimate of 3592 expected number of deaths at the Makro site. Attention should be paid to the reduction of inorganic pollutants from industrial facilities, vehicular traffic, and fossil fuel combustion, due to their extremely high contribution to PM2.5 mass and health risks.

Mixture Effects of Polychlorinated Biphenyls (PCBs) and Three Organochlorine Pesticides on Cognitive Function in Mohawk Adults at Akwesasne.

The Mohawks at Akwesasne have been highly exposed to polychlorinated biphenyls (PCBs), via releases from three aluminum foundries located near the reserve. They are also exposed to organochlorine pesticides, namely hexachlorobenzene (HCB), dichlorodiphenyldichloroethylene (DDE), and mirex. Previous studies have demonstrated reduced cognition in relation to total PCBs, but the effects of the mixtures of different PCB congener groups, HCB, DDE, and mirex on cognitive function have not been studied. Therefore, cognitive performance for executive function, scored via the digit symbol substitution test (DSST), in Mohawk adults aged 17-79 years (n = 301), was assessed in relation to serum concentrations of low-chlorinated PCBs, high-chlorinated PCBs, total PCBs, HCB, DDE, and mirex. We used mixture models employing the quantile-based g-computation method. The mixture effects of low-chlorinated PCBs, high-chlorinated PCBs, HCB, DDE, and mirex were significantly associated with 4.01 DSST scores decrements in the oldest age group, 47-79 years old. There were important contributions to mixture effects from low-chlorinated PCBs, high-chlorinated PCBs, and total PCBs, with smaller contributions of HCB and DDE. Our findings indicate that exposures to both low- and high-chlorinated PCBs increase the risk of cognitive decline in older adults, while DDE and HCB have less effect.

State of gaseous air pollutants and resulting health effects in Karachi, Pakistan.

Karachi, Pakistan, is a priority site for air pollution research due to high emissions of air pollutants from vehicular traffic, industrial activities, and biomass burning, as well as rapid growth in population. The objectives of this study were to investigate the levels of gaseous pollutants (NO, NO2, O3, HNO3, and SO2) in Karachi, to determine temporal and seasonal variations, to compare Karachi's air quality with other urban centers, to identify relationships with meteorological conditions, to identify source characterization, and to perform a backward-in-time trajectory analysis and a health impact assessment. Daily samples of gaseous pollutants were collected for six consecutive weeks in each of the four seasons for a year. Daily maximum concentrations of NO (90 parts per billion by volume (ppbv)), NO2 (28.1 ppbv), O3 (57.8 ppbv), and SO2 (331 ppbv) were recorded in fall, while HNO3 (9129 parts per trillion by volume (pptv)) was recorded in spring. Seasonal average concentrations were high in winter for NO (9.47 ± 7.82 ppbv), NO2 (4.84 ± 3.35 ppbv), and O3 (8.92 ± 7.65 ppbv), while HNO3 (629 ± 1316 pptv) and SO2 (20.2 ± 39.4 ppbv) were high in spring and fall, respectively. The observed SO2 seasonal average concentration in fall (20.2 ± 39.4) was 5 times higher than that in summer (3.97 ± 2.77) with the fall 24-h average (120 ppbv) exceeding the WHO daily guideline (7.64 ppbv) by a factor of about 15.7. A health impact assessment estimated an increase of 1200 and 569 deaths due to short-term exposure to SO2 in fall and spring, respectively. Chronic daily intake estimated risk per 1000 was 0.99, 0.47, 0.45, and 0.26 for SO2 in fall, NO in winter, O3 in winter, and NO2 in spring, respectively. This study confirms the effect of poor urban air quality on public health and demonstrated the influence of photochemical reactions as well as unfavorable meteorological conditions on the formation of secondary pollutants.

Effects of glyphosate and glyphosate-based herbicides like Roundup™ on the mammalian nervous system: A review.

Glyphosate is the active ingredient in glyphosate-based herbicides (GBHs), such as Roundup™, the most widely used herbicides in the world. Glyphosate targets an essential enzyme in plants that is not found in animals. However, both glyphosate and GBHs are rated as Group 2A, probable human carcinogens, and also have documented effects on reproduction, acting as endocrine disruptive chemicals. We have reviewed reports of the effects of glyphosate and GBHs on mammalian nervous system function. As with several other herbicides, GBHs exposure has been associated with an increased risk of Parkinson's Disease and death of neurons in the substantia nigra. There is also some evidence implicating Roundup™ in elevated risk of autism. Other studies have shown the effects of GBHs on synaptic transmission in animal and cellular studies. The major mechanism of action appears to be oxidative stress, accompanied by mitochondrial dysfunction. In addition, some gut bacteria utilize the enzyme used by plants, and glyphosate and GBHs use has been shown to alter the gut microbiome. There is a large and growing body of evidence that the gut microbiome alters susceptibility to great number of human diseases, including nervous system function. The weight of the evidence indicates that in addition to cancer and reproductive effects, glyphosate and GBHs have significant adverse effects on the brain and behavior and increase the risk of at least some serious neurological diseases.

Exocrine pancreatic cancer and living near to waste sites containing hazardous organic chemicals, New York State, USA - an 18-year population-based study.

OBJECTIVES: The etiology of exocrine pancreatic cancer (EPC) remains unknown except for family history and smoking. Despite recent medical advances, rates of pancreatic cancer incidence and mortality are increasing. Although existing evidence suggests a potentially causal relationship between environmental chemical exposures and pancreatic cancer, whether residential exposure impacts pancreatic cancer rates remains unknown. MATERIAL AND METHODS: The authors identified 28 941 patients diagnosed with exocrine pancreatic cancer in New York State exclusive of New York City for the years 1996-2013. Descriptive statistics and negative binomial regression were used in this ecological study to compare pancreatic cancer hospitalization rates among patients who lived in zip codes with hazardous waste sites (HWSs) containing persistent organic pollutants (POPs) and volatile organic pollutants (VOCs) compared with clean zip codes with no identified hazardous waste sites. The authors assessed the effect of selected known and suspected human carcinogens on the EPC hospitalization rates by subgroup analyses. RESULTS: Compared with the clean sites, the pancreatic cancer hospital discharge rate in the "VOCs without POPs" and "VOCs and POPs" sites, after adjustment for potential confounders were 1.06 (95% CI: 1.03-1.09) and 1.05 (95% CI: 1.01-1.08), respectively. In the analysis by specific chemicals, rate ratios (RR) for the benzene (RR = 1.12) and ethylbenzene (RR = 1.34) in the non-chlorinated VOCs group, trichloroethylene (RR = 1.07) and tetrachloroethylene (RR = 1.11) in the chlorinated VOCs group, chlorinated pesticides (RR = 1.11) and PCBs (RR = 1.05) in the POPs groups were statistically significant (p-values <0.05) compared with clean sites. CONCLUSIONS: Compared with the clean sites, the pancreatic cancer hospital discharge rate in the "VOCs without POPs" and "VOCs and POPs" sites, after adjustment for potential confounders were 1.06 (95% CI: 1.03-1.09) and 1.05 (95% CI: 1.01-1.08), respectively. In the analysis by specific chemicals, rate ratios (RR) for the benzene (RR = 1.12) and ethylbenzene (RR = 1.34) in the non-chlorinated VOCs group, trichloroethylene (RR = 1.07) and tetrachloroethylene (RR = 1.11) in the chlorinated VOCs group, chlorinated pesticides (RR = 1.11) and PCBs (RR = 1.05) in the POPs groups were statistically significant (p-values <0.05) compared with clean sites. Int J Occup Med Environ Health. 2022;35(4):459-71.

PFAS and PBDEs in traditional subsistence foods from Sivuqaq, Alaska.

The Arctic is a hemispheric sink for both legacy and current use persistent organic pollutants (POPs). Once in the Arctic, POPs biomagnify in food webs, potentially reaching concentrations in high trophic level animals that pose a health concern for people who subsist on those animals. Indigenous Peoples of the Arctic may be highly exposed to POPs through their traditional diets. The objective of this study was to assess concentrations of polybrominated diphenyl ethers (PBDEs) and per- and polyfluoroalkyl substances (PFAS) in tissues of traditionally harvested foods from Sivuqaq (St. Lawrence Island), Alaska. Community health researchers identified volunteer households and local hunters to donate tissues from traditionally harvested animals. Target species included bowhead whale (Balaena mysticetus), Pacific walrus (Odobenus rosmarus), ringed seal (Pusa hispida), bearded seal (Erignathus barbatus), ribbon seal (Histriophoca fasciata), spotted seal (Phoca largha), and reindeer (Rangifer tarandus). PBDEs were frequently detected in all species and tissues. PBDE concentrations tended to be highest in lipid-rich tissues of seals. PFAS were infrequently detected and did not show obvious patterns among species or tissues. This and other studies demonstrate that POPs such as PBDEs are present in tissues of traditional food animals from Sivuqaq, as they are throughout the Arctic, and consumption of these animals likely contributes to exposure among Arctic Indigenous Peoples.

Associations between Metal Exposures and Cognitive Function in American Older Adults.

Cognitive function frequently declines with older age, independently of the development of neurodegenerative diseases, and few interventions are known to counter this decline. Exposure to neurotoxic metals may contribute to this decline in cognitive function in older adults. Using the National Health and Nutrition Examination Survey (NHANES) data, the performance of 3042 adults aged 60 years and older on three cognitive tests for immediate, delayed, and working memory were examined in relation to blood concentrations of seven metals and metalloids and urinary concentrations of nineteen metals and metabolites. Using linear regression models, associations between cognitive tests and logarithms of metal exposures were adjusted for age, sex, ethnicity, education level, depression, diabetes, alcohol consumption, and cigarette use. Increased selenium was strongly associated with better performance on all three cognitive tests. Cadmium and lead were negatively associated with performance on all three cognitive tests. Some urinary metabolites of arsenic, urinary lead, cadmium, and tungsten were significantly associated with poor performance on some tests. In older adults, higher selenium levels were strongly associated with better cognitive performance.

PCBs in indoor air and human blood in Pittsfield, Massachusetts.

Concentrations of polychlorinated biphenyls (PCBs) and three chlorinated pesticides were determined in serum from 21 residents of Pittsfield, MA and in the basement, living room and outdoor air of the 10 homes in which they lived. Median serum PCB levels were 4.2 ng/g, which are at least four times the average level in the US population, and consisted primarily of more highly chlorinated, persistent congeners. This reflects contamination with PCBs coming from the local General Electric facility. Median basement air concentration was 20.3 ng/m3, while the median living room air was 11.4 ng/m3 and median outdoor air concentration was 3.0 ng/m3. The PCB congeners detected in air were primarily low chlorinated (four and fewer) congeners, reflecting the greater volatility of PCBs with fewer chlorines. The congener pattern between basement and living room air showed a 95% correlation, while correlation with outdoor air was much less. While the congener pattern in air is very different from that of the PCB products used in Pittsfield (Aroclors 1254 and 1260), low chlorinated PCBs are detected in the vapor phase after air is blown across the commercial mixtures. The human serum samples did not show detectible levels of many of the congeners seen in the basement air samples, reflecting rapid metabolism of lower chlorinated PCBs by the human body. However, with continuous inhalation of indoor air, especially in the living room, the exposure to these non-persistent congeners may still have adverse health effects. Cellular studies of some of these non-persistent, low chlorinated congeners indicate that they are neurotoxic, mutagenic and cytotoxic. These results demonstrate the importance of consideration of inhalation of PCBs as a route of exposure, especially in indoor sites, and suggest that monitoring serum PCB concentration may not always provide a good measurement of exposure, especially to congeners that are relatively rapidly metabolized but have significant toxicity.

Mapping research strands of ethics of artificial intelligence in healthcare: A bibliometric and content analysis.

The growth of artificial intelligence in promoting healthcare is rapidly progressing. Notwithstanding its promising nature, however, AI in healthcare embodies certain ethical challenges as well. This research aims to delineate the most influential elements of scientific research on AI ethics in healthcare by conducting bibliometric, social network analysis, and cluster-based content analysis of scientific articles. Not only did the bibliometric analysis identify the most influential authors, countries, institutions, sources, and documents, but it also recognized four ethical concerns associated with 12 medical issues. These ethical categories are composed of normative, meta-ethics, epistemological and medical practice. The content analysis complemented this list of ethical categories and distinguished seven more ethical categories: ethics of relationships, medico-legal concerns, ethics of robots, ethics of ambient intelligence, patients' rights, physicians' rights, and ethics of predictive analytics. This analysis likewise identified 40 general research gaps in the literature and plausible future research strands. This analysis furthers conversations on the ethics of AI and associated emerging technologies such as nanotech and biotech in healthcare, hence, advances convergence research on the ethics of AI in healthcare. Practically, this research will provide a map for policymakers and AI engineers and scientists on what dimensions of AI-based medical interventions require stricter policies and guidelines and robust ethical design and development.

E-Waste in Africa: A Serious Threat to the Health of Children.

Waste electronic and electrical equipment (e-waste) consists of used and discarded electrical and electronic items ranging from refrigerators to cell phones and printed circuit boards. It is frequently moved from developed countries to developing countries where it is dismantled for valuable metals in informal settings, resulting in significant human exposure to toxic substances. E-waste is a major concern in Africa, with large sites in Ghana and Nigeria where imported e-waste is dismantled under unsafe conditions. However, as in many developing countries, used electronic and electrical devices are imported in large quantities because they are in great demand and are less expensive than new ones. Many of these used products are irreparable and are discarded with other solid waste to local landfills. These items are then often scavenged for the purpose of extracting valuable metals by heating and burning, incubating in acids and other methods. These activities pose significant health risks to workers and residents in communities near recycling sites. E-waste burning and dismantling activities are frequently undertaken at e-waste sites, often in or near homes. As a result, children and people living in the surrounding areas are exposed, even if they are not directly involved in the recycling. While toxic substances are dangerous to individuals at any age, children are more vulnerable as they are going through important developmental processes, and some adverse health impacts may have long-term impacts. We review the e-waste situation in Africa with a focus on threats to children's health.