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1.
JCO Glob Oncol ; 7: 1374-1379, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34506223

RESUMO

PURPOSE: The COVID-19 pandemic has imposed a unique challenge to oncology patients. Outcome data on COVID-19 in patients with cancer from the Indian subcontinent are scarce in the literature. We aimed to evaluate the outcome of patients with COVID-19 on active systemic anticancer therapy. MATERIALS AND METHODS: This is a retrospective study of patients with solid organ malignancies undergoing systemic therapy with a diagnosis of COVID-19 between March 2020 and February 2021. COVID-19 was diagnosed if a reverse transcriptase polymerase chain reaction assay from oropharyngeal or nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2. The objectives were to evaluate the outcome of COVID-19 and factors predicting the outcome. RESULTS: A total of 145 patients were included with a median age of 58 years (range, 20-81 years). Treatment was curative in 60 (42%) patients. Of all symptomatic cases (n = 88, 61%), 50 had mild, 27 had moderate and 19 had severe COVID-19-related symptoms as per WHO criteria. Fifty (34%) patients required hospitalization with a median duration of hospital stay of 12 days (range, 4-25 days); five patients required intensive care unit admission. The rest were treated with home isolation and did not require further hospitalization. Twenty-two (15%) patients died, and the risk of death was significantly associated with severity of symptoms (odds ratio, 91.3; 95% CI, 9.1 to 919.5, P = .0001) but not with any other clinical factors. Drug holiday was given to 63 (44%) patients with a median duration of 25 days (range, 7-88 days). The median duration to reverse transcriptase polymerase chain reaction-negative was 16 days (range, 7-62 days). CONCLUSION: COVD-19-related death rate was 15% among patients with solid organ malignancies. The severity of the symptoms was related to mortality. The majority of patients with mild symptoms were treated at home isolation.


Assuntos
COVID-19 , Neoplasias , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Adulto Jovem
2.
Ecotoxicol Environ Saf ; 223: 112572, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34352571

RESUMO

Epidemiological studies have associated chronic exposure to arsenic (As) from drinking water with increased risk of hypertension. However, evidence of an association between As exposure from food and hypertension risks is sparse. To quantify the association between daily As intake from both food (rice, wheat and potatoes) and drinking water (Aswater) along with total exposure (Astotal) and hypertension risks in a study population in Bihar, India, we conducted an individual level cross-sectional analysis between 2017 and 2019 involving 150 participants. Arsenic intake variables and three indicators of hypertension risks (general hypertension, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)) were derived, and any relationship was quantified using a series of crude and multivariable log-linear or logistic regression models. The prevalence of general hypertension was 40% for the studied population. The median level of HDL was 45 mg/dL while median value of LDL was 114 mg/dL. Apart from a marginally significant positive relationship between As intake from rice and the changes of LDL (p-value = 0.032), no significant positive association between As intake and hypertension risks could be ascertained. In fact, Astotal was found to be associated with lower risks of general hypertension and higher levels of HDL (p-value = 0.020 and 0.010 respectively) whilst general hypertension was marginally associated with lower Aswater (p-value = 0.043). Due to limitations regarding study design and residual confounding, all observed marginal associations should be treated with caution.


Assuntos
Arsênio , Água Potável , Hipertensão , Poluentes Químicos da Água , Arsênio/análise , Arsênio/toxicidade , Estudos Transversais , Água Potável/análise , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Contaminação de Alimentos/análise , Humanos , Hipertensão/induzido quimicamente , Hipertensão/epidemiologia , Índia/epidemiologia , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
3.
Artigo em Inglês | MEDLINE | ID: mdl-33802172

RESUMO

The 2020 COVID-19 pandemic has not only resulted in immense loss of human life, but it also rampaged across the global economy and socio-cultural structure. Worldwide, countries imposed stringent mass quarantine and lockdowns to curb the transmission of the pathogen. While the efficacy of such lockdown is debatable, several reports suggest that the reduced human activities provided an inadvertent benefit by briefly improving air and water quality. India observed a 68-days long, nation-wide, stringent lockdown between 24 March and 31 May 2020. Here, we delineate the impact of the lockdown on groundwater and river sourced drinking water sustainability in the arsenic polluted Ganges river basin of India, which is regarded as one of the largest and most polluted river basins in the world. Using groundwater arsenic measurements from drinking water wells and water quality data from river monitoring stations, we have studied ~700 km stretches of the middle and lower reaches of the As (arsenic)-polluted parts of the river for pre-lockdown (January-March 2020), syn-lockdown (April-May), and post-lockdown periods (June-July). We provide the extent of As pollution-free groundwater vis-à-vis river water and examine alleviation from lockdown as an opportunity for sustainable drinking water sources. The overall decrease of biochemical oxygen demand (BOD) and chemical oxygen demand (COD) concentrations and increase of pH suggests a general improvement in Ganges water quality during the lockdown in contrast to pre-and-post lockdown periods, potentially caused by reduced effluent. We also demonstrate that land use (agricultural/industrial) and land cover (urban-periurban/rural) in the vicinity of the river reaches seems to have a strong influence on river pollutants. The observations provide a cautious optimistic scenario for potentially developing sustainable drinking water sources in the arsenic-affected Ganges river basin in the future by using these observations as the basis of proper scientifically prudent, spatially adaptive strategies, and technological interventions.


Assuntos
Arsênio , COVID-19 , Água Potável , Poluentes Químicos da Água , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Humanos , Índia , Pandemias , Rios , SARS-CoV-2 , Poluentes Químicos da Água/análise
4.
J Hazard Mater ; 403: 124064, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33265062

RESUMO

This study determines the bioaccessibility of toxic and carcinogenic arsenic (As) in composite food samples and evaluates potential exposure from food intake in Bangladesh children. Total As (tAs), inorganic As (iAs) and bioaccessible As (BAs) in food composite samples consumed by children were compared between an exposed and a control group (based on As in drinking water). Total As concentrations in composite food samples of children exposed to mean As level of 331 µg/l in drinking and cooking water ranged from 586 to 1975 µg/kg, dry weight over 76-90 µg/kg in the unexposed group. Average iAs in food composites was 73.9% (range: 49.3-90.8%). The fraction of BAs using gastric and gastrointestinal phases was 91 ± 13% and 98 ± 11%, respectively. Daily intake of iAs in the exposed group ranged from 0.41 to 6.38 µg per kg body weight (BW), which was much higher than the unexposed group (0.08-0.15 µg per kg BW). High iAs content and BAs in composite food samples indicated the elevated risk to exposed children. Further research should include both adults and children using larger sample size to determine overall As exposure from food intake in Bangladesh, attention must be given to lowering of As in food.


Assuntos
Arsênio , Arsenicais , Arsênio/análise , Arsênio/toxicidade , Bangladesh/epidemiologia , Criança , Dieta , Exposição Ambiental/análise , Contaminação de Alimentos/análise , Humanos , Medição de Risco
5.
Sci Total Environ ; 754: 142082, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32919317

RESUMO

Extensive evidence of elevated arsenic (As) in the food-chain, mainly rice, wheat and vegetables exists. Nevertheless, the importance of exposure from food towards total As exposure and associated health risks in areas with natural occurring As in drinking water is still often neglected, and accordingly mitigations are largely focused on drinking water only. In this study, the contribution of food over drinking water to overall As exposure was estimated for As exposed populations in Bihar, India. Increased lifetime cancer risk was predicted using probabilistic methods with input parameters based on detailed dietary assessment and estimation of As in drinking water, cooked rice, wheat flour and potato collected from 91 households covering 19 villages. Median total exposure was 0.83 µg/kgBW/day (5th and 95th percentiles were 0.21 and 11.1 µg/kgBW/day) and contribution of food (median = 49%) to overall exposure was almost equal to that from drinking water (median = 51%). More importantly and contrary to previous studies, food was found to contribute more than drinking water to As exposure, even when drinking water As was above the WHO provisional guide value of 10 µg/L. Median and 95th percentile excess lifetime cancer risks from food intake were 1.89 × 10-4 and 7.32 × 10-4 respectively when drinking water As was below 10 µg/L and 4.00 × 10-4 and 1.83 × 10-3 respectively when drinking water As was above 10 µg/L. Our results emphasise the importance of food related exposure in As-endemic areas, and, perhaps surprisingly, particularly in areas with high As concentrations in drinking water - this being partly ascribed to increases in food As due to cooking in high As water. These findings are timely to stress the importance of removing As from the food chain and not just drinking water in endemic areas.


Assuntos
Arsênio , Água Potável , Oryza , Poluentes Químicos da Água , Arsênio/análise , Exposição Ambiental/análise , Farinha , Contaminação de Alimentos/análise , Índia/epidemiologia , Triticum , Poluentes Químicos da Água/efeitos adversos , Poluentes Químicos da Água/análise
7.
Environ Manage ; 66(5): 742-755, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32910292

RESUMO

Worldwide, >2 billion people (~1/3 world population), mostly living in economically stressed areas of Africa and South Asia, still do not have access to basic sanitation, and ~1 billion still practice open defecation. Water pollution due to open defecation may primarily be linked to economy, and other factors such as social and hygiene practices, land use and hydrogeological parameters could also have sufficient influence. The present study describes the effect of human development index (HDI, 2001-2015) and economic development (NL, 1992-2013) on groundwater microbial pollution (FC, 2002-2017) across India. Economic development pattern suggested discernable inverse relationship with FC in most areas, although areas with inferior water quality, improper human practices were found to outweigh economic development. Vulnerability modelling, using these data, along with measured FC in groundwater-sourced drinking water locations (n = 235) demonstrated the heterogeneity of FC distribution potential in areas of homogenous economy, social practices, and land use. High-resolution numerical modelling of the advective transport of the hypothetical FC particles in the aquifers, suggest up to ~24 times faster movement of pollutants under irrigation-induced pumping regimes. Hence, the results of our study highlight and quantify the potential pitfalls that are possible hindrance for achieving the United Nations sustainable development goal, despite social and economic development, across the spatial scales.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , África , Ásia , Monitoramento Ambiental , Objetivos , Humanos , Índia , Desenvolvimento Sustentável , Água , Poluentes Químicos da Água/análise , Poluição da Água , Abastecimento de Água
8.
Sci Total Environ ; 743: 140534, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32659549

RESUMO

Adverse health outcomes, including death from cardiovascular disease (CVD), arising from chronic exposure to inorganic arsenic (iAs) are well documented. Consumption of rice is a major iAs exposure route for over 3 billion people, however, there is still a lack of epidemiological evidence demonstrating the association between iAs exposure from rice intake and CVD risks. We explored this potential association through an ecological study using data at local authority level across England and Wales. Local authority level daily per capita iAs exposure from rice (E-iAsing,rice) was estimated using ethnicity as a proxy for class of rice consumption. A series of linear and non-linear models were applied to estimate the association between E-iAsing,rice and CVD age-standardized mortality rate (ASMR), using Akaike's Information Criterion as the principle model selection criterion. When adjusted for significant confounders, notably smoking prevalence, education level, employment rate, overweight percentage, PM2.5, female percentage and medical and care establishments, the preferred non-linear model indicated that CVD risks increased with iAs exposure from rice at exposures above 0.3 µg/person/day. Also, the best-fitted linear model indicated that CVD ASMR in the highest quartile of iAs exposure (0.375-2.71 µg/person/day) was 1.06 (1.02, 1.11; p-trend <0.001) times higher than that in the lowest quartile (<0.265 µg/person/day). Notwithstanding the well-known limitations of ecological studies, this study further suggests exposure to iAs, including from rice intake, as a potentially important confounder for studies of the factors controlling CVD risks.


Assuntos
Arsênio/análise , Doenças Cardiovasculares , Oryza , Inglaterra , Exposição Ambiental/análise , Feminino , Contaminação de Alimentos/análise , Humanos , País de Gales
9.
JCO Glob Oncol ; 6: 844-851, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32552110

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has imposed a unique challenge to oncology patients and their treatment. There is no study related to the patients' preference for systemic therapy during this pandemic. We have conducted a prospective study to analyze that aspect. METHODS: All consecutive patients who visited during the lockdown period from April 1-10, 2020, for systemic chemotherapy were included in the study for a questionnaire-based survey to evaluate the willingness to continue chemotherapy during this pandemic and factors influencing the decisions. RESULTS: A total of 302 patients were included (median age, 56 years; range, 21-77 years). Most common sites of cancer were breast (n = 114), lung (n = 44), ovary (n = 34), and colon (n = 20). Home address was within the city for 125 patients (42%), outside the city for 138 (46%), and outside the state for 37 (12%). Treatment was curative in 150 patients and palliative in 152. Educational status was primary and above for 231 patients and no formal schooling for 71. A total of 203 patients wanted to continue chemotherapy, 40 wanted to defer, and 56 wanted the physician to decide. Knowledge about COVID-19 strongly correlated with intent of treatment (P = .01), disease status (P = .02), knowledge about immunosuppression (P < .001), home location (P = .02), and education status (P = .003). The worry about catching SARS-CoV-2 was high in those with controlled disease (P = .06) and knowledge about immunosuppression (P = .02). Worry about disease progression was more with palliative intent (P < .001). CONCLUSION: This study shows that oncology patients in our country are more worried about disease progression than the SARS-CoV-2 and wish to continue chemotherapy during this pandemic. The treatment guidelines in the COVID-19 scenario should incorporate patients' perspectives.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Imunoterapia/normas , Neoplasias/terapia , Cuidados Paliativos/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Antineoplásicos Imunológicos/efeitos adversos , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Progressão da Doença , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Imunoterapia/efeitos adversos , Imunoterapia/métodos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/imunologia , Neoplasias/psicologia , Cuidados Paliativos/psicologia , Cuidados Paliativos/estatística & dados numéricos , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , SARS-CoV-2 , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-32272785

RESUMO

To the best of our knowledge, a dose-response meta-analysis of the relationship between cardiovascular disease (CVD) and arsenic (As) exposure at drinking water As concentrations lower than the WHO provisional guideline value (10 µg/L) has not been published yet. We conducted a systematic review and meta-analyses to estimate the pooled association between the relative risk of each CVD endpoint and low-level As concentration in drinking water both linearly and non-linearly using a random effects dose-response model. In this study, a significant positive association was found between the risks of most CVD outcomes and drinking water As concentration for both linear and non-linear models (p-value for trend < 0.05). Using the preferred linear model, we found significant increased risks of coronary heart disease (CHD) mortality and CVD mortality as well as combined fatal and non-fatal CHD, CVD, carotid atherosclerosis disease and hypertension in those exposed to drinking water with an As concentration of 10 µg/L compared to the referent (drinking water As concentration of 1 µg/L) population. Notwithstanding limitations included, the observed significant increased risks of CVD endpoints arising from As concentrations in drinking water between 1 µg/L and the 10 µg/L suggests further lowering of this guideline value should be considered.


Assuntos
Arsênio , Doenças Cardiovasculares , Doença das Coronárias , Água Potável/análise , Poluentes Químicos da Água , Arsênio/toxicidade , Aterosclerose/epidemiologia , Doenças Cardiovasculares/mortalidade , Doença das Coronárias/mortalidade , Humanos , Hipertensão/epidemiologia , Poluentes Químicos da Água/toxicidade
11.
Chemosphere ; 241: 125070, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31629236

RESUMO

Arsenic (As) exposure from surface and groundwater in Peru is being recognised as a potential threat but there are limited studies on As in the food-chain and none on As in Peruvian rice. In this study, we have determined the As content in rice cultivated in the Tumbes river basin located in the northern province of Peru, an area known for extensive rice cultivation. We collected rice and soil samples from agricultural fields, soil was collected using grid sampling technique while rice was collected from the heaps of harvested crop placed across the fields. The average total As concentration in rice was 167.94 ±â€¯71 µg kg-1 (n = 29; range 68.39-345.31 µg kg-1). While the rice As levels were not highly elevated, the As content of few samples (n = 7) greater than 200 µg kg-1 could contribute negatively to human health upon chronic exposure. Average concentration of As in soil was 8.63 ±â€¯7.8 mg kg-1 (n = 30) and soil to grain transfer factor was 0.025 ±â€¯0.018 for 12 matched samples. Compared to our previous pilot study in 2006 (samples collected from the same agricultural fields but not from exact locations) there was a 41% decrease in As soil concentration in this study. Rice samples collected in 2006 (n = 5) had a mean concentration of 420 ±â€¯109 µg kg-1. Our data provides a baseline of rice grain As concentrations in Peruvian province of Tumbes and warrants further studies on factors affecting uptake of As by the rice varieties cultivated in Peru and any potential human health risks.


Assuntos
Arsênio/análise , Monitoramento Ambiental , Oryza/química , Poluentes do Solo/análise , Grão Comestível/química , Cadeia Alimentar , Contaminação de Alimentos/análise , Água Subterrânea , Humanos , Peru , Projetos Piloto , Rios , Solo
12.
Sci Total Environ ; 703: 134774, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31734495

RESUMO

In arsenic (As) endemic areas of south-east Asia, where a subsistence rice-based diet is prevalent, As exposure from food is mainly focused on rice intake. However, consumption of wheat is substantial and increasing. We present a probabilistic assessment of increased cancer risk from wheat-based food intake in a study population of rural Bihar, India where As exposure is endemic. Total As in wheat grains (43.64 ±â€¯48.19 µg/kg, n = 72) collected from 77 households across 19 villages was found to be lower than reported As in wheat grains from other south-east Asian countries but higher than a previous study from Bihar. This is the first study where As concentration in wheat flour was used for risk estimation, bearing in mind that it was the flour obtained after indigenous household processing of the grains that was used for making the home-made bread (chapati) which contributed 95% of wheat intake for the studied population. Interestingly, while 78% of the surveyed participants (n = 154) consumed rice every day, chapati was consumed every day by 99.5% of the participants. In contrast to previous studies, where As concentration in wheat grains was found to be lower than the flour due to the removal of the bran on grinding, we did not find any appreciable lowering of arsenic in the wheat flour (49.80 ±â€¯74.08 µg/kg, n = 58), most likely due to external contamination during processing and grinding. Estimated gender adjusted excess lifetime cancer risk of 1.23 × 10-4 for the studied rural population of Bihar indicated risk higher than the 10-4-10-6 range, typically used by the USEPA as a threshold to guide regulatory values. Hence, our findings suggest As exposure from wheat-based food intake to be of concern not only in As endemic areas of rural Bihar but also in non-endemic areas with similar wheat-based diet due to public distribution of the wheat across India.


Assuntos
Triticum , Arsênio , Farinha , Contaminação de Alimentos , Humanos , Índia , Oryza
13.
Artigo em Inglês | MEDLINE | ID: mdl-29882885

RESUMO

Use of excess water in cooking of rice is a well-studied short-term arsenic removal technique. However, the outcome on the nutritional content of rice is not well addressed. We determined the benefit of different cooking techniques on arsenic removal and the associated risk of losing the essential elements in rice. Overall, we found 4.5%, 30%, and 44% decrease in the arsenic content of rice when cooked with rice-to-water ratios of 1:3, 1:6 (p = 0.004), and 1:10 (parboiling; p < 0.0001), respectively. All the essential elements (except iron, selenium, and copper) incurred a significant loss when rice was cooked using the 1:6 technique: potassium (50%), nickel (44.6%), molybdenum (38.5%), magnesium (22.4%), cobalt (21.2%), manganese (16.5%), calcium (14.5%), selenium (12%), iron (8.2%), zinc (7.7%), and copper (0.2%) and further reduction was observed on parboiling, except for iron. For the same cooking method (1:6), percentage contribution to the recommended daily intake (RDI) of essential elements was highest for molybdenum (154.7%), followed by manganese (34.5%), copper (33.4%), selenium (13.1%), nickel (12.4%), zinc (10%), magnesium (8%), iron (6.3%), potassium (1.8%), and calcium (0.5%). Hence, cooked rice as a staple is a poor source for essential elements and thus micronutrients.


Assuntos
Arsênio/análise , Culinária/métodos , Oryza/química , Oligoelementos/análise , Água/química , Cobalto/análise , Cobre/análise , Humanos , Ferro/análise , Magnésio/análise , Manganês/análise , Níquel/análise , Selênio/análise , Zinco/análise
14.
Sci Rep ; 8(1): 3292, 2018 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-29459624

RESUMO

A combination of burrowing behaviour and very efficient background matching makes the brown shrimp Crangon crangon almost invisible to potential predators and prey. This raises questions on how shrimp succeed in concealing themselves in the heterogeneous and dynamic estuarine habitats they inhabit and what type of environmental variables and behavioural factors affect their colour change abilities. Using a series of behavioural experiments, we show that the brown shrimp is capable of repeated fast colour adaptations (20% change in dark pigment cover within one hour) and that its background matching ability is mainly influenced by illumination and sediment colour. Novel insights are provided on the occurrence of non-adaptive (possibly stress) responses to background changes after long-time exposure to a constant background colour or during unfavourable conditions for burying. Shrimp showed high levels of intra- and inter-individual variation, demonstrating a complex balance between behavioural-plasticity and environmental adaptation. As such, the study of crustacean colour changes represents a valuable opportunity to investigate colour adaptations in dynamic habitats and can help us to identify the mayor environmental and behavioural factors influencing the evolution of animal background matching.


Assuntos
Adaptação Biológica/fisiologia , Comportamento Animal/fisiologia , Ecossistema , Penaeidae/fisiologia , Animais , Pigmentação , Alimentos Marinhos
15.
Biol Methods Protoc ; 2(1): bpx003, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32161786

RESUMO

The study of animal colouration addresses fundamental and applied aspects relevant to a wide range of fields, including behavioural ecology, environmental adaptation and visual ecology. Although a variety of methods are available to measure animal colours, only few focus on chromatophores (specialized cells containing pigments) and pigment migration. Here, we illustrate a freely available and user-friendly method to quantify pigment cover (PiC) with high precision and low effort using digital images, where the foreground (i.e. pigments in chromatophores) can be detected and separated from the background. Images of the brown shrimp, Crangon crangon, were used to compare PiC with the traditional Chromatophore Index (CI). Results indicate that PiC outcompetes CI for pigment detection and transparency measures in terms of speed, accuracy and precision. The proposed methodology provides researchers with a useful tool to answer essential physiological, behavioural and evolutionary questions on animal colouration in a wide range of species.

16.
Environ Health Perspect ; 124(8): 1269-75, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26794451

RESUMO

BACKGROUND: Exposure to some perfluoroalkyl substances (PFAS), such as perfluorohexane sulfonate (PFHxS), perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononanoic acid (PFNA), may alter levels of sex hormones and insulin-like growth factor-1 (IGF-1) in animals. Human studies on this topic are scarce, and none have been conducted in young children. OBJECTIVES: We investigated the relationship between levels of PFAS and estradiol, total testosterone, and IGF-1 in 2,292 children (6-9 years of age) from the C8 Health Project who lived near a chemical plant in the Mid-Ohio Valley (USA) with local contamination from PFOA. METHODS: Serum samples were collected in 2005-2006 and analyzed for PFAS, sex hormones, and IGF-1. Results from regression models were expressed as the adjusted percentage difference (95% CI) per sex-specific interquartile range (IQR) increment of each PFAS serum concentration. Analyses by PFAS quartiles were also conducted. RESULTS: Median concentrations of PFHxS, PFOA, PFOS, and PFNA were 8, 35, 22, and 1.7 ng/mL in boys and 7, 30, 21, and 1.7 ng/mL in girls. In boys, PFOA concentrations were significantly associated with testosterone levels (-4.9%; 95% CI: -8.7, -0.8%); PFOS with estradiol (-4.0%; 95% CI: -7.7, -0.1%), testosterone (-5.8%; 95% CI: -9.4, -2.0%), and IGF-1 (-5.9%; 95% CI: -8.3, -3.3%); and PFNA with IGF-1 (-3.5%; 95% CI: -6.0, -1.0%). In girls, significant associations were found between PFOS and testosterone (-6.6%; 95% CI: -10.1, -2.8%) and IGF-1 (-5.6%; -8.2, -2.9%); and PFNA and IGF-1 (-3.8%; 95% CI: -6.4, -1.2%). In both sexes, the magnitudes of the associations decreased monotonically across quartiles for both testosterone and IGF-1 in relation to PFOS, and for IGF-1 and PFNA in girls. CONCLUSIONS: To our knowledge, this is the first study suggesting that PFAS are associated with lower levels of IGF-1 and sex hormones in young children. CITATION: Lopez-Espinosa MJ, Mondal D, Armstrong BG, Eskenazi B, Fletcher T. 2016. Perfluoroalkyl substances, sex hormones, and insulin-like growth factor-1 at 6-9 years of age: a cross-sectional analysis within the C8 Health Project. Environ Health Perspect 124:1269-1275; http://dx.doi.org/10.1289/ehp.1509869.


Assuntos
Exposição Ambiental/análise , Poluentes Ambientais/metabolismo , Fluorcarbonetos/metabolismo , Hormônios Esteroides Gonadais/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Ácidos Alcanossulfônicos/metabolismo , Caprilatos/metabolismo , Criança , Estudos Transversais , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino
17.
BMC Med ; 12: 220, 2014 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-25428603

RESUMO

BACKGROUND: Stillbirth rates have changed little over the last decade, and a high proportion of cases are unexplained. This meta-analysis examined whether there are inequalities in stillbirth risks according to sex. METHODS: A systematic review of the literature was conducted, and data were obtained on more than 30 million birth outcomes reported in observational studies. The pooled relative risk of stillbirth was estimated using random-effects models. RESULTS: The crude mean rate (stillbirths/1,000 total births) was 6.23 for males and 5.74 for females. The pooled relative risk was 1.10 (95% confidence interval (CI): 1.07-1.13). The attributable fraction in the whole population was 4.2% (95% CI: 3.70-4.63), and the attributable fraction among male fetuses was 7.8% (95% CI: 7.0-8.66). Study populations from countries with known sex-biased sex selection issues had anomalous stillbirth sex ratios and higher overall stillbirth risks than other countries, reflecting increased mortality among females. CONCLUSIONS: Risk of stillbirth in males is elevated by about 10%. The population-attributable risk is comparable to smoking and equates to approximately 100,000 stillbirths per year globally. The pattern is consistent across countries of varying incomes. Given current difficulties in reducing stillbirth rates, work to understand the causes of excess male risk is warranted. We recommend that stillbirths are routinely recorded by sex. This will also assist in exposing prenatal sex selection as elevated or equal risks of stillbirth in females would be readily apparent and could therefore be used to trigger investigation.


Assuntos
Natimorto/epidemiologia , Adulto , Feminino , Saúde Global , Humanos , Masculino , Gravidez , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais
18.
Environ Int ; 70: 106-12, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24927498

RESUMO

Mobile phones are owned by most of the adult population worldwide. Radio-frequency electromagnetic radiation (RF-EMR) from these devices could potentially affect sperm development and function. Around 14% of couples in high- and middle-income countries have difficulty conceiving, and there are unexplained declines in semen quality reported in several countries. Given the ubiquity of mobile phone use, the potential role of this environmental exposure needs to be clarified. A systematic review was therefore conducted, followed by meta-analysis using random effects models, to determine whether exposure to RF-EMR emitted from mobile phones affects human sperm quality. Participants were from fertility clinic and research centres. The sperm quality outcome measures were motility, viability and concentration, which are the parameters most frequently used in clinical settings to assess fertility. We used ten studies in the meta-analysis, including 1492 samples. Exposure to mobile phones was associated with reduced sperm motility (mean difference -8.1% (95% CI -13.1, -3.2)) and viability (mean difference -9.1% (95% CI -18.4, 0.2)), but the effects on concentration were more equivocal. The results were consistent across experimental in vitro and observational in vivo studies. We conclude that pooled results from in vitro and in vivo studies suggest that mobile phone exposure negatively affects sperm quality. Further study is required to determine the full clinical implications for both sub-fertile men and the general population.


Assuntos
Telefone Celular , Ondas de Rádio/efeitos adversos , Espermatozoides/efeitos da radiação , Adulto , Animais , Humanos , Masculino , Análise do Sêmen , Motilidade Espermática/efeitos da radiação , Espermatozoides/citologia
19.
Environ Health Perspect ; 122(2): 187-92, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24280536

RESUMO

BACKGROUND: The presence of perfluoroalkyl acids (PFAAs) in breast milk has been documented, but their lactational transfer has been rarely studied. Determination of the elimination rates of these chemicals during breastfeeding is important and critical for assessing exposure in mothers and infants. OBJECTIVES: We aimed to investigate the association between breastfeeding and maternal serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS). For a subset of the population, for whom we also have their infants' measurements, we investigated associations of breastfeeding with infant serum PFAA concentrations. METHODS: The present analysis included 633 women from the C8 Science Panel Study who had a child < 3.5 years of age and who provided blood samples and reported detailed information on breastfeeding at the time of survey. PFAA serum concentrations were available for all mothers and 8% (n = 49) of the infants. Maternal and infant serum concentrations were regressed on duration of breastfeeding. RESULTS: Each month of breastfeeding was associated with lower maternal serum concentrations of PFOA (-3%; 95% CI: -5, -2%), PFOS (-3%; 95% CI: -3, -2%), PFNA (-2%; 95% CI: -2, -1%), and PFHxS (-1%; 95% CI: -2, 0%). The infant PFOA and PFOS serum concentrations were 6% (95% CI: 1, 10%) and 4% (95% CI: 1, 7%) higher per month of breastfeeding. CONCLUSIONS: Breast milk is the optimal food for infants, but is also a PFAA excretion route for lactating mothers and exposure route for nursing infants.


Assuntos
Aleitamento Materno/efeitos adversos , Poluentes Ambientais/análise , Leite Humano/química , Fatores Etários , Ácidos Alcanossulfônicos/análise , Ácidos Alcanossulfônicos/sangue , Caprilatos/análise , Caprilatos/sangue , Poluentes Ambientais/sangue , Feminino , Fluorcarbonetos/análise , Fluorcarbonetos/sangue , Humanos , Londres , Ácidos Sulfônicos/análise , Ácidos Sulfônicos/sangue , Inquéritos e Questionários
20.
Sci Rep ; 3: 2195, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23873074

RESUMO

Arsenic in drinking water may cause major deleterious health impacts including death. Although arsenic in rice has recently been demonstrated to be a potential exposure route for humans, there has been to date no direct evidence for the impact of such exposure on human health. Here we show for the first time, through a cohort study in West Bengal, India, involving over 400 human subjects not otherwise significantly exposed to arsenic through drinking water, elevated genotoxic effects, as measured by micronuclei (MN) in urothelial cells, associated with the staple consumption of cooked rice with >200 µg/kg arsenic. Further work is required to determine the applicability to populations with different dietary and genetic characteristics, but with over 3 billion people in the world consuming rice as a staple food and several percent of this rice containing such elevated arsenic concentrations, this study raises considerable concerns over the threat to human health.


Assuntos
Arsênio/toxicidade , Contaminação de Alimentos , Oryza/química , Adulto , Arsênio/urina , Exposição Ambiental , Feminino , Humanos , Índia , Masculino , Micronúcleos com Defeito Cromossômico/induzido quimicamente , Testes para Micronúcleos , Pessoa de Meia-Idade , Mutagênicos/toxicidade , Fatores de Risco , Poluentes Químicos da Água , Adulto Jovem
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