Junenette Peters, ScD Boston University School of Public Health April 23, 2013

Transcription

1 Junenette Peters, ScD Boston University School of Public Health April 23, 2013

2 Immune dysregulation at birth suggest influence of prenatal exposures on neonatal immune response (Martino & Prescott, 2011) Suggested pathways: Direct exposure of the fetus to antigens that cross the placental barrier (Martino & Prescott, 2011; Peters et al. 2009) Maternal response to exposure influencing in- utero environment (Folsgaard et al. 2002) Fetal programming may occur through Imprinting of the infant gut microbiota Epigenetic regulation of immune function (Kozyrskyj et al. 2011; Azad & Kozyrskyj 2012; Martino & Prescott, 2011; Prescott & Saffery 2011)

3 Pinpointing the critical window of exposure Exposures tend to continue postnatally Co- occurring environmental and societal exposure Lifestyle risk factors (e.g. limited prenatal care) combined with smoking Complex interactions between genetics, development, social factors, and environmental exposure Sex Parental atopic status

4 Allergens exposure Timing/Type Maternal and environmental tobacco smoke Variation in associations Interactions Intrauterine growth (Havstad et al.2012) Maternal atopic status + allergen sensitization (Bjerg et al. 2011; Murin et al. 2011) Traffic- related air pollution Evidence of relation to respiratory disease Importance of cumulative exposure versus solely prenatal exposure (Patel et al. 2011)

5 Lead Association with increased risk of sensitization to common allergens (Jedrychowski et al. 2011) Mercury Related to immune response but not allergic phenotype (Nyland et al. 2011; Jedrychowski et al. 2011)

6 Authors Outcome Type Findings Jusko et al., 2011 Grandjean et al Reichrtova et al Miyashita et al Glynn et al Total immunoglobulin at age 6 months PCB No association IgE PCB No association IgE in infancy and childhood Allergic outcomes Immune modulation PCB Dioxin- like compounds PCBs p,p'- DDE Association Weak association Variable association

7 Used to make hard, clear plastic Reusable water bottles Found in epoxy resins Protective lining on the inside of metal- based food and beverage cans. Source: bpa/

8 Human study Associated with increased odds of wheeze at 6 months of age, Did not persist to age 3 (Spanier et al 2012) Animal studies Showed an asthma phenotype with in utero exposure only (Nakajima et al., 2012) Subtle and qualitatively different effects on allergic inflammation (Bauer et al., 2012) Differed by sensitization route and sex Did not persist into adulthood

9 Perfluoroalkyl acids, their salts and telomer alcohols have wide consumer application Protective coatings for fabrics and carpets stain resistant Keeping food from sticking to cookware Food packaging Firefighting materials Most studied: perfluorooctane sulfonate (PFOS) perfluorohexanesulfonate (PFHxS) and perfluorocarboxylate perfluorooctanoate (PFOA) Found in low levels in environment and human blood. Extremely persistent and bioaccumulative

10 Authors Outcome Type Findings Granum et al Okada et al Wang et al Allergy/asthma- related health outcomes Cord blood IgE Allergic symptoms (eczema, wheeze) Cord blood IgE Atopic Dermatitis Any PFC PFOA PFOA PFOS PFOA PFOS Any PFC No association Girls inverse relationship Boys - No association No association Associations, particularly in boys No association

11 Used to make plastics more flexible and harder to break Some used as solvents Used in hundreds of products Vinyl flooring Adhesives Detergents Personal- care products (soaps, shampoos, hair sprays, and nail polishes) Source: NIEHS

12 Monobenzyl phthalate (MBzP) (Just et al. 2012) No association with allergic sensitization or total IgE Associated with early- onset eczema in the children Source: Hauser et al. 2006, Epidemiology 17:

13 invisible areas of energy characterized by wavelength or frequency Source: WHO, emf/about/en/ Non- ionizing: low- level radiation - generally perceived as harmless to humans Microwave Cellphones, Bluetooth Ionizing: high- level radiation - has the potential for cellular and DNA damage X- ray

14 Dose response relationship between maternal magnetic field exposure and risk of asthma (Li et al. 2011) Concern expressed over unaccounted confounders E.g. correlation between magnetic field and air pollution

15 Chemical Metals Organochlorine Compounds Bisphenol A Perfluorinated Compounds Phthalates Magnetic field Strength of Association Possibly with asthma phenotype Not classifiable because of inadequate evidence Possibly with asthma phenotype Not classifiable because of inadequate evidence Not classifiable because of inadequate evidence Not classifiable because of inadequate evidence