Children's Environmental Health Research Articles

Combined and sequential exposure to prenatal second hand smoke and postnatal maternal distress is associated with cingulo-opercular global efficiency and attention problems in school-age children

BackgroundPrenatal exposure to secondhand (environmental) tobacco smoke (SHS) is associated with adverse neurodevelopmental outcomes, including altered functional activation of cognitive control brain circuitry and increased attention problems in children. Exposure to SHS is more common among Black youth who are also disproportionately exposed to socioeconomic disadvantage and concomitant maternal distress. We examine the combined effects of exposure to prenatal SHS and postnatal maternal distress on the global efficiency (GE) of the brain's cingulo-opercular (CO) and fronto-parietal control (FP) networks in childhood, as well as associated attention problems. MethodsThirty-two children of non-smoking mothers followed in a prospective longitudinal birth cohort at the Columbia Center for Children's Environmental Health (CCCEH) completed magnetic resonance imaging (MRI) at ages 7–9 years old. GE scores were extracted from general connectivity data collected while children completed the Simon Spatial Incompatibility functional magnetic resonance imaging (fMRI) task. Prenatal SHS was measured using maternal urinary cotinine from the third trimester; postnatal maternal distress was assessed at child age 5 using the Psychiatric Epidemiology Research Interview (PERI-D). The Child Behavior Checklist (CBCL) measured Attention and Attention Deficit Hyperactivity Disorder (ADHD) problems at ages 7–9. Linear regressions examined the interaction between prenatal SHS and postnatal maternal distress on the GE of the CO or FP networks, as well as associations between exposure-related network alterations and attention problems. All models controlled for age, sex, maternal education at prenatal visit, race/ethnicity, global brain correlation, and mean head motion. ResultsThe prenatal SHS by postnatal maternal distress interaction term associated with the GE of the CO network (β = 0.673, Bu = 0.042, t(22) = 2.427, p = .024, D = 1.42, 95% CI [0.006, 0.079], but not the FP network (β = 0.138, Bu = 0.006, t(22) = 0.434, p = .668, 95% CI [−0.022, 0.033]). Higher GE of the CO network was associated with more attention problems (β = 0.472, Bu = 43.076, t(23) = 2.780, p = .011, D = 1.74, n = 31, 95% CI [11.024, 75.128], n = 31) and ADHD risk (β = 0.436, Bu = 21.961, t(29) = 2.567, p = .018, D = 1.81, 95% CI [4.219, 39.703], n = 30). ConclusionsThese preliminary findings suggest that sequential prenatal SHS exposure and postnatal maternal distress could alter the efficiency of the CO network and increase risk for downstream attention problems and ADHD. These findings are consistent with prior studies showing that prenatal SHS exposure is associated with altered function of brain regions that support cognitive control and with ADHD problems. Our model also identifies postnatal maternal distress as a significant moderator of this association. These data highlight the combined neurotoxic effects of exposure to prenatal SHS and postnatal maternal distress. Critically, such exposures are disproportionately distributed among youth from minoritized groups, pointing to potential pathways to known mental health disparities.

Indoor Temperature and Energy Insecurity: Implications for Prenatal Health Disparities in Extreme Heat Events.

Extreme heat events are a major public health concern and are only expected to increase in intensity and severity as climate change continues to accelerate. Pregnant people are physiologically more vulnerable to the effects of extreme heat, and exposure can induce harm on both the pregnant person and the fetus. This commentary argues that there is a need for greater epidemiological research on indoor heat exposure and energy insecurity as potential drivers of maternal and child environmental health disparities. While there is substantial evidence linking ambient (outdoor) high temperature to pregnancy-related outcomes, there is a lack of epidemiological evidence to date on pregnant people's exposure to high indoor temperature and adverse maternal and/or child health outcomes. Energy insecurity is disproportionately experienced by people with low incomes and/or people of color, and indoor temperature may play a role in shaping socioeconomic and racial/ethnic disparities in maternal and child health in the United States. Further research is needed to understand the relationship between indoor heat exposure, energy insecurity, and pregnancy outcomes in both parents and children and to inform potential policies and practices to enhance resilience and reduce maternal/child health disparities. https://doi.org/10.1289/EHP13706.

Ambient particulate matter and surrounding greenness in relation to sleep quality among pregnant women: A nationwide cohort study

BackgroundParticulate air pollution and residential greenness are associated with sleep quality in the general population; however, their influence on maternal sleep quality during pregnancy has not been assessed. ObjectiveThis cross-sectional study investigated the individual and interactive effects of exposure to particulate matter (PM) air pollution and residential greenness on sleep quality in pregnant women. MethodsPregnant women (n = 4933) enrolled in the Korean Children's Environmental Health Study with sleep quality information and residential address were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The average concentrations of PM (PM2.5 and PM10) during pregnancy were estimated through land use regression, and residential greenness in a 1000 m buffer area around participants' residences was estimated using the Normalized Difference Vegetation Index (NDVI1000-m). Modified Poisson regression models were used to estimate the associations between PM and NDVI and poor sleep quality (PSQI >5) after controlling for a range of covariates. A four-way mediation analysis was conducted to examine the mediating effects of PM. ResultsAfter adjusting for confounders, each 10 μg/m3 increase in PM2.5 and PM10 exposure was associated with a higher risk of poor sleep quality (relative risk [RR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11; and RR: 1.09; 95% CI: 1.06, 1.13, respectively), and each 0.1-unit increase in NDVI1000-m was associated with a lower risk of poor sleep quality (RR: 0.97; 95% CI: 0.95, 0.99). Mediation analysis showed that PM mediated approximately 37%–56% of the association between residential greenness and poor sleep quality. ConclusionsThis study identified a positive association between residential greenness and sleep quality. Furthermore, these associations are mediated by a reduction in exposure to particulate air pollution and highlight the link between green areas, air pollution control, and human health.

Cohort Profile: The Mothers and Newborns (MN) Cohort of the Columbia Center for Children's Environmental Health.

Cohort Profile: The Mothers and Newborns (MN) Cohort of the Columbia Center for Children's Environmental Health.

Associations of Night Shift Status During Pregnancy With Small for Gestational Age and Preterm Births.

Shift work, including night shift work, during pregnancy has been associated with adverse birth outcomes such as small for gestational age (SGA) infants and preterm births. This study, conducted in South Korea using the Korean CHildren's ENvironmental health Study (Ko-CHENS) cohort, aimed to investigate the association between shift work and night shift status during pregnancy and adverse birth outcomes. The Korean Ko-CHENS is a nationwide prospective birth cohort study of children's environmental diseases, conducted by the Ministry of Environment and the National Institute of Environmental Research. This study included pregnant women recruited from 2015 to 2020 for Ko-CHENS Core Cohorts, and 4,944 out of a total of 5,213 pregnant women were selected as final subjects. A logistic regression model was used to identify the risk factors affecting SGA births, preterm births, and low-birth-weight infants, and the odds ratio (OR) was adjusted. This was confirmed by calculating ORs. Maternal age, infant sex, maternal educational status, body mass index, smoking status, alcohol consumption status, parity, gestational diabetes mellitus, preeclampsia, and abortion history were used as adjusted variables. No statistically significant differences were observed in the birth outcomes or maternal working patterns. There were no significant differences in the adjusted odds ratios (aORs) of SGA and preterm births between the non-worker, day worker, and shift worker. However, there was a significant difference in the aORs of SGA between non-workers and night shift workers. (aORs [95% confidence interval], 2.643 [1.193-5.859]). Working during pregnancy did not increase the risk of SGA or preterm birth, and night shift work did not increase the risk of preterm birth. However, night-shift work increases the risk of SGA.

Association of postnatal exposure to mixture of bisphenol A, Di-n-butyl phthalate and Di-(2-ethylhexyl) phthalate with Children's IQ at 5 Years of age: Mothers and Children's environmental health (MOCEH) study

Early childhood is important for neurodevelopment, and exposure to endocrine disruptors such as bisphenol A (BPA) and phthalates in this period may cause neurodevelopmental disorders and delays. The present study examined the association between exposure to mixtures of BPA and three metabolites of phthalates in early childhood and IQ at 5 years of age. The Mother and Children's Environmental Health (MOCEH) study is a prospective birth cohort study conducted in Korea with 1751 pregnant women enrolled from 2006 to 2010. After excluding those without relevant data, 47 children were included in the final analysis. We measured children's urinary concentrations of metabolites of endocrine-disrupting chemicals (Bisphenol A, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-butyl) phthalate) at ages of 24 and 36 months. We evaluated the children's IQ with the Korean Wechsler Intelligence Test at the age of 5 years. After adjusting for potential confounders, a multiple linear regression was conducted to examine the associations between individual endocrine-disrupting chemicals and the IQ of the children. Weighted Quantile Sum (WQS) regression and quantile-based g-computation were used to assess the association between IQ at age 5 and exposure to mixtures of BPA and phthalates. In the single-chemical analyses, mono-(2-ethyl-5-butyl) phthalate exposure at 36 months was adversely associated with children's IQ (β = −4.93, 95% confidence interval (CI): -9.22, −0.64). In the WQS regression and quantile-based g-computation analyses, exposure to the mixture of BPA and phthalates was associated with lower IQ [β = −9.13 (P-value = 0.05) and β = −9.18 (P-value = 0.05), respectively]. The largest contributor to the overall association was exposure to mono-(2-ethyl-5-butyl) phthalate at 36 months. In the present study, postnatal exposure to mixtures of BPA and three metabolites of phthalates was associated with decreased IQ of children at age 5.

5 Translating developmental neurotoxicity for the public: A large, international, randomized-control trial investigating children's environmental health literacy

Objective:Exposure to toxic chemicals during early brain development increases the risk of neurodevelopmental problems in children. Parents' and prospective parents' understanding of the impact of toxic chemicals on brain development and the efficacy of translation tools for children's environmental health literacy are poorly understood. We developed and validated a questionnaire, PRevention of Toxic chemicals in the Environment for Children Tool (PRoTECT) to assess knowledge of toxic chemicals and neurodevelopment, intentions to reduce exposures to toxic chemicals, and preferences for actions by government and industry to prevent neurodevelopmental disorders. Using PRoTECT, we surveyed people of child-bearing age across five countries (Canada, United States (US), United Kingdom (UK), India, and Australia) to identify general patterns of responses on this questionnaire by demographic characteristics, including country, age, gender, parental status, pregnancy status, and education. We also employed a randomized control design to examine the efficacy of a knowledge translation video to instill knowledge and prompt behavioral changes to reduce exposures to toxic chemicals immediately following its presentation and after a six-week follow-up period.Participants and Methods:We recruited 15,594 participants, ages 18 to 45, via CloudResearch's Prime Panels between October-December 2021. After completing the PRoTECT survey, participants were randomly assigned to watch the video Little Things Matter: Impact of Toxic Chemicals on Brain Development (i.e., the experimental group) or to serve as the control group. Next, both groups answered a series of questions to assess their knowledge of toxic chemicals, their intentions to reduce exposures to toxic chemicals, and barriers to changing their behaviours. After six-weeks, we recontacted a subset (N=4,842) of participants to repeat PRoTECT and answer the same series of behavioural questions assessing whether they modified any of their behaviours to reduce exposure and why or why not.Results:Most participants (i.e., 75-85%) agreed that toxic chemicals can impact brain development and endorsed preferences (∼85%) for allocating more resources to prevent neurodevelopmental disorders, especially people with higher education, parents and pregnant women, and people who lived in India. Despite this, a large proportion of participants (∼50%) trusted industry and believed that government effectively regulated toxic chemicals. After the six-week follow-up, experimental participants showed greater changes in scores on PRoTECT (i.e., between 5-15% change), indicating greater knowledge about harms posed by toxic chemicals, more intentions to reduce exposure, and stronger preferences for prevention as compared to the control group. Differences were larger among people from the US, those who were more highly educated, and people in their thirties. However, the differences between groups in making behavioural changes to reduce exposures were attenuated at the six-week follow up as compared to baseline. Significant barriers to reduce exposure to toxic chemicals were reported by both groups and included cost, inconvenience, and not knowing how to determine whether a product is non-toxic or where to purchase non-toxic products.Conclusions:We observed greater knowledge and concerns about toxic chemicals among more affluent respondents, pregnant women and parents, and people living in India across both groups. While the video enhanced participants' knowledge about toxic chemicals and intentions to reduce exposure, they indicated that barriers hindered them from making behavioral changes.

Symposium 15: Impact of Environmental Contaminants on Child Neurodevelopment

Summary Abstract:Children are exposed to toxic chemicals throughout development and the long-term consequences of this exposure can be profound. Despite decades of research documenting the vulnerability of the developing brain to environmental contaminants, there has been little progress in protecting against developmental neurotoxicity. This symposium will discuss recent research in developmental neurotoxicology using a "developmental origins of health and disease" (DOHaD) framework that examines the context in which environmental contaminants exert their effects. We will examine the timescale for developmental toxicity, windows of vulnerability, and the bases of individual differences in vulnerability, including sex-specific effects of chemical exposures. This symposium will feature new pregnancy and birth cohort studies that have implicated fluoride as a developmental neurotoxin and endocrine disruptor. In addition, we will discuss emerging issues in epidemiology, including how environmental contaminants may interact with non-chemical stressors and have lifelong impacts on cognition and behaviours. This symposium will be capped with a discussion of the public's knowledge, attitudes, and behaviours related to developmental toxicity and strategies to reduce exposure. All speakers will be asked to draw conclusions on research priorities, and discuss how to balance regulators' need for "ideal evidence" with a public health strategy that aims to protect the public from critical environmental hazards. The symposium will consist of the following five presentations, each 12 minutes in length, followed by a 15 minute discussion.1. John Krzeckowski, PhD, York University, Toronto, Canada.TITLE: Applying a Dimensional Framework to the Study of Developmental Neurotoxicity2. Carly Goodman, PhD candidate, York University, Toronto, CanadaTITLE: Sex difference of Developmental Neurotoxicants on Intellectual abilities: A systematic review and meta-analysis3. Meaghan Hall, PhD candidate, York University, Toronto, Canada.TITLE: Fluoride Exposure and Hypothyroidism in Pregnant Women: A Potential Mechanism of Fluoride Neurotoxicity4. Ashley Malin, PhD, University of Florida,Florida, USA.TITLE: Urinary Fluoride Levels and Metal Co-Exposures among Pregnant Women in Los Angeles, California5. Rivka Green, PhD, The Hospital for Sick Children, Toronto, Canada.TITLE: Translating developmental neurotoxicity for the public: A large, multi-country, randomized-control trial investigating children's environmental health literacy

Associations between mitochondrial biomarkers, urban residential exposures and childhood asthma outcomes over 6 months

Determining biomarkers of responses to environmental exposures and evaluating whether they predict respiratory outcomes may help optimize environmental and medical approaches to childhood asthma. Relative mitochondrial (mt) DNA abundance and other potential mitochondrial indicators of oxidative stress may provide a sensitive metric of the child's shifting molecular responses to its changing environment. We leveraged two urban childhood cohorts (Environmental Control as Add-on Therapy in Childhood Asthma (ECATCh); Columbia Center for Children's Environmental Health (CCCEH)) to ascertain whether biomarkers in buccal mtDNA associate with airway inflammation and altered lung function over 6 months of time and capture biologic responses to multiple external stressors such as indoor allergens and fine particulate matter (PM2.5). Relative mtDNA content was amplified by qPCR and methylation of transfer RNA phenylalanine/rRNA 12S (TF/RNR1), cytochrome c oxidase (CO1), and carboxypeptidase O (CPO) was measured by pyrosequencing. Data on residential exposures and respiratory outcomes were harmonized between the two cohorts. Repeated measures and multiple regression models were utilized to assess relationships between mitochondrial biomarkers, respiratory outcomes, and residential exposures (PM2.5, allergens), adjusted for potential confounders and time-varying asthma. We found across the 6 month visits, a 0.64 fold higher level of TF/RNR1 methylation was detected among those with asthma in comparison to those without asthma ((parameter estimate (PE) 0.64, standard error 0.28, p = 0.03). In prospective analyses, CPO methylation was associated with subsequent reduced forced vital capacity (FVC; PE -0.03, standard error 0.01, p = 0.02). Bedroom dust mouse allergen, but not indoor PM2.5, was associated with higher methylation of TF/RNR1 (PE 0.015, standard error 0.006, p = 0.01). Select mtDNA measures in buccal cells may indicate children's responses to toxic environmental exposures and associate selectively with asthma and lung function.

Prediction of Low Birth Weight Using Machine Learning on Environmental and Maternal Risk Factors: Korean CHildren's ENvironmental health Study

Prediction of Low Birth Weight Using Machine Learning on Environmental and Maternal Risk Factors: Korean CHildren's ENvironmental health Study

Big CHildren's ENvironmental health Study (Big-CHENS): a Nationwide Population-Based Birth Cohort Study

Big CHildren's ENvironmental health Study (Big-CHENS): a Nationwide Population-Based Birth Cohort Study

Protecting Children's Environmental Health in a Changing Climate: A Model Collaboration of the Maternal and Child Health Section and the Environment Section of APHA.

The complexities of modern civilization, coupled with challenges including systemic racism and climate change-related impacts, compel public health professionals to break down silos and collaborate towards the shared goals of protecting the wellbeing of current and future generations. This article highlights the growing collaboration between the Maternal and Child Health (MCH) and the Environment (ENV) Sections of the American Public Health Association (APHA) as members bring their collective focus to the protection of children's and pregnant people's environmental health. The MCH Section and the Children's Environmental Health (CEH) Committee of the ENV Section are collaborating on efforts to: inform key stakeholders?including public health and health care professionals, child care professionals, families, and youth?about environmental hazards and climate change impacts to children's and pregnant people's health and wellbeing; and provide tools and guidance about how to best protect these groups and how to advocate for climate action. The CEH Committee embraces a health equity paradigm and intentionally centers environmental, racial, and social justice as integral to effective children's health and climate change initiatives. Projects to date include multiple joint sessions about children's environmental health and climate change at APHA's annual meetings, publications and various children's environmental health tools and resources, including a toolkit and lesson plan that equips public health professionals to provide guest lectures at their local high schools on climate change and health, and educational materials for caregivers on extreme heat, wildfires, and ticks and mosquitos. This collaboration could serve as a replicable model that can be applied to other interdisciplinary efforts seeking strategic partnerships to address complex health issues.

Prenatal exposure to polybrominated diphenyl ethers and inattention/hyperactivity symptoms in mid to late adolescents.

Prenatal exposure to polybrominated diphenyl ethers (PBDEs) has been associated with increased symptoms of attention deficit/hyperactivity disorder (ADHD) in early to middle childhood, as well as early adolescence. However, data are limited for the long-lasting impact of exposure on outcomes assessed across the entire adolescent period and the sex-specificity of such associations. We investigated the association between continuous natural-log-transformed cord plasma PBDE concentrations and ADHD rating scale 4th edition (ADHD-RS-IV) score from mid adolescence (approximately 11 years old) to late adolescence (approximately 17 years old). The study sample includes a subset (n = 219) of the African American and Dominican children enrolled in the Columbia Center for Children's Environmental Health Mothers and Newborns birth cohort. We used generalized estimating equations to account for the repeated measure of ADHD-RS scores. We examined interactions between exposure to PBDE and sex using cross-product terms and sex-stratified models. In addition, we used linear regression using an age-stratified sample as a sensitivity analysis. Associations between prenatal exposure and parents' reports of ADHD symptoms varied by sex (p-interaction <0.20), with positive relationships observed among girls but not boys from sex-stratified models. Our finding suggests prenatal exposure to PBDE may affect ADHD symptoms assessed during middle to late adolescence and the sex-specificity of such impact. Our results can be confirmed by future studies with larger and more diverse samples.

Environmental health perceptions of urban youth from low-income communities: A qualitative photovoice study and framework.

Children are amongst the most susceptible groups to environmental exposures, for both immediate and life-course health outcomes. Despite their increased susceptibility, children's knowledge, experiencesand voices are understudied. A deeper understanding of children's environmental health perceptions has the potential to better inform policy, develop targeted interventionsand improve public health outcomes. In this study, our community-academic partnership used the Photovoice research method to examine how urban children from low-income communities perceive environmental influences on their health. Twenty children, ages 10-12, took photographs and participated in focus group interviews regarding their perspectives on how the environment influences their health. Qualitative analyses revealed five major thematic categories: environmental exposures, environmental health sentiments, environmental health outcomes, interest in environmental healthand environmental health solutions. We used the findings to develop an environmental health perspective theoretical framework that can inform future work designed to promote the environmental health and well-being of children from low-income communities in urban communities. Photovoice enabledchildren from low-income communities to capture and communicate their environmental health perceptions. These findings have the potential to inform and identify potential targets and opportunities for environmental health interventions and promotion in their communities. Partnerships with community-based organizations were central to the present study. By design, these community-based partners were involved in the conduct and procedures of the study.

Independent and combined associations of multiple-heavy-metal exposure with lung function: a population-based study in US children.

Previous research has found relationships between some single metals and lung function parameters. However, the role of simultaneous multi-metal exposure is poorly understood. The crucial period throughout childhood, when people are most susceptible to environmental dangers, has also been largely ignored. The study aimed to evaluate the joint and individual associations of 12 selected urinary metals with pediatric lung function measures using multi-pollutant approaches. A total of 1227 children aged 6-17years from the National Health and Nutrition Examination Survey database of the 2007-2012 cycles were used. The metal exposure indicators were 12 urine metals adjusted for urine creatinine, including arsenic (As), barium (Ba), cadmium (Cd), cesium (Cs), cobalt (Co), mercury (Hg), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), tungsten (Tu), and uranium (Ur). The outcomes of interest were lung function indices, including the 1st second of a forceful exhalation (FEV1), forced vital capacity (FVC), forced expiratory flow between 25 and 7% of vital capacity (FEF25-75%), and peak expiratory flow (PEF). Multivariate linear regression, quantile g-computation (QG-C), and Bayesian kernel machine regression models (BKMR) were adopted. A significantly negative overall effect of metal mixtures on FEV1 (β = - 161.70, 95% CI - 218.12, - 105.27; p < 0.001), FVC (β = - 182.69, 95% CI - 246.33, - 119.06; p < 0.001), FEF25-75% (β = - 178.86 (95% CI - 274.47, - 83.26; p < 0.001), and PEF (β = - 424.17, 95% CI - 556.55, - 291.80; p < 0.001) was observed. Pb had the largest negative contribution to the negative associations, with posterior inclusion probabilities (PIPs) of 1 for FEV1, FVC, and FEF25-75%, and 0.9966 for PEF. And Pb's relationship with lung function metrics showed to be nonlinear, with an approximate "L" shape. Potential interactions between Pb and Cd in lung function decline were observed. Ba was positively associated with lung function metrics. Metal mixtures were negatively associated with pediatric lung function. Pb might be a crucial element. Our findings highlight the need for prioritizing children's environmental health to protect them from later respiratory disorders and to guide future research into the toxic mechanisms of metal-mediated lung function injury in the pediatric population.

Associations between prenatal exposure to second hand smoke and infant self-regulation in a New York city longitudinal prospective birth cohort

BackgroundPrenatal exposure to active or passive maternal smoking –also referred to as second hand smoke (SHS) exposure – are associated with externalizing behaviors, hyperactivity and attention deficit hyperactivity disorder, problems which derive in part from altered self-regulation. ObjectivesDetermine the influence of prenatal SHS on infant self-regulation using direct measures of infant behavior in 99 mothers from the Fair Start birth cohort followed at the Columbia Center for Children's Environmental Health. MethodsSelf-regulation was operationalized with self-contingency, the likelihood of maintaining/changing behavior from second-to-second, measured via split-screen video recordings of mothers playing with their 4-month infants. Mother and infant facial and vocal affect, gaze-on/-off partner, and mother touch were coded on a 1 s time-base. Third trimester prenatal SHS was assessed via self-report of a smoker in the home. Weighted-lag time-series models tested conditional effects of SHS-exposure (vs. non-exposure) on infant self-contingency for eight modality-pairings (e.g., mother gaze-infant gaze). Individual-seconds time-series models and analysis of predicted values at t0 interrogated significant weighted-lag findings. Because prior findings link developmental risk factors with lowered self-contingency, we hypothesized that prenatal SHSSHS would predict lowered infant self-contingency. ResultsRelative to non-exposed infants, those who were prenatally exposed to SHS had lower self-contingency (more variable behavior) in all eight models. Follow-up analyses showed that, given infants were likely to be in the most negative facial or vocal affect, those with prenatal SHS were more likely to make larger behavioral changes, moving into less negative or more positive affect and to alternate between gaze-on and off mother. Mothers who were exposed to SHS during pregnancy (vs. non-exposed) showed a similar, albeit less prevalent, pattern of larger changes out of negative facial affect. ConclusionThese findings extend prior work linking prenatal SHS with youth dysregulated behavior, showing similar effects in infancy, a critically important period that sthe stage for future child development.

Environmental history-taking as part of pediatric consultations: a pilot study.

Introduction. Children's environmental health studies the influence of the environment on health and disease in children. Global environmental exposures pose a serious threat to health, warranting further research and action. Objective. To assess the environmental health of a sample of children living in urban and rural areas in Uruguaiana, Brazil. Population and methods. We included parents/legal guardians (n = 714) of children seen at Policlinica Infantil de Uruguaiana between January and October 2021, who completed the environmental historytaking in pediatrics (Brazilian Society of Pediatrics). Collected data were analyzed based on place of residence (urban or rural) or household income. Results. The comparison between inhabitants of the urban area (n = 660) and the rural area (n = 54) established that, among those living in the rural area, activity with chemical substances (15% versus 32.7%; p = 0.004), living near a plantation (7.5% versus 74.5%; p < 0.001) or near a source of contamination (4.8% versus 32.7%; p < 0.001), having a dog (62% versus 87.3%; p < 0.001), using pesticides (0.6% versus 32.7%; p < 0.001), and exposure to chemical contamination (2.6% versus 18.2%; p < 0.001) were significantly higher. In the urban area, exposure to vehicle traffic near the house (85% versus 48.1%; p < 0.001), an average income below 3 minimum wages (90%), and a low level of education predominated. Conclusion. Environmental history-taking is critical for the detection of environmental threats present in the areas where children and adolescents live, learn, play, and study.

Estimating Causal Effects of Interventions on Early-life Environmental Exposures Using Observational Data.

We discuss how epidemiologic studies have used observational data to estimate the effects of potential interventions on early-life environmental exposures. We summarize the value of posing questions about interventions, how a group of techniques known as "g-methods" can provide advantages for estimating intervention effects, and how investigators have grappled with the strong assumptions required for causal inference. We identified nine studies that estimated health effects of hypothetical interventions on early-life environmental exposures. Of these, six examined air pollution. Interventions evaluated by these studies included setting exposure levels at a specific value, shifting exposure distributions, and limiting exposure levels to less than a threshold value. Only one study linked exposure contrasts to a specific intervention on an exposure source, however. There is growing interest in estimating intervention effects of early-life environmental exposures, in part because intervention effects are directly related to possible public health actions. Future studies can build on existing work by linking research questions to specific hypothetical interventions that could reduce exposure levels. We discuss how framing questions around interventions can help overcome some of the barriers to causal inference and how advances related to machine learning may strengthen studies by sidestepping the overly restrictive assumptions of parametric regression models. By leveraging advancements in causal inference and exposure science, an intervention framework for environmental epidemiology can guide actionable solutions to improve children's environmental health.

Association of paternal cadmium and other heavy metal exposure to birth outcomes using propensity score matching.

BackgroundHuman exposure to cadmium has various effects on health, especially on male reproductive organs. Although it is widely known that prenatal maternal cadmium exposure can affect birth outcomes, the effect of paternal exposure to cadmium remains unclear. ObjectivesThis study aimed to evaluate the effect of paternal cadmium exposure on fetal growth by considering maternal cadmium exposure and exposure to other heavy metals, namely mercury and lead. MethodsThe Mothers and Children's Environmental Health (MOCEH) study is a prospective birth cohort study in Korea. Overall, 1313 families (father-mother-child triple) without child abnormalities and who completed paternal whole blood cadmium assessments were included in this study. Families were divided into two subgroups based on the blood sampling periods, namely early and late pregnancy. Subjects were selected as follows: one family triple with a high level of paternal cadmium and two triples with low levels of paternal cadmium, using the method of propensity score matching. And linear regression analyses were performed. ResultsThe group with high paternal cadmium exposure (80% or more; 1.93 μg/L) had lower birth weight infants compared to the group with low cadmium concentrations (β(se) = −0.21(0.10); p-value = 0.0283). After stratification by infant sex, prenatal paternal cadmium exposure significantly reduced the birth weight of females in subgroups of different sampling times, namely early pregnancy (β(se) = −0.52 (0.22); p-value = 0.0170) and late pregnancy (β(se) = −0.43 (0.18); p-value = 0.0160). Finally, after performing propensity score matching in the early pregnancy measurement group, it was found that the prenatal exposure of father to cadmium significantly reduced birth weight in females (β(se) = −0.72(0.25); p-value = 0.0047). ConclusionThis study assessed the effect of paternal cadmium exposure on birth outcomes in family units consisting of a father, mother, and child. Prenatal paternal cadmium exposure negatively affected birth weight, especially that of female, considering covariates and other heavy metals exposure, namely mercury and lead.

A priority list of environmental health issues for Malaysia.

Environmental risk factors contribute to 24% of the global burden of disease from all causes in disability-adjusted life years (DALYs), and to 23% of all global deaths. Malaysia being an advanced developing country, there is a need to prioritise environmental health issues to enable environmental health practitioners to focus on the most significant and urgent environmental health concerns. This project was undertaken by a Thematic Working Group on Environmental Health Experts (TWG 10) under the Malaysian National Environmental Health Action Plan. Sixteen pre-selected environmental health issues were presented to a two focus group discussions among 20 environmental health and related professionals who then scored each issue on its magnitude and severity scale. The total of these scores generated a list of priority environmental health issues for Malaysia. Children environmental health came out as the environmental health issue of the highest priority. We hope that this list of priority environmental health issues will be used for prioritising academic and professional manpower training, research funding allocation and planning for intervention programmes by various stakeholders.