Studies of firefighters have shown increased exposures to carcinogenic compounds and elevated rates of certain cancers compared to the general population, yet this research has focused almost exclusively on men. To address this gap, the Women Firefighters Biomonitoring Collaborative created a biological sample archive and analyzed levels of perfluoroalkyl substances (PFAS) among women firefighters (N = 86) and office workers (N = 84) in San Francisco. Serum samples were collected and analyzed using liquid chromatography−tandem mass spectrometry (LC−MS/MS) to measure and compare PFAS levels between firefighters and office workers. 7 of 12 PFAS congeners were detected in the least 70% of the study population, and 4 congeners were detected in 100% of participants. In regression models comparing PFAS levels by occupation and adjusting for potential confounders, firefighters had higher geometric mean concentrations of PFAS compared to office workers PFHxS (2.22 (95% CI = 1.55, 3.18)), PFUnDA (1.83 (95% CI = 0.97, 3.45)), and PFNA (1.26 (95% CI = 1.01, 1.58)). Among firefighters, occupational position predicted exposurefirefighters and officers had higher PFNA, PFOA, PFDA, and PFUnDA levels compared to drivers. Women firefighters are exposed to higher levels of some PFAS compared to office workers, suggesting that some of these exposures may be occupationally related.

ObjectiveDescribe the attitudes, beliefs, and practices of U.S. obstetricians on the topic of prenatal environmental exposures.Study DesignA national online survey of American Congress of Obstetricians and Gynecologists (ACOG) fellows and 3 focus groups of obstetricians.ResultsWe received 2,514 eligible survey responses, for a response rate of 14%. The majority (78%) of obstetricians agreed that they can reduce patient exposures to environmental health hazards by counseling patients; but 50% reported that they rarely take an environmental health history; less than 20% reported routinely asking about environmental exposures commonly found in pregnant women in the U.S.; and only 1 in 15 reported any training on the topic. Barriers to counseling included: a lack of knowledge of and uncertainty about the evidence; concerns that patients lack the capacity to reduce harmful exposures; and fear of causing anxiety among patients.ConclusionU.S. obstetricians in our study recognized the potential impact of the environment on reproductive health, and the role that physicians could play in prevention, but reported numerous barriers to counseling patients. Medical education and training, evidence-based guidelines, and tools for communicating risks to patients are needed to support the clinical role in preventing environmental exposures that threaten patient health.

Background:Glycol ethers (GE) are widely used organic solvents. Despite the potential neurotoxicity of several families of organic solvents, little is known about the impact of GE on the neurodevelopment of infants and children.Objectives:We investigated the relation between urinary concentrations of GE metabolites in pregnant women and neurocognitive abilities in their 6-year-old children in the PELAGIE mother–child cohort.Methods:Five GE metabolites were measured in first morning void urine samples of 204 French pregnant women in early pregnancy (< 19 weeks of gestation). Psychologists assessed the neurocognitive abilities of their 6-year-old children with the Wechsler Intelligence Scale for Children IV (WISC) and the Developmental Neuropsychological Assessment (NEPSY). We analyzed the results with linear (WISC) and Poisson regression models (NEPSY), adjusted for potential confounders, including child’s stimulation at home.Results:GE metabolites were detected in 90–100% of maternal urine samples. The WISC Verbal Comprehension score was significantly lower for children with the highest tertile of urinary phenoxyacetic acid (PhAA) [β (third vs. first tertile) = –6.53; 95% CI: –11.44, –1.62]. Similarly, the NEPSY Design Copying subtest score was lower in those with the highest tertile of urinary ethoxyacetic acid (EAA) [β (third vs. first tertile) = –0.11; 95% CI: –0.21, 0.00]. The other GE metabolites we studied were not significantly associated with WISC or NEPSY scores.Conclusions:Prenatal urine concentrations of two GE metabolites were associated with lower WISC Verbal Comprehension Index scores and NEPSY Design Copying subscale scores, respectively, at age 6 years. PhAA is the primary metabolite of 2-phenoxyethanol (EGPhE), which is commonly found in cosmetics, and precursors of EAA are frequently used in cleaning agents. Additional research is needed to confirm our findings and further explore potential effects of prenatal GE exposures on neurocognitive performance in children.Citation:Béranger R, Garlantézec R, Le Maner-Idrissi G, Lacroix A, Rouget F, Trowbridge J, Warembourg C, Monfort C, Le Gléau F, Jourdin M, Multigner L, Cordier S, Chevrier C. 2017. Prenatal exposure to glycol ethers and neurocognitive abilities in 6-year-old children: the PELAGIE cohort study. Environ Health Perspect 125:684–690; http://dx.doi.org/10.1289/EHP39

Firefighters (FF) are exposed to recognized and probable carcinogens, yet there are few studies of chemical exposures and associated health concerns in women FFs, such as breast cancer. Biomonitoring often requires a priori selection of compounds to be measured, and so, it may not detect relevant, lesser known, exposures. The Women FFs Biomonitoring Collaborative (WFBC) created a biological sample archive and conducted a general suspect screen (GSS) to address this data gap. Using liquid chromatography−quadrupole time-of-flight tandem mass spectrometry, we sought to identify candidate chemicals of interest in serum samples from 83 women FFs and 79 women office workers (OW) in San Francisco. We identified chemical peaks by matching accurate mass from serum samples against a custom chemical database of 722 slightly polar phenolic and acidic compounds, including many of relevance to firefighting or breast cancer etiology. We then selected tentatively identified chemicals for confirmation based on the following criteria: (1) detection frequency or peak area differences between OW and FF; (2) evidence of mammary carcinogenicity, estrogenicity, or genotoxicity; and (3) not currently measured in large biomonitoring studies. We detected 620 chemicals that matched 300 molecular formulas in the WFBC database, including phthalate metabolites, phosphate flame-retardant metabolites, phenols, pesticides, nitro and nitroso compounds, and per-and polyfluoroalkyl substances. Of the 20 suspect chemicals selected for validation, 8 were confirmedincluding two alkylphenols, ethyl paraben, BPF, PFOSAA, benzophenone-3, benzyl p-hydroxybenzoate, and triphenyl phosphateby running a matrix spike of the reference standards and using m/z, retention time, and the confirmation of at least two fragment ions as criteria for matching. GSS provides a powerful highthroughput approach to identify and prioritize novel chemicals for biomonitoring and health studies.

Background Per- and poly-fluoroalkyl substances (PFAS) are commonly detected in a variety of foods and food packaging materials. However, few studies have examined diet as a potential source of PFAS exposure during pregnancy. In the present cross-sectional study, we examined prenatal PFAS levels in relation to self-reported consumption of meats, dairy products, and processed foods during pregnancy. Methods Participants were enrolled in the Chemicals in Our Bodies study, a demographically diverse pregnancy cohort in San Francisco, CA (N = 509). Diet was assessed using a self-reported interview questionnaire administered during the second trimester. Participants were asked on average how many times a day, week, or month they ate 11 different foods since becoming pregnant. Responses were categorized as at least once a week or less than once a week and foods were grouped into three categories: processed foods, dairy products, and meats. Twelve PFAS (ng/mL) were measured in second trimester serum samples. We investigated relationships between consumption of individual dairy products, meats, and processed foods and natural log-transformed PFAS using separate linear regression models adjusted for maternal age, education, race/ethnicity, and nativity. Results Seven PFAS were detected in ≥65% of participants. Consumption of dairy milk and cheese at least once per week was moderately associated with elevated levels of perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDeA) relative to those who ate dairy products less than once week. The strongest associations observed were with PFDeA for dairy milk (β = 0.2, 95% confidence interval [CI] = 0.02, 0.39) and PFNA for cheese (β = 0.22, 95% CI = 0.02, 0.41). Eating fish, poultry, and red meat at least once per week was associated with higher levels of perfluoroundecanoic acid, PFDeA, PFNA, and perflucorooctane sulfonic acid. Conclusions Results indicate that consumption of animal products may contribute to elevated prenatal PFAS levels.

Background: Studies in male firefighters have demonstrated increased exposures to carcinogenic compounds and increased rates of certain cancers compared to the general population. Many chemicals related to these occupational exposures have been associated with breast tumor development in animal and human studies, yet, there have been no studies on women firefighters due to their low numbers in most fire departments. To address this data gap, the Women Firefighters Biomonitoring Collaborative (WFBC) created a biological sample archive and analyzed levels of perfluoroalkyl substances (PFAS) among women firefighters and office workers in San Francisco. Methods: Active duty women firefighters (n=86) and office workers (n=84) were recruited from the San Francisco Fire Department and the City and County of San Francisco, respectively. Serum samples were collected and analyzed using liquid chromatography tandem mass spectrometry (LC MS/MS) to measure and compare PFAS levels between firefighters and office workers. For PFAS congeners detected in at least 70% of our study population, we examined differences in serum PFAS levels controlling for dietary, demographic and other confounders. Among firefighters, we assessed associations between occupational activities and PFAS levels. Results: Eight of 12 PFAS congeners were detected at levels above the limit of detection and seven were detected in at least 70% of the study population. Four PFAS were detected in all study participants (PFNA, PFOA, PFOS, PFHxS). In regression models comparing PFAS levels by occupation and adjusting for potential confounders, firefighters had higher geometric mean (GM) concentrations of PFAS compared to office workers: 2.39 (95%CI = 1.64,3.48), 2.32 (95% CI = 1.17,4.62) and 1.26 (95% CI = 0.99, 1.59) times higher for PFHxS, PFUnDA and PFNA, respectively. In analyses limited to firefighters, PFAS levels varied by assigned position in the fire department. Firefighters and officers had higher PFNA, PFOA, PFDA, and PFUnDA compared to drivers. Additionally, firefighters who reported having used firefighting foam had higher concentrations of PFOA compared firefighters who reported never having used foam. Conclusion: Our study found ubiquitous exposures to PFAS among WFBC participants, with women firefighters exposed to higher levels of some PFAS compared to office workers, suggesting that some of these exposures may be occupationally related.

Occupational exposures to flame retardants (FRs), a class of suspected endocrine-disrupting compounds, are of health concern for firefighters. We sought to characterize exposure to FR compounds and evaluate their association with thyroid hormone levels, a biomarker of early effect, in female firefighters and office workers in San Francisco. In a cross-sectional study, we measured replacement organophosphate and organohalogen FRs in spot urine samples from firefighters ( N = 86) and office workers ( N = 84), as well as total thyroxine (T 4 ) and thyroid-stimulating hormone in plasma for 84 firefighters and 81 office workers. Median bis(1,3-dichloro-2-propyl)phosphate (BDCPP) levels were 5 times higher in firefighters than office workers. Among firefighters, a doubling of BDCPP was associated with a 2.88% decrease (95% confidence interval −5.28, −0.42) in T 4 . We did not observe significant associations between FRs and T 4 among office workers. In the full group, intermediate body mass index and a college education were associated with higher FR levels. The inverse association observed between FRs and T 4 coupled with the lack of studies on women workers and evidence of adverse health effects from FR exposure—including endocrine disruption and breast cancer risk—warrant further research on occupational exposures and identification of opportunities for exposure reduction.

Background: Occupational exposures to flame retardants (FR), which are suspected endocrine disrupting compounds, may be of particular concern for firefighters as they are commonly found in consumer products and have been detected in fire station dust and firefighter gear. Objectives: The Women Workers Biomonitoring Collaborative is a community based participatory research study that sought to measure environmental chemicals relevant to firefighting and evaluate their effects on thyroid hormone levels. Methods: We measured 10 FR or their metabolites in urine of female firefighters and office workers from San Francisco: bis(1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCEP), dibutyl phosphate (DBuP), dibenzyl phosphate (DBzP), di-p-cresyl phosphate (DpCP), di-o-cresyl phosphate (DoCP), 2,3,4,5-tetrabromobenzoic acid (TBBA), tetrabromobisphenol-A (TBBPA), 5-OH-BDE 47, and 5-OH-BDE 100. We assessed potential predictors of exposure levels and the association between FR exposures and thyroxine (T4) and thyroid stimulating hormone (TSH). Results: BDCPP, BCEP, and DBuP were the most commonly detected FRs, among all study participants, with intermediate BMI and college educated women having the highest levels, and Black women having higher BDCPP levels than White women. Firefighters had higher detection frequencies (DF) and exposure levels compared to office workers; median BDCPP levels were five times higher in firefighters than in office workers. Among firefighters, occupational activities were not significantly associated with FR levels, although position (i.e. officer and firefighter versus driver), being on-duty (versus off-duty) and assigned to the airport suggested a positive association with FR levels. Among firefighters, a doubling of BDCPP was associated with a 2.88% decrease (95%CI -5.28,-0.42) in T4. We did not observe significant associations between FR and T4 among office workers. Discussion: Firefighters had significantly higher exposures to FR compared to office workers, and we observed a negative association between BDCPP and thyroxine in firefighters. Future research should elucidate occupational sources of FR exposure and opportunities for exposure reduction.