Huan Shu

PVC flooring at home and development of asthma among young children in Sweden, a 10-year follow-up

UNLABELLEDnThe incidence of asthma and allergy has increased throughout the developed world over the past decades. During the same period of time, the use of industrial chemicals such as phthalates, commonly used as plasticizers in polyvinylchloride (PVC) flooring material, has increased. The aim of this study was to investigate whether PVC flooring in the home of children in the age of 1-5 years is associated with the development of asthma in 5- and 10-year follow-up investigations (n = 3228). Dampness in Buildings and Health Study (DBH Study) commenced in 2000 in Värmland, Sweden. The current analyses included subjects who answered all baseline and follow-up questionnaires. Logistic regression analyses were applied to questionnaire results. Children who had PVC floorings in the bedroom at baseline were more likely to develop doctor-diagnosed asthma during the following 10-year period when compared with children living without. There were indications that PVC flooring in the parents bedrooms was strongly associated with the new cases of doctor-diagnosed asthma when compared with childs bedroom. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time; prenatal exposure and measurements of phthalate metabolites should be included in the future.nnnPRACTICAL IMPLICATIONSnThis study has found that PVC flooring material in early life was related to incidence of asthma during the following 10 years when compared with other flooring materials and especially when comparing with wood flooring type.The study has further indicated that PVC flooring in the parents’ bedroom (proxy for prenatal exposure) was more associated with the development of asthma than PVC in the child’s bedroom was. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time. In future prospective cohort study, prenatal exposure and measurements of phthalate metabolites should be included.

Prenatal phthalate exposure was associated with croup in Swedish infants

This study examined whether prenatal phthalate exposure was associated with lower or upper airway inflammation in infants.

Reference ranges and determinants of thyroid function during early pregnancy: the SELMA study.

ContextnEstablishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for triiodothyronine measurements, and most studies do not take into account thyroid antibodies or human chorionic gonadotropin.nnnObjectivenTo determine reference ranges and to identify/quantify determinants of TSH, free T4 (FT4), free triiodothyronine (FT3), total T4 (TT4), and total triiodothyronine (TT3).nnnDesign, Setting, and ParticipantsnThis study included 2314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5th to 97.5th percentiles after excluding thyroperoxidase antibody (TPOAb)-positive and/or thyroglobulin antibody (TgAb)-positive women.nnnInterventionnNone.nnnMain Outcome MeasuresnTSH, FT4, FT3, TT4, and TT3 in prenatal serum.nnnResultsnAfter exclusion of TPOAb-positive women, reference ranges were as follows: TSH, 0.11 to 3.48 mU/L; FT4, 11.6 to 19.4 pmol/L; FT3, 3.72 to 5.92 pg/mL; TT4, 82.4 to 166.2 pmol/L; and TT3, 1.28 to 2.92 nmol/L. Additional exclusion of TgAb-positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. Body mass index (BMI) and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4, and TT3.nnnConclusionsnWe show that the exclusion of TgAb-positive women on top of excluding TPOAb-positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4, and TT3 that could reflect endocrine-disrupting effects and/or effects on thyroid hormone transport or deiodination.

Temporal trends of phthalate exposures during 2007–2010 in Swedish pregnant women

BackgroundThe general population is exposed to phthalates, a group of chemicals with strong evidence for endocrine disrupting properties, commonly used in a large number of consumer products. Based on published research and evidence compiled by environmental agencies, certain phthalate applications and products have become restricted, leading to an increasing number of “new generation compounds” coming onto the market during recent years replacing older phthalates. Some examples of such newer compounds are di-iso-nonyl phthalate (DiNP), di-iso-decyl phthalate (DiDP), and most recently di-isononyl-cyclohexane-1,2-dicarboxylate (DiNCH).ObjectivesIn order to evaluate temporal trends in phthalate exposure, first trimester urinary biomarkers of phthalates were measured in the Swedish SELMA study over a period of 2.5 years (2007–2010).MethodsWe collected first morning void urine samples around week 10 of pregnancy from 1651 pregnant women. Spot samples were analyzed for 13 phthalate metabolites and one phthalate replacement and least square geometric mean (LSGM) levels of the metabolites were compared between the sampling years when adjusted for potential confounders.ResultsAll 14 metabolites were detectable in more than 99% of the SELMA subjects. The levels were generally comparable to other studies, but the SELMA subjects showed slightly higher exposure to butyl-benzyl phthalate (BBzP) and di-butyl phthalate (DBP). Di-ethyl-hexyl phthalate (DEHP) metabolites levels decreased while DiNP, DiDP/di-2-propylheptyl phthalate (DPHP), and DiNCH metabolites levels increased during the sampling period.ConclusionsUrinary metabolite levels of the older phthalates and more recently introduced phthalate replacement compound changed during the short sampling period in this Swedish pregnancy cohort. Our results indicate that replacement of phthalates can make an impact on human exposure to these chemicals. During this particularly vulnerable stage of life, phthalate exposures are of particular concern as the impacts, though not immediately noticeable, may increase the risk for health effects later in life.

PVC Flooring at Home and Uptake of Phthalates in Pregnant Women

Phthalates are used as plasticizers in polyvinyl chloride (PVC) materials and it is known that phthalates may migrate into the surrounding environment and then become a source for human uptake. The aim of the study was to investigate whether residential PVC flooring was related to the urinary levels of phthalate metabolites determined in pregnant women. The data were from the Swedish SELMA study where sampling was conducted during the time period 2007-2010. Spot urine samples from 1674 women at the end of the first trimester were analyzed for 14 metabolites from seven phthalates and one phthalate alternative. Data on flooring material in the kitchen and the parents bedrooms as well as potential confounders were collected by postal questionnaires at the same time as the urine samples were taken. Multiple regression modeling by least square geometric mean and weighted quantile sum regression was applied to log-transformed and creatinine-adjusted phthalate metabolite concentrations adjusted for potential confounders from questionnaire data. This study has found significantly higher urinary levels of the BBzP metabolite (MBzP) in pregnant women living in homes with PVC flooring as compared to homes with other flooring materials.

Incorporating regulatory guideline values in analysis of epidemiology data

Fundamental to regulatory guidelines is to identify chemicals that are implicated with adverse human health effects and inform public health risk assessors about acceptable ranges of such environmental exposures (e.g., from consumer products and pesticides). The process is made more difficult when accounting for complex human exposures to multiple environmental chemicals. Herein we propose a new class of nonlinear statistical models for human data that incorporate and evaluate regulatory guideline values into analyses of health effects of exposure to chemical mixtures using so-called desirability functions (DFs). The DFs are incorporated into nonlinear regression models to allow for the simultaneous estimation of points of departure for risk assessment of combinations of individual substances that are parts of chemical mixtures detected in humans. These are, in contrast to published so-called biomonitoring equivalent (BE) values and human biomonitoring (HBM) values that link regulatory guideline values from in vivo studies of single chemicals to internal concentrations monitored in humans. We illustrate the strategy through the analysis of prenatal concentrations of mixtures of 11 chemicals with suspected endocrine disrupting properties and two health effects: birth weight and language delay at 2.5u202fyears. The strategy allows for the creation of a Mixture Desirability Function i.e., MDF, which is a uni-dimensional construct of the set of single chemical DFs; thus, it focuses the resulting inference to a single dimension for a more powerful one degree-of-freedom test of significance. Based on the application of this new method we conclude that the guideline values need to be lower than those for single chemicals when the chemicals are observed in combination to achieve a similar level of protection as was aimed for the individual chemicals. The proposed modeling may thus suggest data-driven uncertainty factors for single chemical risk assessment that takes environmental mixtures into account.

P080 Assessment of environmental exposures in the canadian healthy infant longitudinal development (CHILD) birth cohort

The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort was designed to elucidate environment-gene relationships underlying the development of asthma and allergy. 3,624 pregnant mothers were recruited from four provinces in Canada. 3542 infants were eligible for the study and have detailed longitudinal individual-level data. Key domains investigated include indoor and outdoor air pollutants, household chemicals, mould, and other biological allergens, behaviour, infections, gut microbiome, nutrition, psychosocial environment and medications. Assessments of early life exposures focus on inflammatory responses driven by the acquired and innate immune systems. Half of the cohort has reached the 5-year diagnostic endpoints of asthma and allergy. Methods Exposure assessment methods include extensive environmental questionnaires including time-activity-behaviour at several time points until age five. House dust was collected at 3–4 months, and biological specimens were obtained for multiple exposure-related measurements. Homes and daycares were geo-coded to apply to individual-level land-use regression estimates for traffic-related air pollutants. Results The data show a geographic variation in the housing age, with the greatest percentage of new homes (built after 1989) in Edmonton (51%) and more families living in older homes (built before 1970) in Winnipeg and Toronto (52% each). Edmonton had the largest number of homes with attached garages (41%) and Vancouver the fewest (13%). Outdoor air pollution estimates are from land-use regression models of nitrogen dioxide (NO2) levels at the home address. Median outdoor NO2 concentration ranges from 4 ppb (Winnipeg) to 13.5 ppb (Toronto). At 3 months of age, 1947/2607 (74.7%) had detectable cotinine in urine while 1575/1583 (99.5%) had detectable phthalate metabolites in urine Discussion Detailed longitudinal individual-level data exposure assessment can be accomplished in large cohorts. Assessing the associations between health outcomes and multiple exposures across time is challenging. We will discuss several of the modelling efforts we are testing to address these complexities.