Health Risk Assessment in Children Occupationally and Para-Occupationally Exposed to Benzene Using a Reverse-Translation PBPK Model.

Benzene is a known human carcinogen and one of the ten chemicals of major public health concern identified by the World Health Organization. Our objective was to evaluate benzene's carcinogenic and non-carcinogenic health risks (current and projected) in highly exposed children in Yucatan, Mexico. Benzene exposure was estimated through a reverse-translation, four-compartment, physiologically based pharmacokinetic model (PBPK) based on previously performed urine trans, trans-muconic acid (benzene metabolite) determinations. Using a risk assessment methodology, the carcinogenic and non-carcinogenic risks of benzene were estimated for 6-12-year-old children from a family of shoemakers. The children's hazard quotients for decreased lymphocyte count were 27 and 53 for 4 and 8 h/day exposure, respectively, and 37 for the projected 8 h/day exposure in adults. The risks of developing leukemia were 2-6 cases in 1000 children exposed 4 h/day; 4-10 cases in 1000 children exposed 8 h/day, and 2-9 cases in 1000 adults with an 8 h/day lifetime exposure. Children in Yucatan working in shoe-manufacturing workshops, or living next to them, are exposed to benzene concentrations above the reference concentration and have unacceptably high risks of presenting with non-carcinogenic and carcinogenic hematologic symptoms, now and in the future. Interventions to prevent further exposure and mitigate health risks are necessary.

Hydrochemical controls on arsenic contamination and its health risks in the Comarca Lagunera region (Mexico): Implications of the scientific evidence for public health policy.

Nearly half of the world's urban population depends on aquifers for drinking water. These are increasingly vulnerable to pollution and overexploitation. Besides anthropogenic sources, pollutants such as arsenic (As) are also geogenic and their concentrations have, in some cases, been increased by groundwater pumping. Almost 40 % of Mexico's population relies on groundwater for drinking water purposes; much the aquifers in semi-arid and arid central and northern Mexico is contaminated by As. These are agricultural regions where irrigation water is primarily provided from intenstive pumping of the aquifers leading to long-standing declines in the water table. The focus of this study is the main aquifer within the Comarca Lagunera region in Northern Mexico. Although the scientific evidence demonstrates that health effects are associated with long-term exposure to elevated As concentrations, this knowledge has not yielded effective groundwater development and public health policy. A multidisciplinary approach - including the evaluation of geochemistry, human health risk and development and public health policy - was used to provide a current account of these links. The dissolved As concentrations measured exceeded the corresponding World Health Organization guideline for drinking water in 90 % of the sampled wells; for the population drinking this water, the estimated probability of presenting non-carcinogenic health effects was >90 %, and the lifetime risk of developing cancer ranged from 0.5 to 61 cases in 10,000 children and 0.2 to 33 cases in 10,000 adults. The results suggest that insufficient policy responses are due to a complex and dysfunctional groundwater governance framework that compromises the economic, social and environmental sustainability of this region. These findings may valuable to other regions with similar settings that need to design and enact better informed, science-based policies that recognize the value of a more sustainable use of groundwater resources and a healthier population.

Prenatal Co-Exposure to Manganese, Mercury, and Lead, and Neurodevelopment in Children during the First Year of Life.

Lead (Pb), mercury (Hg), and manganese (Mn) are neurotoxic, but little is known about the neurodevelopmental effects associated with simultaneous prenatal exposure to these metals. We aimed to study the associations of Pb, Hg, and Mn prenatal levels (jointly and separately) with neurodevelopment in the first year of life. Methods: Pb, Hg, and Mn blood lead levels were measured in 253 pregnant women. Their offspring's neurodevelopment was assessed through the Bayley Scale of Infant Development III® at one, three, six, and twelve months. The metals' mean blood levels (µg/L) were Pb = 11.2, Hg = 2.1, and Mn = 10.2. Mean language, cognitive, and motor development scores of the infants at each age were between low-average and average. Multilevel models' results showed that language development coefficients of the offspring decreased by 1.5 points per 1 µg/dL increase in maternal blood lead levels (p = 0.002); the magnitude of the aforementioned association increased in children with maternal blood Mn < 9.6 µg/L (ß = -1.9, p = 0.003) or Hg > 1.9 µg/L (ß = -1.6, p = 0.013). Cognitive and motor development had negative associations with maternal blood Pb levels; the latter was statistically significant when the interaction term between Pb, Mn, and Hg was included (ß = -0.037, p = 0.03). Prenatal exposure to low Pb levels may impair infants' neurodevelopment in the first year of life, even more so if they are exposed to Hg or deficient in Mn.

A review of studies on blood lead concentrations of traditional Mexican potters.

BACKGROUND: Traditional Mexican potters and their families have been occupationally exposed to lead for centuries; however, studies on blood lead levels (BLL) and their adverse health impact on this population are scarce. There is no safe BLL, even at 1 µg/dL there are associated health effects. OBJECTIVE: To systematize and characterize Mexican potters' historic lead exposure through their BLL and associated health outcomes. METHODS: Using PRISMA guidelines, we conducted a systematic review through January 2021 of published studies on BLL and associated health outcomes in Mexican potters. RESULTS: Fifteen studies containing data from 1980 to 2013 met the inclusion criteria and were published between 1980 and 2018. Study populations ranged from n = 5 to n = 457, and included adult potters (mean BLL 37.9 ± 16.2 µg/dL) and/or their children (mean BLL 22.5 ± 10.5 µg/dL). Studies reported on general lead poisoning symptoms, neurotoxic and nephrotoxic outcomes as well as correlated biomarkers. CONCLUSIONS: Our results confirm high occupational and para-occupational lead exposure. Despite governmental and non-governmental initiatives to promote lead-free glazes, lead continues to be used by traditional potters and their families.

Fluoride Exposure through Different Drinking Water Sources in a Contaminated Basin in Guanajuato, Mexico: A Deterministic Human Health Risk Assessment.

Water fluoride levels above the World Health Organization's guideline (1.5 mg/L), common in overexploited aquifers, represent a health hazard. Our objective was to assess the health risks posed by exposure to fluoride in different drinking water sources in a contaminated basin in Mexico. Fluoride was measured in mutual drinking water sources and in the urine of 39 children and women. Risks were estimated through hazard quotient (HQ) by drinking water source. Dental fluorosis was assessed in the children. Mean fluoride water concentrations (mg/L) were: well, 4.2; waterhole, 2.7; bottled, 2.1; rainwater, 0.4. The mean urinary fluoride concentrations (specific gravity adjusted) were 2.1 mg/L and 3.2 mg/L in children and women, respectively. Our multiple linear regression model showed children's urinary fluoride concentrations increased 0.96 mg/L for every 1 mg/L increase in water fluoride (p < 0.001). Dental fluorosis was diagnosed in 82% of the children, and their HQ according to drinking water source was: well, 1.5; waterhole, 1.1; bottled, 0.8; harvested rainwater, 0.3. The pervasive dental fluorosis indicates a toxic past fluoride exposure; urinary fluoride levels and HQs indicate high exposure and current health risks for most children. Drinking harvested rainwater will likely prevent most of the local fluoride exposure.

First clinical trials of novel ENaC targeting therapy, SPX-101, in healthy volunteers and adults with cystic fibrosis.

BACKGROUND: ENaC inhibition has been investigated as a CF treatment; however, small molecule inhibitors of ENaC lack efficacy and/or have shown dose-limiting hyperkalemia. SPX-101 is a novel, investigational small peptide (SPLUNC1 mimetic) that regulates ENaC density with the potential for efficacy without systemic effects. METHODS: Two trials are presented: The first was a Phase 1, 2-part, randomized, double-blind, placebo-controlled, ascending-dose study of nebulized SPX-101 in healthy adults. Part 1 evaluated 4 single doses of SPX-101 ranging from 20 to 240 mg. Part 2 evaluated a 14-day regimen of SPX-101 at 4 doses of SPX-101 ranging from 10 to 120 mg BID. Pharmacokinetics, adverse events, spirometry, vital signs, electrocardiograms, pulse oximetry, and clinical laboratory values were assessed. The second trial was a tolerability-confirming, Phase 1b, open-label study conducted in 5 adult subjects with CF. Ascending doses of SPX-101 inhalation solution (10 mg-120 mg BID) were administered for 7 days. Safety was assessed as described above. RESULTS: All 64 healthy volunteers (32 in each Part) completed the single and multiple dose study. SPX-101 was well tolerated with little/no systemic exposure and with no hyperkalemia. Adverse events were generally mild with reported respiratory events associated with the purported pharmacological activity of SPX-101. Tolerability of SPX-101 was similarly observed in adults with CF; all 5 subjects treated with SPX-101 completed the study. CONCLUSIONS: SPX-101 was well-tolerated across a range of doses and had little/no systemic exposure in healthy adults and adults with CF, thus supporting further study in patients with CF. CLINICALTRIAL. GOV REGISTRATION: NCT03056989.

Environmental Health Promotion of a Contaminated Site in Mexico.

Entangled in complex ecological, sociocultural, and economic systems, current environmental health problems require integrated participatory approaches. Alpuyeca, a semi-urban, highly marginalized community in South-Central Mexico burdened by lead and polychlorinated biphenyl (PCB) contamination, dengue fever, and intestinal diseases, illustrates this. Its residents are distinctive, however, for their concerted actions in the face of environmental problems and the presence of defenders of a prehispanic worldview based on the protection of nature. This article addresses the health impacts of an integrated environmental health promotion strategy implemented through a participatory action research intervention based on qualitative and quantitative methods. Different actors, sectors, dimensions, and knowledge types were harmonized in a collaborative space created specifically for our interdisciplinary research team, community residents and local authorities. Reflections, plans and actions were developed collectively in this space with the view of finding solutions anchored in the local culture. Results included sharp reductions in blood-lead concentrations among children, in entomological indices, and in PCB contamination, as well as capacity strengthening. Medium-level community participation was achieved. This work contributes evidence that participatory environmental health research can be effective in analyzing and reducing problems in communities with multiple environmental health concerns. It complements ecohealth and environmental health literacy approaches.

Prenatal exposure to persistent organic compounds and their association with anogenital distance in infants.

RESEARCH QUESTION: What is the association between prenatal exposure to persistent organic pollutants, separately and combined, and anogenital distance (in-utero endocrine disruption marker). DESIGN: A cohort study conducted in Sonora, Mexico. Blood concentrations of polychlorobiphenyls (PCB) 28, 74, 118, 138/158, 153, 170, 180 and the isomers of dichlorodiphenyltrichloroethane (DDT) and its metabolites were determined in women in the third trimester of pregnancy; three variants of anogenital distance were measured on five occasions during the first year of life of their infants: 82 girls (402 observations) and 74 boys (356 observations). RESULTS: Boys had negative and significant associations between anogenital distance/height and the concentrations of PCB 28 (beta = - 0.005;P = 0.006), PCB 74 (beta = - 0.003;P = 0.013), and PCB 170 (beta = - 0.005;P = 0.001) when analysed individually. Negative and significant associations were also found using statistical models applied to mixtures of compounds. The latter associations were sometimes larger in magnitude and significance, suggesting a possible potentiation of the compounds. No associations were observed between anogenital distance and DDT in either sex or with PCB in girls. CONCLUSIONS: The decreased anogenital distance associated with prenatal exposure to the persistent organic pollutants, observed consistently in different analyses, suggests an under-masculinizing effect of these environmental pollutants in boys.

Alterations in male reproductive hormones in relation to environmental DDT exposure.

DDT [1, 1, 1-trichloro-2,2-bis (p-chlorophenyl)-ethane] compounds are used for indoor residual spraying (IRS) to control malaria mosquitoes. DDT is an endocrine disruptor chemical in experimental conditions, but little is known of adverse effects related to living conditions with continual uptake across a time span by all possible means of exposure. Based on estrogenic and/or anti-androgenic effects found in animal studies, we hypothesized that chronic DDT/DDE exposures in men may be associated with changes in male reproductive hormones. We tested this hypothesis by compared the magnitude and direction of associations between DDT and DDE (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene) concentrations and male reproductive hormones in samples collected from IRS and non-IRS areas. We sampled a cross-section of 535 men (aged 18-40 years). Men living in IRS villages had significantly higher DDT and DDE concentrations compared with men from non-IRS villages. Men with DDT or DDE uptake (as reflected in detectable plasma concentrations) had significantly higher total-, free and bio-available testosterone (T), and lower follicle stimulating hormone (FSH) concentrations; lower luteinizing hormone (LH) concentrations were only evident with DDT uptake. To establish a dose-dependent effect, four sub-categories were defined. Men with the highest DDT (74-519 µg/g) and DDE (173-997 µg/g) concentrations had significantly higher total-, free and bio-available T, and lower FSH concentrations compared with subjects with non-detectable isomer concentrations. Estradiol concentrations were significantly higher in men with DDT and DDE concentrations in both the third (DDE: 27-172 µg/g; DDT: 5-73 µg/g) and fourth (DDE: 173-997 µg/g; DDT: 74-519 µg/g) categories. Men from IRS villages were significantly more likely to have higher total and bioavailable T as well as higher estradiol concentrations OR = 2.5 (95% CI 1.2, 3.2); OR 2.5 (95% CI 1.6, 4.0) and OR = 2.3 (95% CI 1.3, 4.1) compared to men from non-IRS villages, after controlling for age, BMI, personal use of pesticides, and smoking. Men living in IRS villages with life-long exposure (17.6 (±6) years) at the current residence with multiple exposure modalities incurred the highest degree of physiological imbalance over and above circulating isomer concentrations. Further studies are needed to elucidate the health implications of these findings.

Anogenital distance: A longitudinal evaluation of its variants and indices in boys and girls of Sonora, Mexico.

There is no consensus on which anogenital distance (AGD) variant to use and how to adjust it by body size in humans. This study quantitatively evaluated AGD variants and body size adjustments to determine which would be the best choice. AGD variants, height, and weight were measured on five occasions during the first year of life of 307 infants. The ratio of anoscrotal distance (ASD) in boys and anofourchette distance (AFD) in girls increased from 1.9 at birth to 2.3 at 12 months of age. Each AGD variant was divided by each body size variable to generate different indices. Such indices were standardized to make them comparable when analyzing their performance through mixed models. ASD and AFD adjusted by height generated precise (p<0.05) AGD indices: 0.4-0.5 and 0.2, respectively. Results suggest that the best body size adjustment for all AGD variants in the first year of life is height.

Carcinogenic risk of emerging persistent organic pollutant perfluorooctane sulfonate (PFOS): A proposal of classification.

Perfluoroalkyls are stable synthetic chemicals, able to repel oils, fats and water. These compounds have been used in the manufacturing of products such as Teflon®, lubricants, paints, fire-fighting foams, coatings for pans, carpets, clothes, and paperboard for packaging, among others. It is believed that populations are exposed constantly to them. Its regulation in the world is under development and several controversies are in the course of litigation. One occupational study shows bladder cancer risk. This paper intends to review scientific information on the most critical perfluoroalkyl compound and proposes a procedure to get a cancer-risk categorization which PFOS can cause to populations. METHODS: As a guiding axis, we used the IARC process for developing monographs of carcinogenic risks. We used the SIGN guides for evaluating the quality of studies in human populations; and finally, we used the Squire method for evaluating studies in laboratory animals. Inadequate evidence of carcinogenicity was found in human studies mainly due to chance, threshold effect and confounders. In experimental animal studies, inadequate evidence of carcinogenicity was found in view of the number of affected species, different types of neoplasms, dose-response relationship and genotoxicity found in in-vivo and in-vitro studies. In this proposal, we concluded that cancer risk for PFOS, according to the IARC method, is not classifiable as carcinogenic to humans (group 3).

Measuring diaphragm thickness with ultrasound in mechanically ventilated patients: feasibility, reproducibility and validity.

PURPOSE: Ultrasound measurements of diaphragm thickness (T di) and thickening (TFdi) may be useful to monitor diaphragm activity and detect diaphragm atrophy in mechanically ventilated patients. We aimed to establish the reproducibility of measurements in ventilated patients and determine whether passive inflation by the ventilator might cause thickening apart from inspiratory effort. METHODS: Five observers measured T di and TFdi in 96 mechanically ventilated patients. The probe site was marked in 66 of the 96 patients. TFdi was measured at peak and end-inspiration (airway occluded and diaphragm relaxed) in nine healthy volunteers inhaling to varying lung volumes. The association with diaphragm electrical activity was quantified. RESULTS: Right hemidiaphragm thickness was obtained on 95 % of attempts; left hemidiaphragm measurements could not be obtained consistently. Right hemidiaphragm thickness measurements were highly reproducible (mean ± SD 2.4 ± 0.8 mm, repeatability coefficient 0.2 mm, reproducibility coefficient 0.4 mm), particularly after marking the location of the probe. TFdi measurements were only moderately reproducible (median 11 %, IQR 3-17 %, repeatability coefficient 17 %, reproducibility coefficient 16 %). TFdi and diaphragm electrical activity were positively correlated, r² = 0.32, p < 0.01). At inspiratory volumes below 50 % of inspiratory capacity, passive inflation did not cause diaphragm thickening. TFdi was considerably lower in patients on either partially assisted or controlled ventilation compared to healthy subjects (median 11 vs. 35 %, p < 0.001). CONCLUSIONS: Ultrasound measurements of right hemidiaphragm thickness are feasible and highly reproducible in ventilated patients. At clinically relevant inspiratory volumes, diaphragm thickening reflects muscular contraction and not passive inflation. This technique can be reliably employed to monitor diaphragm thickness, activity, and function during mechanical ventilation.

Lead in school children from Morelos, Mexico: levels, sources and feasible interventions.

BACKGROUND: Lead is a pervasive pollutant, associated at low levels to many adverse health effects. OBJECTIVE: To investigate lead levels, exposure pathways and intervention possibilities in school children from Alpuyeca, in Morelos, Mexico. METHODS: Blood lead concentrations (BPb) were measured in 226 children in 2011. Exposure pathways were assessed through a questionnaire, lead measurements in different environmental matrices and spatial aggregation analysis of lead concentrations. RESULTS: BPb ranged from 1.5 to 36.5 ìg/dL, with a mean (SD) of 7.23 (4.9) ìg/dL. Sixty-four and 18% of the children had BPb > 5 ìg/dL and > 10 ìg/dL, respectively. The use of lead glazed ceramics was reported in almost half of the households; it was the main BPb determinant and it was associated with an increased risk of having BPb > 5 g/dL by 2.7 times (p = 0.001). Environmental samples were within US EPA's lead recommended limits, and blood lead levels were randomly distributed in the community. CONCLUSIONS: Lead remains a public health problem in Alpuyeca, Mexico. Unlike other local pollutant lead exposure prevention can be achieved inexpensively and in a short term. Interventions should make mothers aware of lead's health effects and empower them to safeguard their children's health by avoiding the culturally ingrained use of lead glazed pottery.

DDT and urogenital malformations in newborn boys in a malarial area.

OBJECTIVE: To determine the risk of external urogenital birth defects (UGBDs) in newborn boys from a malarial area currently sprayed with technical 1,1,1-trichloro-2,2-bis(4-chlorophenyl) ethane (DDT), as increased fetal oestrogenic or anti-androgenic exposure might be involved in the pathogenesis of increased prevalence of human male reproductive tract anomalies, and DDT and metabolites interact with both these receptors. SUBJECTS AND METHODS: We examined 3310 newborn baby boys and recorded external UGBDs. RESULTS: Of the newborn boys 10.8% (357) had UGBDs; a multivariate logistic model showed that mothers who lived in villages sprayed with DDT between 1995 and 2003 had a significantly greater chance (33%) of having a baby with a UGBD than mothers whose homes were not sprayed (odds ratio 1.33, 95% confidence interval 1.04-1.72). Being a homemaker instead of being employed further significantly increased the risk of having a baby with a UGBD by 41% (odds ratio 1.41, 1.13-1.77). CONCLUSIONS: Maternal exposure to DDT by living in a DDT-sprayed village was associated to having male offspring with one or more UGBDs. Monitoring the impact of indoor residual spraying on human and environmental health is imperative if DDT is being used, especially as climate change raises concerns about the global spread of malaria. Integrating adequate indoor residual spraying measures by malarial vector control programmes, and increased public awareness to limit personal exposure, are crucial components that need to be addressed.

Impaired semen quality associated with environmental DDT exposure in young men living in a malaria area in the Limpopo Province, South Africa.

The pesticide DDT [1,1,1-trichloro-2,2-bis(chlorodiphenyl)ethane] is 1 of the 12 persistent organic pollutants (POPs) under negotiation at the Stockholm Convention to restrict or ban their production and use because of their toxicity, resistance to breakdown, bioaccumulation, and potential for being transported over long distances. DDT has estrogenic potential, and the main metabolite, p,p'-dichlorodiphenyl-dichloroethylene (p,p'-DDE), is a potent antiandrogen. In response to mounting evidence on the endocrine-disrupting influence of environmental chemicals on human health, this epidemiological study was initiated to test the hypothesis that nonoccupational exposure to DDT affects male reproductive parameters. In a cross-sectional study, healthy male subjects (n=311) between 18 and 40 years (23+/-5) of age were recruited from 3 communities in an endemic malaria area in which DDT is sprayed annually. A semen analysis according to World Health Organization (WHO) standards was performed. The Hamilton Thorne Computer Assisted Sperm Analysis (CASA) system was simultaneously used to determine additional sperm motility parameters. Blood plasma samples were assayed for p,p'-DDT and metabolites as a measure of exposure. The exposure levels were expressed as lipid-adjusted p,p'-DDT and p,p'-DDE values. The mean p,p'-DDT and p,p'-DDE concentrations were 90.23 microg/g(+/-102.4) and 215.47 microg/g(+/-210.6), respectively. The multivariate linear regression analyses indicated that mean CASA motility was lower with a higher p,p'-DDE concentration (beta=-0.02, P=.001) and the CASA parameter beat cross-frequency (BCF) was higher with a higher p,p'-DDT concentration (beta=0.01, P=.000). There was also a statistically significant positive association between percent sperm with cytoplasmic droplets and p,p'-DDT concentration (beta=0.0014, P=.014). The ejaculate volume (mean 1.9+/-1.33 mL) was lower than the normal range (>or=2.0 mL) according to WHO, and a significant decrease with increasing p,p'-DDE values was seen for both square root-transformed volume (beta=-0.0003; P=.024) and count (beta=-0.003; P=.04). Although there were no associations between either p,p'-DDT or p,p'-DDE concentrations and the rest of the seminal parameters, the incidence of teratozoospermia (99%; normal sperm<15%) was high. Twenty-eight percent of the study group presented with oligozoospermia (<20x10(6) sperm/mL), which had a significant positive association with p,p'-DDE (odds ratio [OR]=1.001, P=.03). There was a significant positive association between participants with asthenozoospermia (32%) and p,p'-DDT (OR 1.003, P=.006) and p,p'-DDE (OR 1.001, P=.02). The results imply that nonoccupational exposure to DDT is associated with impaired seminal parameters in men. The high exposure levels of p,p'-DDT and p,p'-DDE are of concern because these levels could have far-reaching implications for reproductive and general health.

Reduced seminal parameters associated with environmental DDT exposure and p,p'-DDE concentrations in men in Chiapas, Mexico: a cross-sectional study.

In response to mounting concerns about the endocrine-disrupting influence of environmental chemicals on human health, this epidemiological study was initiated to test the hypothesis that nonoccupational exposure to the estrogenic pesticide 1,1,1-trichloro-2,2-bis(chlorodiphenyl)ethane (DDT) affects male reproductive parameters. One hundred and sixteen men aged 27 years (SD = 8.2) living in malaria endemic-areas in Chiapas (Mexico), where DDT was sprayed until 2000, participated in a cross-sectional study. Semen analyses were conducted according to World Health Organization methods and a quality control program was followed. DDT exposure was defined as the level of blood plasma p,p'-dichlorodiphenyl dichloroethylene (DDE), the major metabolite of DDT. The p,p'-DDE concentration adjusted for total lipids was 100 times higher than that reported for nonexposed populations at 45 plus or minus 32 mug/g (mean +/- SD). Crude regression analysis showed that several sperm motion parameters, including the percentage of motile sperm, decreased with higher p,p'-DDE concentrations (beta = -8.38; P = .05 for squared motility), and the percentage of sperm with morphological tail defects increased with higher plasma p,p'-DDE concentration (beta = 0.003; P = .017). Insufficient sperm chromatin condensation was observed in 46.6% of participants, and the most severe category of incomplete DNA condensation was also positively correlated with p,p'-DDE concentration (r = .223; P = .044). Therefore, nonoccupational exposure to DDT, as assessed by plasma p,p'-DDE concentrations, is associated with poorer semen parameters in men, indicating adverse effects on testicular function and/or the regulation of reproductive hormones. Previously, a causal role of environmental toxicants in human male infertility has been lacking because observed effects have been the result of unusually high exposures, either occupationally or as a result of industrial accidents, resulting in unprecedented controversy (reviewed by Cheek & McLachlan, Environmental hormones and the male reproductive system. J Androl. 1998;19:5). This is the first epidemiological study demonstrating effects after nonoccupational exposures to DDT. Based on these findings, the effect of DDT on male reproductive health should not be ignored.

Bone, blood and semen lead in men with environmental and moderate occupational exposure.

Lead (Pb) in blood, bone, and semen was measured in 162 to 186 environmentally exposed men from Mexico City, aged 19- 48. Semen Pb was measured by inductively coupled plasma mass spectrometry, blood Pb by atomic absorption spectrometry and bone Pb by K X-ray fluorescence. Mean Pb levels in blood, semen, tibia (cortical) and patella (trabecular) bone were 12 microg/dl, 2.7 microg/l, 13 microg/g, and 20 microg/g, respectively. Semen Pb was determined by blood Pb and patella Pb. Determinants of higher tibia Pb were age, living near industry in which Pb is used, and a high occupational Pb exposure index. Higher patella Pb was predicted by age, higher traffic density near home, a high index of occupational exposure to Pb and a greater number of cigarettes smoked per day in the year prior to the study. Blood and bone Pb results are consistent with findings in other populations. Semen results provide new information on the semen-bone Pb relationship. Bone, especially trabecular one, proved to be a significant endogenous lead source for blood and semen burdens in reproductive aged men.

Nonoccupational determinants of plasma DDT and p,p'-DDE in men from Chiapas, Mexico.

A cross-sectional study was conducted to evaluate nonoccupational biological exposure to 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT) compounds and to identify the main factors associated with such exposure in a malaria endemic region in Mexico. Capillary gas column chromatography was used to determine levels of p,p'-DDT and its metabolites in plasma. The mean age of the 144 male participants was 28 yr. Mean p,p'-DDE (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene) and p,p'-DDT levels were 203.5 microg/l and 67.4 microg/l, respectively. Those whose houses had been sprayed for malaria control had much higher p,p'-DDE levels (p < 0.001). High levels of chlorinated pesticides were found despite being banned in Mexico for agricultural and public health use. Findings demonstrate the role of antimalarial campaigns as a major contributing factor for high DDT plasma levels.

Concentraciones de DDT/DDE y riesgo de hipospadias: un estudio piloto de casos y controles / DDT/DDE concentrations and risk of hypospadias: a case-control pilot study

OBJETIVO: Evaluar la asociación entre los niveles séricos maternos de DDT/DDE y el riesgo de hipospadias. MATERIAL Y MÉTODOS: Estudio de casos y controles, efectuado en la Ciudad de México durante el periodo 1997-1999, con 41 casos de hipospadias y 28 controles. La informacion obtenida por cuestionario y las muestras sanguíneas fueron evaluadas mediante modelos multivariados de regresión logística. RESULTADOS: Las concentraciones materna de DDT y DDE no mostraron asociación con el riesgo de hipospadias (RM 1.13; IC 95 por ciento 0.24-5.29 y RM 0.48; IC 95 por ciento 0.15-1.60, respectivamente). Los predictores encontrados fueron hijos de madres con mayor edad (RM 8.69; IC 95 por ciento 1.69-44.9), y la actividad laboral durante el embarazo (RM, 4.68; IC 95 por ciento 1.15-18.9). CONCLUSIONES: Dado que se cuenta con escasa información sobre los efectos endocrinos a diferentes concentraciones de DDT/DDE en humanos, la dosis pudiera ser un factor determinante sobre el tipo de efecto.

OBJECTIVE: To evaluate the association between maternal serum DDT/DDE levels and risk of hypospadias. MATERIAL AND METHODS: A case-control study in Mexico City was conducted during 1997-1999 among 41 subjects with hypospadias and 28 controls. Blood samples were obtained from study subjects. Information was obtained using a standardized questionnaire. Data were analyzed using multivariate logistic regression models. RESULTS: Maternal DDT and DDE levels showed no association with hypospadias (OR 1.13; 95 percent CI 0.24-5.29 and OR=0.48; 95 percent CI 0.15-1.60, respectively). Associated factors were older age of mothers (OR 8.69; 95 percent CI 1.69-44.9), and working during pregnancy (OR 4.68; 95 percent CI 1.15-18.9). CONCLUSIONS: Information about the endocrine effects of different levels of DDT/DDE in human subjects is scarce; dosage may be a determinant factor of the type of effect.