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Wastewater-based epidemiology as a novel assessment approach for population-level metal exposure.
Markosian, C, Mirzoyan, N
The Science of the total environment. 2019;:1125-1132
Abstract
Pollution by heavy metals and metalloids is detrimental to human health due to their toxic, genotoxic, and carcinogenic effects. The traditional approach to assess the extent of environmental and occupational exposures of metals is human biomonitoring (HBM). This method has several limitations, including invasiveness, sampling bias, cost- and time-intensiveness, and ethical issues. This suggests the need for a more robust, non-invasive, epidemiological tool for assessment of exposure to metals and their public health effects. Recently, wastewater-based epidemiology (WBE) has been suggested and utilized as a novel approach to accurately determine the extent of exposure to multiple substances on the population level. We suggest the potential application of WBE to the study of metal exposure on the population level, including possible biomarkers for wastewater analysis of 10 metals belonging to three categories according to health effects and nutritional benefits, and its public health implications. Similar to previous studies of exposure to regulated or illegal drugs, unregulated legal substances, and pesticides, WBE can be applied to the study of metal exposure in a given community. Parental substance biomarkers (PSBs), metabolic substance biomarkers (MSBs), and non-substance biomarkers (NSBs) of 10 common metals are available for consideration in wastewater analysis. The use of WBE would allow for the interpretation of the relationship between metal exposure and population health, reveal synergistic effects of different health factors, and model public health risks under different scenarios.
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2.
The ApoE ε4 Isoform: Can the Risk of Diseases be Reduced by Environmental Factors?
Bos, MM, Noordam, R, Blauw, GJ, Slagboom, PE, Rensen, PCN, van Heemst, D
The journals of gerontology. Series A, Biological sciences and medical sciences. 2019;(1):99-107
Abstract
Candidate gene studies and genome-wide association studies found that genetic variation in APOE is robustly associated with multiple age-related diseases and longevity. Apolipoprotein E (ApoE) is an apolipoprotein that plays an important role in triglyceride and cholesterol metabolism. In literature, especially the ApoE ɛ4 isoform has been associated with an increased risk of mortality and age-related diseases such as Alzheimer's disease (AD), cardiovascular diseases (CVD), as compared to the "neutral" ApoE ɛ3 isoform. There are, however, large differences in the deleterious effects of the ApoE ɛ4 isoform between ancestries and populations, which might be explained by differences in environmental and lifestyle exposures. In this respect, poor nutrition and physical inactivity are two important lifestyle factors that have been associated with increased risks for AD and CVD. Therefore, in this narrative review, we discuss how omega-3 fatty acid intake and physical activity may modify the impact of ApoE ɛ4 on AD and CVD risk.
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3.
Polycyclic aromatic hydrocarbons as a potential source of carcinogenicity of mate.
Oranuba, E, Deng, H, Peng, J, Dawsey, SM, Kamangar, F
Journal of environmental science and health. Part C, Environmental carcinogenesis & ecotoxicology reviews. 2019;(1):26-41
Abstract
Drinking mate, an infusion of the herb ilex paraguariensis, is very common in several South American countries, and has been associated with an increased risk of esophageal cancer. This increased risk may be attributed to drinking mate very hot, or to mate's potentially carcinogenic contaminants, such as polycyclic aromatic hydrocarbons (PAHs). Mate leaves are often dried via smoking, and therefore commercial samples may have high amounts of PAHs. We found 10 original articles that had measured PAHs in commercial dry samples, and nearly all found very high mass fractions. Most studies found benzo[a]pyrene mass fractions to be over 25 ng/g, and some found levels up to 600 ng/g. However, carcinogenic PAHs are often hydrophobic, and may not readily transfer into infusions. Seven articles studied transfer rates, and these rates varied from 1 to 50%, depending on the methods employed. Further careful studies of transfer rates in situations that mimic real life drinking of mate are recommended. Also, further studies of biological indicators of PAH exposure, particularly in randomized experiments, and analyzing DNA from tumor samples of mate drinkers are recommended.
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4.
Etiologic links between environmental and lifestyle factors and Essential tremor.
Ong, YL, Deng, X, Tan, EK
Annals of clinical and translational neurology. 2019;(5):979-989
Abstract
Essential tremor (ET) is one of the most common adult movement disorders, characterized by clinical tremor and other nonmotor symptoms. It is a progressive disease that shares features with other neurodegenerative diseases. ET is a complex disease with both genetic and environmental underpinnings. While genetic forms of ET are well recognized, the role of environmental and lifestyle factors in ET has been debated. Studies suggest that exposure to neurotoxic compounds such as β-carboline alkaloids and ethanol are potential risk factors for ET, while antioxidant intake may be protective. In addition, smoking acts as a protective factor in ET, parallel to its effects in other neurological diseases. New evidence points to pesticide and lead exposure as potential risk factors. There is growing evidence to suggest that environmental and lifestyle factors play a role in ET but additional research is needed in order to completely understand their cause and effect association. There is also a need for larger case-control and prospective cohort studies across different populations to further evaluate the etiological importance of these factors in ET.
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5.
A review of gene-by-air pollution interactions for cardiovascular disease, risk factors, and biomarkers.
Ward-Caviness, CK
Human genetics. 2019;(6):547-561
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Abstract
Air pollution is recognized as causal factor for cardiovascular disease (CVD) and is associated with multiple CVD risk factors. Substantial research effort has been invested in understanding the linkages between genetic variation and CVD risk, resulting in over 50 CVD-associated genetic loci. More recently, gene-air pollution interaction studies have quantified the contribution of genetic variation to inter-individual heterogeneity in air pollution health risks, and aided in elucidating mechanisms of air pollution exposure health risks. Here, we perform a comprehensive review of gene-air pollution interaction studies for CVD, as well as risk factors and emerging CVD biomarkers. The literature review revealed that most published interaction studies have been candidate gene studies, causing observed interactions to cluster in a few genes related to detoxification (GSTM1 and GSTT1), inflammation (IL-6), iron processing (HFE), and microRNA processing (GEMIN4 and DGCR8). There have been a few genome-wide interaction studies with results indicating that interactions extend beyond commonly considered genetic loci. Gene-air pollution interactions are observed for exposure periods ranging from hours to years and a variety of air pollutants including particulate matter, gaseous pollutants, and pollutant sources such as traffic. Though the existing evidence for the existence of relevant gene-air pollution interactions for CVD outcomes is substantial, it could be strengthened by improved replication and meta-analyses as well as functional validation.
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6.
Chronic kidney disease of unknown aetiology in Sri Lanka and the exposure to environmental chemicals: a review of literature.
Kulathunga, MRDL, Ayanka Wijayawardena, MA, Naidu, R, Wijeratne, AW
Environmental geochemistry and health. 2019;(5):2329-2338
Abstract
Chronic kidney disease of unknown aetiology (CKDu) has emerged as a serious health issue in Sri Lanka. The disease has been recorded in the North Central Province of the country. While studies have elicited many hypotheses concerning the pathogenicity of CKDu, none adequately explains the cause of CKDu and the measures needed to minimise its occurrence. Nephrotoxic heavy metal (oid)s such as cadmium, arsenic, lead, and chromium are present in biological samples of people from endemic areas. This review appraises evidence on the effects of long-term exposure to low concentration of nephrotoxic heavy metals, which could be the principal cause of CKDu. Although a considerable variation exists in metal concentrations in patients' blood and urine, higher levels of heavy metals were consistently observed in affected areas. This review finds that the populations in the endemic areas are exposed to heavy metal (oid)s at low concentrations, which are considered as safe levels; nevertheless, it influences the incidence of CKDu. Recent global studies on chronic kidney disease (CKD) revealed a low concentration of heavy metals in diseased patients. Research findings indicated that CKDu patients in Sri Lanka demonstrated similar blood levels of Cd, Pb, and higher concentrations of Cr than that have been reported globally. Further studies on the influence of combinations of nephrotoxic heavy metals at low concentrations on reduced glomerular filtration rate and other renal biomarkers could explain CKDu pathogenicity.
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7.
Exposure to environmental chemicals and type 1 diabetes: an update.
Howard, SG
Journal of epidemiology and community health. 2019;(6):483-488
Abstract
This narrative review summarises recently published epidemiological and in vivo experimental studies on exposure to environmental chemicals and their potential role in the development of type 1 diabetes mellitus (T1DM). These studies focus on a variety of environmental chemical exposures, including to air pollution, arsenic, some persistent organic pollutants, pesticides, bisphenol A and phthalates. Of the 15 epidemiological studies identified, 14 include measurements of exposures during childhood, 2 include prenatal exposures and 1 includes adults over age 21. Together, they illustrate that the role of chemicals in T1DM may be complex and may depend on a variety of factors, such as exposure level, timing of exposure, nutritional status and chemical metabolism. While the evidence that these exposures may increase the risk of T1DM is still preliminary, it is critical to investigate this possibility further as a means of preventing T1DM.
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8.
The Effects of Air Pollution on the Development of Atopic Disease.
Hassoun, Y, James, C, Bernstein, DI
Clinical reviews in allergy & immunology. 2019;(3):403-414
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Abstract
Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO2), nitric oxide (NO), sulfur dioxide (SO2), particulate matter (PM2.5 and PM10), carbon monoxide (CO), and carbon dioxide (CO2). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.
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9.
Gene-environment interactions in primary atopic disorders.
Sacco, KA, Milner, JD
Current opinion in immunology. 2019;:148-155
Abstract
Environmental factors modify disease presentation and severity in allergic disorders. Primary atopic disorders (PADs) are a heterogenous group of single gene disorders that lead to significant atopic and allergic disease manifestations. However, a number of these monogenic diseases have variable penetrance suggesting that gene-gene and/or gene-environment interactions could modulate the clinical phenotype. Environmental factors such as diet, the microbiome at the epithelial-environment interface, the presence and/or extent of infection, and psychologic stress can alter disease phenotypic expression of allergic diseases, and PADs provide discrete contexts in which to understand these influences. We outline how gene-environment interactions likely contribute to a variable penetrance and expressivity in PADs. Dietary modifications of both macronutrients and/or micronutrients alter T-cell metabolism and may influence effector T-cell function. The mucosal microbiome may affect local inflammation and may remotely influence regulatory elements, while psychologic stress can affect mast cell and other allergic effector cell function. Understanding gene-environment interactions in PADs can hopefully provide a foundation for interrogating gene-environment interactions to common allergic disorders, and also present opportunities for personalized interventions based on the altered pathways and environmental influences in affected individuals.
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10.
It's Not Mom's Fault: Prenatal and Early Life Exposures that Do and Do Not Contribute to Food Allergy Development.
Abrams, EM, Chan, ES
Immunology and allergy clinics of North America. 2019;(4):447-457
Abstract
Thus far, the most effective strategy for the prevention of food allergy is early introduction of allergenic solids to at-risk infants. Early skin moisturization may have a role in food allergy prevention. There is insufficient evidence for hydrolyzed formula as a means of allergy prevention. Studies on vitamin D, omega 3, and probiotic supplementation; breastfeeding; early infant dietary diversity; and maternal peanut ingestion during pregnancy and breastfeeding are inconsistent.