A framework for assessing the impact of chemical exposures on neurodevelopment in ECHO: Opportunities and challenges

Schantz, Susan L.; Eskenazi, Brenda; Buckley, Jessie P.; Braun, Joseph M.; Sprowles, Jenna N.; Bennett, Deborah H.; Cordero, José F.; Frazier, Jean A.; Lewis, Johnnye; Hertz‐Picciotto, Irva; Lyall, Kristen; Nozadi, Sara S.; Sagiv, Sharon K.; Stroustrup, Anne Marie; Volk, Heather E.; Watkins, Deborah J.

doi:10.1016/j.envres.2020.109709

Cited by 18 publications

(11 citation statements)

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“…Interestingly, prenatal Hg was also associated with poorer performance in same domains of cognitive function, including both perceptual reasoning and verbal comprehension in Faroese children [ 14 ] as in Inuit children from Northern Canada where both cohorts were exposed through maternal consumption of contaminated fish and mammals [ 19 ]. Similar domains have also been shown to be vulnerable to other neurotoxicants (Reviewed in [ 35 ] and these specific domains of cognitive function might be more sensitive to neurotoxic chemicals. Similar to other investigations, the observed effect sizes in this study are relatively modest and subtle.…”

Section: Discussionmentioning

confidence: 99%

Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother–child cohort in Guadeloupe

et al. 2023

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Background Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, resulting in a widespread contamination. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affects visual and fine motor developments during infancy and childhood, with greater susceptibility in boys. Objective To assess the associations between pre- and postnatal exposures to chlordecone and cognitive and behavioral functions in school-aged children from Guadeloupe. Methods We examined 576 children from the TIMOUN mother–child cohort in Guadeloupe at 7 years of age. Concentrations of chlordecone and other environmental contaminants were measured in cord- and children’s blood at age 7 years. Cognitive abilities of children were assessed with the Wechsler Intelligence Scale for Children-IV (WISC-IV), and externalizing and internalizing problem behaviors documented with the Strengths and Difficulties Questionnaire (SDQ) completed by the child’s mother. We estimated covariate-adjusted associations between cord- and 7-years chlordecone concentrations and child outcomes using structural equations modeling, and tested effect modification by sex. Results Geometric means of blood chlordecone concentrations were 0.13 µg/L in cord blood and 0.06 µg/L in children’s blood at age 7 years. A twofold increase in cord blood concentrations was associated with 0.05 standard deviation (SD) (95% Confidence Interval [CI]: 0.0, 0.10) higher internalizing problem scores, whereas 7-years chlordecone concentrations were associated with lower Full-Scale IQ scores (FSIQ) and greater externalized behavioral problem scores. A twofold increase in 7-year chlordecone concentrations was associated with a decrease of 0.67 point (95% CI: -1.13, -0.22) on FSIQ and an increase of 0.04 SD (95% CI: 0.0, 0.07) on externalizing problems. These associations with Cognitive abilities were driven by decreases in perceptive reasoning, working memory and verbal comprehension. Associations between 7-year exposure and perceptive reasoning, working memory, and the FSIQ were stronger in boys, whereas cord blood and child blood associations with internalizing problems were stronger in girls. Conclusions These results suggests that cognitive abilities and externalizing behavior problems at school age are impaired by childhood, but not in utero, exposure to chlordecone, and that prenatal exposure is related to greater internalizing behavioral problems.

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Section: Discussionmentioning

confidence: 99%

Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother–child cohort in Guadeloupe

et al. 2023

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“… 56 Examining mental health consequences of early-life exposure to environmental chemicals is an area where further research is warranted as existing prospective birth cohorts age into adolescence and early adulthood. 57 …”

Section: Discussionmentioning

confidence: 99%

Prenatal and Childhood Exposure to Organophosphate Pesticides and Behavior Problems in Adolescents and Young Adults in the CHAMACOS Study

Sagiv¹,

Mora²,

Kogut³

et al. 2023

Environ Health Perspect

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Background: We previously reported associations of prenatal exposure to organophosphate (OP) pesticides with poorer neurodevelopment in early childhood and at school age, including poorer cognitive function and more behavioral problems, in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a birth cohort study in an agriculture community. Objective: We investigated the extent to which early-life exposure to OP pesticides is associated with behavioral problems, including mental health, in youth during adolescence and early adulthood. Methods: We measured urinary dialkylphosphates (DAPs), nonspecific OP metabolites, in urine samples collected from mothers twice during pregnancy (13 and 26 wk) and at five different times in their children (ages 6 months to 5 y). We assessed maternal report and youth report of externalizing and internalizing behavior problems using the Behavior Assessment System for Children, 2nd edition (BASC-2), when the youth were ages 14, 16, and 18 y. Because there was evidence of nonlinearity, we estimated associations across quartiles of DAPs and modeled repeated outcome measures using generalized estimating equations. Results: There were 335 youths with prenatal maternal DAP measures and 14-. 16-, or 18-y BASC-2 scores. Prenatal maternal DAP concentrations (specific gravity–adjusted median, , ) were associated with higher T-scores (more behavior problems) from maternal report, including more hyperactivity [fourth vs. first quartile of exposure ; 95% confidence interval (CI): 0.18, 4.45], aggression ( ; 95% CI: 0.15, 3.66), attention problems ( ; 95% CI: 0.26, 5.30), and depression ( ; 95% CI: 0.08, 5.24). Associations with youth report of externalizing problems were null, and associations with depression were suggestive (fourth vs. first quartile of exposure ; 95% CI: , 4.67). Childhood DAP metabolites were not associated with behavioral problems. Discussion: We found associations of prenatal, but not childhood, urinary DAP concentrations with adolescent/young adult externalizing and internalizing behavior problems. These findings are consistent with prior associations we have reported with neurodevelopmental outcomes measured earlier in childhood in CHAMACOS participants and suggests that prenatal exposure to OP pesticides may have lasting effects on the behavioral health of youth as they mature into adulthood, including their mental health. https://doi.org/10.1289/EHP11380

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“…However, increasing numbers of cohort studies are accounting for a more extensive number of environmental exposures with a holistic view of the exposome, e.g., the totality of exposures an individual experiences, from prior to birth throughout the lifespan [ 29 , 30 ]. More modern approaches have also highlighted important challenges in the evaluation of exposures in human populations including the understanding and evaluation of how chemicals act in mixtures [ 11 , 31 – 33 ]; an appreciation that people may be more sensitive to environmental perturbations during certain periods of life, but exposures may not be evaluated during these susceptible periods [ 34 , 35 ]; differences in physiochemical properties that impact whether single or multiple biological samples are needed to properly characterize exposures (e.g., exposures to persistent chemicals can often be well characterized with single measurements whereas non-persistent chemicals may need multiple samples to fully characterize exposures); and also whether internal or excreted measurements are more appropriate [ 36 ].…”

Section: The Role For Exposure Assessment In Scientific Inquiry Risk ...mentioning

confidence: 99%

Addressing systemic problems with exposure assessments to protect the public’s health

et al. 2023

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Background Understanding, characterizing, and quantifying human exposures to environmental chemicals is critical to protect public health. Exposure assessments are key to determining risks to the general population and for specific subpopulations given that exposures differ between groups. Exposure data are also important for understanding where interventions, including public policies, should be targeted and the extent to which interventions have been successful. In this review, we aim to show how inadequacies in exposure assessments conducted by polluting industries or regulatory agencies have led to downplaying or disregarding exposure concerns raised by communities; that underestimates of exposure can lead regulatory agencies to conclude that unacceptable risks are, instead, acceptable, allowing pollutants to go unregulated; and that researchers, risk assessors, and policy makers need to better understand the issues that have affected exposure assessments and how appropriate use of exposure data can contribute to health-protective decisions. Methods We describe current approaches used by regulatory agencies to estimate human exposures to environmental chemicals, including approaches to address limitations in exposure data. We then illustrate how some exposure assessments have been used to reach flawed conclusions about environmental chemicals and make recommendations for improvements. Results Exposure data are important for communities, public health advocates, scientists, policy makers, and other groups to understand the extent of environmental exposures in diverse populations. We identify four areas where exposure assessments need to be improved due to systemic sources of error or uncertainty in exposure assessments and illustrate these areas with examples. These include: (1) an inability of regulatory agencies to keep pace with the increasing number of chemicals registered for use or assess their exposures, as well as complications added by use of ‘confidential business information’ which reduce available exposure data; (2) the failure to keep assessments up-to-date; (3) how inadequate assumptions about human behaviors and co-exposures contribute to underestimates of exposure; and (4) that insufficient models of toxicokinetics similarly affect exposure estimates. Conclusion We identified key issues that impact capacity to conduct scientifically robust exposure assessments. These issues must be addressed with scientific or policy approaches to improve estimates of exposure and protect public health.

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A framework for assessing the impact of chemical exposures on neurodevelopment in ECHO: Opportunities and challenges

Cited by 18 publications

References 293 publications

Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother–child cohort in Guadeloupe

Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother–child cohort in Guadeloupe

Prenatal and Childhood Exposure to Organophosphate Pesticides and Behavior Problems in Adolescents and Young Adults in the CHAMACOS Study

Addressing systemic problems with exposure assessments to protect the public’s health

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