In Utero Exposure to Compounds with Dioxin-like Activity and Birth Outcomes

Vafeiadi, Marina; Agramunt, Sílvia; Pedersen, Marie; Besselink, Harrie; Chatzi, Leda; Fthenou, Eleni; Fleming, Sarah; Hardie, Laura J.; Wright, John; Knudsen, Lisbeth E.; Nielsen, Jeanette K.; Sunyer, Jordi; Carreras, Ramón; Brunborg, Gunnar; Gützkow, Kristine B.; Nygaard, Unni Cecilie; Løvik, Martinus; Kyrtopoulos, Soterios A.; Segerbäck, Dan; Merlo, Domenico Franco; Kleinjans, Jos; Vrijheid, Martine; Kogevinas, Manolis

doi:10.1097/ede.0000000000000046

Cited by 21 publications

(17 citation statements)

References 62 publications

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“…The birth outcome most frequently investigated was birth weight (see Annex A.8.3, Table 67 therein). Some studies showed significant negative associations between maternal PCDD/Fs and DL‐PCBs exposure and birth weight (Vartiainen et al., ; Tajimi et al., ; Tsukimori et al., ; Konishi et al., ; Papadopoulou et al., , ), whereas others did not observe any statistically significant associations (Eskenazi et al., ; Halldorsson et al., ; Vafeiadi et al., ; Wesselink et al., ; Govarts et al., ). The strengths and the consistency of the associations varied and in general the studies have some major weaknesses such as exposure measured up to 40 years after the birth (Tsukimori et al., ) and doubts regarding confounders exemplified by a study where smoking was not associated with birth weight (Konishi et al., ).…”

Section: Assessmentmentioning

confidence: 99%

Risk for animal and human health related to the presence of dioxins and dioxin‐like PCBs in feed and food

Knutsen¹,

Alexander²,

Barregård³

et al. 2018

EFS2

143

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The European Commission asked EFSA for a scientific opinion on the risks for animal and human health related to the presence of dioxins (PCDD/Fs) and DL‐PCBs in feed and food. The data from experimental animal and epidemiological studies were reviewed and it was decided to base the human risk assessment on effects observed in humans and to use animal data as supportive evidence. The critical effect was on semen quality, following pre‐ and postnatal exposure. The critical study showed a NOAEL of 7.0 pg WHO2005‐TEQ/g fat in blood sampled at age 9 years based on PCDD/F‐TEQs. No association was observed when including DL‐PCB‐TEQs. Using toxicokinetic modelling and taking into account the exposure from breastfeeding and a twofold higher intake during childhood, it was estimated that daily exposure in adolescents and adults should be below 0.25 pg TEQ/kg bw/day. The CONTAM Panel established a TWI of 2 pg TEQ/kg bw/week. With occurrence and consumption data from European countries, the mean and P95 intake of total TEQ by Adolescents, Adults, Elderly and Very Elderly varied between, respectively, 2.1 to 10.5, and 5.3 to 30.4 pg TEQ/kg bw/week, implying a considerable exceedance of the TWI. Toddlers and Other Children showed a higher exposure than older age groups, but this was accounted for when deriving the TWI. Exposure to PCDD/F‐TEQ only was on average 2.4‐ and 2.7‐fold lower for mean and P95 exposure than for total TEQ. PCDD/Fs and DL‐PCBs are transferred to milk and eggs, and accumulate in fatty tissues and liver. Transfer rates and bioconcentration factors were identified for various species. The CONTAM Panel was not able to identify reference values in most farm and companion animals with the exception of NOAELs for mink, chicken and some fish species. The estimated exposure from feed for these species does not imply a risk.

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Section: Assessmentmentioning

confidence: 99%

Risk for animal and human health related to the presence of dioxins and dioxin‐like PCBs in feed and food

Knutsen¹,

Alexander²,

Barregård³

et al. 2018

EFS2

143

View full text Add to dashboard Cite

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“…Research based on representative sampling of the population at large [37] has documented that virtually every pregnant woman in the USA has at least 43 different environmental chemicals in her body. Persistent organic pollutants are found in pregnant and lactating women across the globe [25,38,39]. A report by the US National Cancer Institute found that “to a disturbing extent babies are born ‘pre‐polluted’” [40].…”

Section: Nature and Extent Of Prenatal And Preconception Exposure To mentioning

confidence: 99%

International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals

Renzo

Conry

Blake

et al. 2015

Intl J Gynecology & Obste

264

235

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Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.

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“…Although our current analysis uniquely studied how maternal smoking, black carbon, and PFASs may interact to influence birth size, prior studies have focused on how mixtures of other pollutants may impact birth weight. One study of about 1000 European mother-infant pairs observed a stronger negative cross-sectional association between cord blood dioxin-like activity and birth weight among infants of women who smoked during pregnancy versus non-smokers, but the interaction was not significant [ 47 ]. Another study of over 1000 mother-infant pairs from Greenland, Poland, and Ukraine observed greater birth weight reductions for infants of smokers concomitantly prenatally exposed to PFOA and di(2-ethylhexyl) phthalate (DEHP) versus non-smokers exposed to these two chemicals [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Cumulative exposure to environmental pollutants during early pregnancy and reduced fetal growth: the Project Viva cohort

et al. 2018

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BackgroundReduced fetal growth is associated with perinatal and later morbidity. Prenatal exposure to environmental pollutants is linked to reduced fetal growth at birth, but the impact of concomitant exposure to multiple pollutants is unclear. The purpose of this study was to examine interactions between early pregnancy exposure to cigarette smoke, traffic pollution, and select perfluoroalkyl substances (PFASs) on birth weight-for-gestational age (BW/GA).MethodsAmong 1597 Project Viva mother-infant pairs, we assessed maternal cigarette smoking by questionnaire, traffic pollution at residential address by black carbon land use regression model, and plasma concentration of select PFASs in early pregnancy. We calculated sex-specific BW/GA z-scores, an index of fetal growth, from national reference data. We fit covariate-adjusted multi-pollutant linear regression models and examined interactions between exposures, using a likelihood-ratio test to identify a best-fit model.ResultsTwo hundred six (13%) mothers smoked during pregnancy. Mean [standard deviation (SD)] for black carbon was 0.8 (0.3) μg/m3, perfluorooctane sulfonate (PFOS) was 29.1 (16.5) ng/mL, and BW/GA z-score was 0.19 (0.96). In the best-fit model, BW/GA z-score was lower in infants of mothers exposed to greater black carbon [− 0.08 (95% CI: -0.15, − 0.01) per interquartile range (IQR)]. BW/GA z-score (95% CI) was also lower in infants of mothers who smoked [− 0.09 (− 0.23, 0.06)] or were exposed to greater PFOS [− 0.03 (− 0.07, 0.02) per IQR], although confidence intervals crossed the null. There were no interactions between exposures. In secondary analyses, instead of PFOS, we examined perfluorononanoate (PFNA) [mean (SD): 0.7 (0.4) ng/mL], a PFAS more closely linked to lower BW/GA in our cohort. The best-fit multi-pollutant model included positive two-way interactions between PFNA and both black carbon and smoking (p-interactions = 0.03).ConclusionsConcurrent prenatal exposures to maternal smoking, black carbon, and PFOS are additively associated with lower fetal growth, whereas PFNA may attenuate associations of smoking and black carbon with lower fetal growth. It is important to examine interactions between multiple exposures in relation to health outcomes, as effects may not always be additive and may shed light on biological pathways.Electronic supplementary materialThe online version of this article (10.1186/s12940-018-0363-4) contains supplementary material, which is available to authorized users.

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In Utero Exposure to Compounds with Dioxin-like Activity and Birth Outcomes

Abstract: Results from this international general population study suggest an association between low-level prenatal dioxin-like activity and shorter gestational age, particularly in boys, with weaker associations for birth weight.

Cited by 21 publications

References 62 publications

Risk for animal and human health related to the presence of dioxins and dioxin‐like PCBs in feed and food

Risk for animal and human health related to the presence of dioxins and dioxin‐like PCBs in feed and food

International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals

Cumulative exposure to environmental pollutants during early pregnancy and reduced fetal growth: the Project Viva cohort

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