Exposure In Adolescents Research Articles

Which are the clinical consequences of Molar Incisor hypomineralization (MIH) in children and adolescents? Systematic review and meta-analysis.

This systematic review was conducted to address the following research question: "What are the clinical consequences (outcome) of Molar Incisor Hypomineralization (MIH) (exposure) in children and adolescents (population/patient)?". After defining the strategy, a search was performed in different databases (MEDLINE via Pubmed, Cochrane Library, BBO, LILACS, Scopus, Web of Science, Embase) and Grey literature in August 2023. Cross-sectional observational studies that identified clinical consequences of MIH (dental caries, post-eruptive structural loss, atypical restorations, hypersensitivity and tooth extraction) were included. The risk of bias was assessed following the Joanna Briggs Institute protocol for cross-sectional studies. Meta-analyses were conducted for each outcome, taking into account the number of patients and teeth. The effect measure considered was the prevalence; random-effects model was adopted. Heterogeneity was assessed using I2 statistics and prediction intervals (PI). A total of 903 studies were identified; 41 were selected for qualitative analysis and 38 for quantitative analysis. Twenty eight studies were classified as presenting uncertain risk of bias, 11 as low risk and 3 as high risk of bias. The prevalence levels, ranked from highest to lowest and considering the tooth and patient units, respectively, were: caries lesions (0.252 - 95% CI 0.158-0.375; 0.512 - 95% CI 0.385-0.639); hypersensitivity (0.286 - 95% CI 0.190-0.407; 0.417 - 95% CI 0.197-0.674), post-eruptive fracture (0.125 - 95% CI 0.099-0.158; 0.257 - 95% CI 0.145-0.412); atypical restorations (0.048 - 95% CI 0.030-0.077; 0.167 - 95% CI 0.096 - 0.274); tooth extraction (0.012 - 95% CI 0.007-0.019; 0.090 - 95% CI 0.019 - 0.331). All meta-analyses resulted in heterogeneity greater than 85%, with the exception of the outcome "tooth extraction" according to the tooth unit (I2 = 57.83). This heterogeneity may be attributed to factors such as differences in the location where the study was realized, the socioeconomic conditions of the studied population, the asymmetric nature of MIH, and patient age. The most common consequences of MIH are caries lesions, hypersensitivity, and post-eruptive breakdown. (PROSPERO:CRD42020201410).

Pesticide exposure and blood cholinesterase levels among adolescents from farming families in Northern Thailand.

Adolescents living in agricultural communities may be at risk for the adverse effects of pesticide exposure because they are involved in agriculture either as a career or to support their families. The purpose of this study was to investigate the association of farm activities related to pesticide exposure on blood cholinesterase (ChE) levels among adolescents from farming families in the north of Thailand. This cross-sectional study included 336 adolescents aged 12-19 years from farming families in Chiang Dao District, Chiang Mai Province. Data on pesticide exposure was collected using a questionnaire, and blood ChE activity was assessed using a ChE reactive paper test kit via fingerstick blood sampling. Overall, 51.2% of participants had abnormal blood ChE levels. Univariable logistic regression analysis revealed that pesticide-related activities on farms associated with abnormal ChE levels were mixing/spraying (OR=10.54; 95%CI=4.63-23.99), assisting or working in areas with pesticide application (OR=5.54; 95%CI=3.45-8.89), and harvesting (OR=3.70; 95%CI=2.35-5.82). In a multivariable model (Nagelkerke R2=0.374), mixing/spraying (OR=4.90; 95%CI=2.03-11.83) and assisting or working in areas with pesticide application (OR=2.61; 95%CI=1.49-4.57) were significantly associated with abnormal ChE levels, but harvesting (OR=1.48; 95%CI=0.84-2.61) was not significant after adjusting for sex, age in years, and entering or walking through a farm. The findings indicated that Thai adolescents living in farming families are at risk of pesticide exposure, particularly those involved in agricultural activities such as pesticide applicators. An intervention and measure to raise awareness and reduce the risk of pesticide exposure in adolescents is required.

Childhood exposure to organophosphate pesticides: Functional connectivity and working memory in adolescents

BackgroundEarly life exposure to organophosphate (OP) pesticides is linked with adverse neurodevelopment and brain function in children. However, we have limited knowledge of how these exposures affect functional connectivity, a measure of interaction between brain regions. To address this gap, we examined the association between early life OP pesticide exposure and functional connectivity in adolescents. MethodsWe administered functional near-infrared spectroscopy (fNIRS) to 291 young adults with measured prenatal or childhood dialkylphosphates (DAPs) in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a longitudinal study of women recruited during pregnancy and their offspring. We measured DAPs in urinary samples collected from mothers during pregnancy (13 and 26 weeks) and children in early life (ages 6 months, 1, 2, 3, and 5 years). Youth underwent fNIRS while they performed executive function and semantic language tasks during their 18-year-old visit. We used covariate-adjusted regression models to estimate the associations of prenatal and childhood DAPs with functional connectivity between the frontal, temporal, and parietal regions, and a mediation model to examine the role of functional connectivity in the relationship between DAPs and task performance. ResultsWe observed null associations of prenatal and childhood DAP concentrations and functional connectivity for the entire sample. However, when we looked for sex differences, we observed an association between childhood DAPs and functional connectivity for the right interior frontal and premotor cortex after correcting for the false discovery rate, among males, but not females. In addition, functional connectivity appeared to mediate an inverse association between DAPs and working memory accuracy among males. ConclusionIn CHAMACOS, a secondary analysis showed that adolescent males with elevated childhood OP pesticide exposure may have altered brain regional connectivity. This altered neurofunctional pattern in males may partially mediate working memory impairment associated with childhood DAP exposure.

The association between screen time exposure and myopia in children and adolescents: a meta-analysis

ObjectiveThis study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature.MethodThere were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period.ResultsWe searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47–3.42) for cross-sectional studies, and 2.39 (2.07–2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01–1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78–14.04; continuous: OR = 1.22, 95%CI: 1.10–1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02–2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method.ConclusionOur findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.

Association between Volatile Organic Compound Exposure and Sex Hormones in Adolescents: The Mediating Role of Serum Albumin

The associations between VOCs and sex hormones in adolescents remain unclear, and the role of serum albumin in these associations deserves to be explored. We conducted cross-sectional analyses using generalized linear models (GLMs), weighted quantile sum (WQS) regression, and mediation analysis, based on data from 584 adolescents from the National Health and Nutrition Examination Survey (NHANES). The GLM analyses revealed that seven kinds of mVOCs potentially affected sex hormone levels. According to the WQS regression results, 2-aminothiazoline-4-carboxylic acid (ATCA) was the major contributor to the significant associations of mixed mVOC exposure with testosterone, estradiol, and free androgen index in males; N-acetyl-S-(N-methylcarbamoyl)-L-cysteine (AMCC) was the major contributor to the significant associations of mixed mVOC exposure with sex hormone-binding globulin in males; and N-acetyl-S-(benzyl)-L-cysteine (BMA) was the major contributor to the significant associations of mixed mVOC exposure with the ratio of testosterone to estradiol in females. Moreover, serum albumin could mediate up to 9.2% of the associations between mixed exposure to mVOCs and sex hormones. Our findings could provide a reference for studies on the mechanisms underlying the effects of VOCs on sex hormones in adolescents and emphasize the necessity of reducing exposure to ATCA, AMCC, BMA, and their parent compounds.

316. Persistent and Transient Health Associations of Prenatal Substance Exposure in Children and Adolescents

316. Persistent and Transient Health Associations of Prenatal Substance Exposure in Children and Adolescents

Myopia prevalence and ocular biometry in children and adolescents at different altitudes: a cross-sectional study in Chongqing and Tibet, China

ObjectiveTo investigate the differences in myopia prevalence and ocular biometry in children and adolescents in Chongqing and Tibet, China.DesignCross-sectional study.SettingThe study included children and adolescents aged 6–18 years in Chongqing,...

Mastering Digital Ethic: Uncovering the Influence of Self-Control, Peer Attachment, and Emotional Intelligence on Netiquette through Adolescent Social Media Exposure

The use of social media in the daily lives of adolescents is inevitable. The behavior in the virtual space also needs to be considered so that it does not have a negative impact on others. Internet Etiquette (Netiquette) is a set of social norms in cyberspace that all users need to apply. This study analyzes the influence of self-control, peer attachment, and emotional intelligence on netiquette through social media exposure in adolescents. Two hundred and thirty-seven (237) adolescents aged 10-24 from 21 provinces in Indonesia participated in this online survey. Researchers used five questionnaires and analyzed them using SEM with SmartPLS. The results showed an influence of emotional intelligence, self-control, and social media exposure on the application of teenage netiquette. Emotional intelligence has the highest influence on the application of netiquette. On the other hand, peer attachment indirectly affects netiquette with the mediator variable of social media exposure. It is essential to promote an understanding of netiquette to adolescents as one of the foundations of digital literacy.

The relationship between environmental exposure and asthma in adolescents aged 10–13 years: A cross-sectional study in Chongqing, China

BackgroundAsthma is one of the most prevalent diseases worldwide and is closely related to environmental exposure. The prevalence of asthma and the relationship between asthma and the duration of environmental exposure in adolescents has not been reported in Chongqing, China. ObjectivesTo examine the prevalence of asthma among adolescents in Chongqing and investigate the relationships between asthma and environmental exposure. MethodsThe subjects were recruited from a previous cohort study. The data, demographics and respiratory characteristics were collected after a monthly follow-up visit. PM 2.5 concentrations were matched to the residential addresses of participants. ResultsThis study included 4146 samples (11.74 ± 0.71 years) and the prevalence of asthma was 3.98 % (165/4146). In terms of PM 2.5 exposure, the annual average PM 2.5 level was significantly higher in adolescents with asthma, and the annual average PM 2.5 was positively associated with asthma (OR = 1.252, 95%CI: 1.049, 1.495). After adjusting for multiple potential confounding factors, comparing with PM 2.5 concentration in the first interquartile range (Q1), seasonal PM 2.5 (OR = 1.791, 95%CI: 1.119, 2.866) and monthly PM 2.5 (OR = 1.484, 95%CI: 0.929, 2.373) in the third interquartile range (Q3), there was a statistically significant increased risk of asthma. In terms of weather-related factors, seasonal humidity (OR = 3.157, 95%CI: 1.168, 8.536), monthly humidity (OR = 2.397, 95%CI: 1.307, 4.397) and temperature (OR = 2.510, 95%CI: 1.157, 5.447), they were positively correlated with asthma. ConclusionsThis study illustrated the impact of chronic exposure of PM 2.5, temperature and humidity on asthma in adolescents.

Positive association between chlorinated paraffins and the risk of allergic diseases in children and adolescents

Contaminants may induce immune response polarization, leading to immune diseases, such as allergic diseases. Evidence concerning the effects of chlorinated paraffins (CPs), an emerging persistent organic pollutant, on immune system is scarce, particularly for epidemiological evidence. This study explores the association between CPs exposure and allergic diseases (allergic rhinitis, atopic eczema, and allergic conjunctivitis) in children and adolescents in the Pearl River Delta (PRD) in China. Herein, 131,304 children and adolescents from primary and secondary schools in the PRD were included and completed the questionnaire survey. The particulate matter (PM) samples were collected in the PRD and the PM2.5-bound CP concentrations were analyzed. In the multivarious adjustment mixed effect model (MEM), an IQR increase in ∑CPs was significantly associated with allergic diseases (rhinitis, eczema, and conjunctivitis) with the estimated odds ratios (ORs) for 1.11 (95% CI: 1.10, 1.13), 1.17 (95% CI: 1.15, 1.19), and 1.82 (95% CI: 1.76, 1.88), respectively. Interaction analysis indicated that overweight and obese individuals might have greater risk. Similar effect estimates were observed in several sensitivity analyses. This study provided epidemiological evidence on the immunotoxicity of CPs. More studies to confirm our findings and investigate mechanisms are needed.

Peer bullying in adolescents and related factors

Abstract:
 Objective: This study aims to determine the frequency of peer bullying and exposure in adolescents and the factors associated with these behaviors. Methods: This cross-sectional study was carried out in a high school between February 2016 and November 2017. The study population was 203students. The 2013-2014 version of the questionnaire form (HBSCQ) used in the Health Behavior in School-aged Children study of the World Health Organization was used as the measurement tool. Logistic regression analysis was used to show the effect of social support to bullying. Results: The frequency of being exposed to peer bullying was 19.8%, and performing bullying was 23.7%.Being exposed to peer bullying was observed with a higher rate in those who migrated from another city. The average peer support score, family support score, and family communication score were significantly lower in those who were exposed to bullying. The behavior of bullying was observed with a significantly higher rate in those with fewer siblings, had negative opinions about the school and involved in a physical fight. According to the logistic regression analysis results, family support score was found to be protective against exposure to bullying. The protective effect of family communication and peer support scores continued to be significant after the adjustment. Conclusions: The results of the present research have shown that social support is effective in dealing with bullying and reducing bullying.
 
 Keywords: Adolescent, peer bullying, school health, social support

Predictors of smoking exposure in non-smoking adolescents in Indonesia

Exposure to secondhand smoke is one of the leading causes of death for non-smokers worldwide. The prevalence of exposure to secondhand smoke is higher among adolescents. Research on predictors of secondhand smoke exposure in adolescents is still rarely conducted in Indonesia. This study aimed to analyze the predictors of exposure to secondhand smoke among non-smoking adolescents in Indonesia. This study used data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019 with a cross-sectional design. A total of 7,594 adolescents aged 13 to 15 were selected using purposive sampling. The dependent variables were exposure to secondhand smoke at home and in public. The independent variables included age, gender, smoking parents, smoking friends, and knowledge of the dangers of secondhand smoke. Data were analyzed using STATA with inferential tests, namely chi-square and logistic regression. The prevalence of adolescents exposed to secondhand smoke at home and in public was 49.57% and 71.86%, respectively. At-home exposure was significantly associated with smoking parents [AOR=3.50, 95% CI=2.97 to 4.12], smoking friends [AOR=1.50, 95% CI=1.30 to 1.73], and knowledge of the dangers of secondhand smoke [AOR=2.11, 95% CI=1.52 to 2.93]. Public exposure was associated with ages 13-15 [AOR=1.32, 95% CI=1.10 to 1.58] and older than 15 [AOR=1.77, 95% CI=1.39 to 2.25], male gender [AOR=1.31, 95% CI=1.11 to 1.53], smoking parents [AOR=1.58, 95% CI=1.36 to 1.84], smoking friends [AOR=2.16, 95% CI=1.85 to 2.53], and knowledge of secondhand smoke dangers [AOR=2.84, 95% CI=2.15 to 3.75]. Adolescents’ exposure to secondhand smoke in public spaces is higher in prevalence and has more associated factors compared to exposure at home. Exposure reductions require comprehensive actions from authorities by strictly implementing and expanding non-smoking areas covered by existing regulations. Also, family and school management should be involved in prevention efforts.

Association of Zinc Intake, Tobacco Smoke Exposure, With Metabolic Syndrome: Evidence from NHANES 2007-2018.

The objective was to explore the effect modification of zinc (Zn) intake levels on the relationship of tobacco smoke exposure and risk of metabolic syndrome (MetS) in children and adolescents. We used data from 2007-2018 National Health and Nutrition Examination Survey (N = 3701). MetS was considered as main endpoint. Weighted multivariable logistic regression models showed that high cotinine level (≥ 0.05ng/mL) was associated with increased odds of MetS [odds ratio = 1.54, 95% confidence interval: 1.01, 2.36], and the association between Zn intake levels and MetS did not demonstrate statistical significance. Importantly, the multiplicative interaction term between low Zn intake (≤ 4.89mg/1000kcal) and high cotinine level was related to higher odds of MetS (p-value for interaction 0.018). For the group with low Zn intake, high cotinine level was associated with increased odds of MetS. However, there was no significant relationship between cotinine levels and MetS risk in the group with high Zn intake. The effect modification by Zn intake on the relationship of tobacco smoke exposure and risk of MetS is significant in individuals who had a sedentary time of ≥ 6h, identified as non-Hispanic White, or resided in households with smokers. In short, low Zn intake may potentiate the association of tobacco smoke exposure and MetS risk in children and adolescents.

SOCIAL MEDIA’S RIPPLE EFFECT: UNRAVELLING ADOLESCENTS AGGRESSION SAND ITS TOLL ON PARENTAL MENTAL WELL-BEING

PURPOSE: To investigate the correlation between social media exposure and aggressive behaviour in adolescents and assess the subsequent impact on parent’s mental health for informed intervention. DESIGN / METHODOLOGY: Utilizing a mixed methods approach this study will make use of journals magazines , reference books, qualitatively to assess social media usage patterns and aggressive behaviour in a diverse adolescent population. Concurrently secondary sources of data were used in the study which will provide in depth insight into the perceived impact on mental health of parents. FINDINGS AND RESULTS:To obtain the most recent an relevant findings. recommend checking recent academics journals, publications or reputed sources that focus on social psychology or related fields. ORIGINALITY / VALUE:The study of social medias influences on aggressive behaviour and its impact on parents mental well-being holds significant value and originality due to several factors like emerging issues of excessive use of social media and its effect on emotional life of adolescence as well as their parents, interdisciplinary nature that adds depth to the investigation providing a more comprehensive views, identifying the impact of social media on aggressive behaviour allows for the exploration of strategies to mitigate negative consequences and the potential for ignoring practical strategies policies and educational initiatives. TYPE OF PAPER:Descriptive research with exploratory research design. KEYWORD: Aggressive behaviour, comprehensive, adolescenc

Association between exposure to tobacco information through mass media, smoking households and secondhand smoke exposure in adolescents: Survey data from South Korea.

To explore the current situation of exposure of Korean adolescents to secondhand smoke (SHS) in households our study aimed to determine the relationship between family member smoking status, exposure to tobacco information through mass media, and household SHS exposure. The present study uses pooled data from the Korean adolescent health behavior online survey conducted in 2015, 2018 and 2021, with 157944 participants. The regression models were used to explore the association between the smoking status of households, and exposure to tobacco information through mass media, and household SHS exposure in adolescents, controlling for potential confounding factors. SHS exposure duration of Korean adolescents in households was 0.88 days per week. The households with smokers including the father (β=1.087; 95% CI: 1.0-1.126), mother (β=1.461; 95% CI: 1.379- 1.543), siblings (β=0.545; 95% CI: 0.493-0.597), grandparents (β=0.224; 95% CI: 0.174-0.272), and other relatives (β=0.170; 95% CI: 0.126-0.214), showed a positive association with SHS exposure in adolescents within the household. At the same time, information about anti-smoking ads on television (β= -0.042; 95% CI: -0.069 - -0.015) and public transportation (β= -0.031; 95% CI: -0.054 - -0.010), showed a negative association with SHS exposure in adolescents. However, broadcasts, online, and newspaper non-smoking ads were not associated with SHS exposure (p>0.05). In addition, regression models revealed that exposure to cigarette advertising in magazines (β=0.131; 95% CI: 0.097-0.166), networks (β=0.151; 95% CI: 0.127-0.175), convenience stores (β=0.061; 95% CI: 0.035-0.087), and supermarkets (β=0.133; 95% CI: 0.108-0.158) is associated with SHS exposure in adolescents. Finally, our study showed stronger ties between SHS exposure, family smoking, and tobacco ads in girls. The link between maternal smoking, supermarket ads, and adolescent SHS exposure intensified in 2021 compared to 2015. Family and media were identified as potential factors associated with SHS exposure in adolescents. Therefore, publicity and education regarding household SHS hazards, and smoking bans in media, can be helpful in protecting adolescents from SHS.

Access to digital pornography by children and teenagers: when should you be alerted?

Pornography and, more broadly, the consumption of sexually explicit images are not new phenomena. However, the rise of new technologies has significantly facilitated access to this type of content, especially among young people. In what family context does the use of digital tools occur? What are the stakes of exposure in children and adolescents? What impacts on psychosexual development? What are the reasons for the difficulty in restricting this behaviour? Is there an addictive dimension? Health professionals and trusted adults have a role to play, both in preventing exposure to unsolicited and potentially shocking content, and in opening up a dialogue in the case of problematic situations for the child or adolescent.

Hubungan Dukungan Keluarga dengan Paparan Pornografi pada Remaja

Adolescents are currently growing up in the digital era with the increase and development of internet technology which not only brings benefits, but also harms, one of which is exposure to sexual content, namely pornography. The increase of information and technology development constructs adolescents that are susceptible to the possibility of pornography exposure through accessibility such as social media and online games. Pornography is one of the negative impacts that can affect adolescent behavior, so it requires supervision. The role of parents is really needed by adolescents in providing sexual knowledge information and safe internet use, as well as support as an effort to prevent pornography exposure. This study aims to examine the relationship between family support and pornography exposure in adolescents. This descriptive correlative design used a cross sectional study. The population was all students in one of the State Junior high Schools in South Aceh Regency with a sample of 94 students. Data collection was carried out using questionnaires as a research instrument. Chi Square test was used in analyzing the data. The Results indicated that 66% of adolescents were exposed to pornography. The results of the analysis showed that there was a significant relationship of p=0.0001 (p<0.05) between family support and pornography exposure. Family support has a significant relationship with pornography exposure. It is expected that families and schools can increase support in monitoring and preventing adolescents from accessing pornography.

Stress exposure in at-risk, depressed, and suicidal adolescents.

Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.

Association between Heavy Metal Exposure and Idiopathic Aplastic Anemia in Adolescents and Adults:a Case Control Study from Northern India

Introduction:Compared to western world the incidence of AA in South Asian countries is higher. There are studies to suggest that incidence of this disease is 2-3 times higher in LMICs. Besides immune mediated pathophysiology and inherited presdispostion, toxic insult to the hematopoietic elements due to chemotherapy, radiation exposure, drugs,and environmental toxins such as pesticides and heavy metals have been associated with Aplastic Anemia.The higher incidence of AA in lower socio-economic status and its association with drinking water habits, industrial exposure suggests a possible link with heavy metals in the pathogenesis of disease. Methodology:Fifty patients diagnosed with idiopathic aplastic anaemia and 50 age and gender matched healthy controls were included in the study. 2 ml of blood and 20 hair shafts were collected as samples from each subject for the analysis of arsenic, lead, cadmium, mercury, and thallium in both samples by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Results:The total study population consisted of 61 males and 39 females. 42% of the cases were residents of rural areas, and 58% belonged to urban areas. 54% participants among the controls belonged to rural areas. Among the total population, 48% cases and 58% controls were using tap water as major source of water. Out of the total participant in the study, 10% of the cases and 12% of the controls were found to be exposed to pesticides previously, however no direct occupational exposure of heavy metal was found among the study population. Twenty-three patients (46%) had NSAA, and 15 patients had SAA (30%) while 12 patients (24%) had VSAA.Mean values of arsenic in blood of patients and controls are 3.52±2.9mcg/L,and 0.0mcg/L respectively and the difference was statistically significant (p &amp;lt;0.001) however the mean arsenic values in hair of cases and controls were not different significantly(0.13±0.1mg/g and 0.15±0.1mg/g;p=0.16).Mean values of cadmium in blood of patients and controls were 2.5±1.9mcg/L and 0 mcg/L (p &amp;lt;0.001). Mean values of cadmium in hair of patients and controls are 0.10±0.16, 0.13±0.28 respectively.We noticed blood cadmium higher than safer limits in 24% of cases none in the controls.We found 6% of cases had higher than permissible limit of mercury level and 8% of cases have higher than permissible limit of lead level in their hair samples which represent chronic exposure. Conclusion: We found higher mean values of blood Arsenic and blood Cadmium in cases compared to controls. Upto one fourth cases had higher than safety levels of cadmium in their blood. Although causal association cannot be determined in this study our results indicate that heavy metal toxicity may be one of the reasons for AA in regions with higher environmental exposure and soil and water contamination.

Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults

Over one million European children undergo computed tomography (CT) scans annually. Although moderate- to high-dose ionizing radiation exposure is an established risk factor for hematological malignancies, risks at CT examination dose levels remain uncertain. Here we followed up a multinational cohort (EPI-CT) of 948,174 individuals who underwent CT examinations before age 22 years in nine European countries. Radiation doses to the active bone marrow were estimated on the basis of body part scanned, patient characteristics, time period and inferred CT technical parameters. We found an association between cumulative dose and risk of all hematological malignancies, with an excess relative risk of 1.96 (95% confidence interval 1.10 to 3.12) per 100 mGy (790 cases). Similar estimates were obtained for lymphoid and myeloid malignancies. Results suggest that for every 10,000 children examined today (mean dose 8 mGy), 1–2 persons are expected to develop a hematological malignancy attributable to radiation exposure in the subsequent 12 years. Our results strengthen the body of evidence of increased cancer risk at low radiation doses and highlight the need for continued justification of pediatric CT examinations and optimization of doses.