Environmental Health[JOURNAL]
Sun
200 papers
Lead exposure and risk of ADHD and conduct disorders in children: evidence from a retrospective cohort in Philadelphia, PA.
Pei X, Kordas K, Wang M … +6 more , Xu M, Nie J, Hequembourg A, Khan AI, Turella J, Feiler MO
Environ Health · 2026 Jun · PMID 42343461 · Full text
BACKGROUND: Childhood lead exposure remains a significant public health concern, particularly in urban settings with persistent socioeconomic disadvantage. Although prior studies have linked lead exposure to adverse neur...
BACKGROUND: Childhood lead exposure remains a significant public health concern, particularly in urban settings with persistent socioeconomic disadvantage. Although prior studies have linked lead exposure to adverse neurodevelopmental outcomes, evidence using clinically diagnosed neurobehavioral disorders at contemporary low blood lead levels (BLLs) is limited. METHODS: We conducted a retrospective cohort study of children aged 11 years or younger who received care through the Temple University Health System in Philadelphia, Pennsylvania, between 2010 and 2020. BLLs were obtained from electronic health records and analyzed as continuous measures and dichotomized at 3.5 µg/dL. Attention-deficit/hyperactivity disorder (ADHD) and conduct disorders were identified using international classification diagnoses (ICD) codes, and only incident diagnoses occurring after blood lead measurement were considered. Multivariable logistic regression models were fit adjusted for individual- and neighborhood-level sociodemographic factors selected using a directed acyclic graph framework. Sex-stratified analyses were conducted to assess effect modification. RESULTS: Among 13,989 children included in the ADHD analysis, 751 (5.4%) were diagnosed with ADHD. Among 14,098 children included in the conduct disorder analysis, 247 (1.8%) were diagnosed with a conduct disorder. Higher log-transformed continuous BLLs were associated with increased odds of ADHD diagnosis (adjusted OR 1.51; 95% CI 1.37, 1.67). Children with BLLs ≥ 3.5 µg/dL had higher odds of ADHD (adjusted OR 1.84; 95% CI 1.56, 2.16) compared with those with BLLs < 3.5 µg/dL, with stronger associations observed among males than females. Associations between log-transformed continuous BLLs and conduct disorders were positive but not statistically significant (adjusted OR 1.12; 95% CI 0.95, 1.31), and no sex-specific associations were observed. CONCLUSION: Childhood lead exposure was associated with increased risk of ADHD in this urban clinical population, including at blood lead levels at or above the current reference value set by the Centers for Disease Control and Prevention, emphasizing the importance of continued prevention efforts. These findings underscore the ongoing neurodevelopmental risks of low-level lead exposure and highlight the disproportionate burden placed on children residing in socioeconomically disadvantaged urban communities.
Observational and genetically-informed characterization of Gulf War Illness symptoms in 1990-1991 Gulf War deployed Veterans and non-deployed Gulf War Era Veterans.
He J, Pathak GA, Cabrera-Mendoza B … +11 more , Qiu D, Zawack K, Steele L, Quaden R, Harrington KM, Gifford EJ, Aslan M, Helmer DA, Hauser ER, Polimanti R, Department of Veterans Affairs Cooperative Studies Program #2006 and the VA Million Veteran Program
Environ Health · 2026 Jun · PMID 42277823 · Full text
BACKGROUND: Gulf War Illness (GWI) has been identified in more than 20% of Veterans following military service in the 1990-1991 Gulf War (GW). Unfortunately, after several decades, GWI pathogenesis remains unclear and th...
BACKGROUND: Gulf War Illness (GWI) has been identified in more than 20% of Veterans following military service in the 1990-1991 Gulf War (GW). Unfortunately, after several decades, GWI pathogenesis remains unclear and the patterns of GWI symptom co-occurrence are still poorly understood. METHODS: This population-based case-control study included 34,179 (16% females; 34% GW deployed; mean age 61 years) Veterans enrolled in the Million Veteran Program (MVP) who were active-duty military personnel in 1990-1991. We analyzed 14 GWI symptoms in GW-deployed and non-deployed GW-Era Veterans. Multivariable generalized linear models were used to estimate GWI symptom associations with demographic factors and deployment status. Correlation, factor, and network analyses were performed to examine the underlying structure of GWI symptoms. In addition, polygenic risk score and one-sample Mendelian randomization analyses were conducted to evaluate the genetically inferred effects of health-related traits on symptom factors. RESULTS: Among 14 GWI symptoms, joint pain had the highest prevalence in both GW deployed (86%) and non-deployed GW-Era Veterans (79%). The median age of symptom onset ranged from 38 to 46 years among deployed Veterans and from 45 to 54 years among non-deployed Veterans. Factor analysis identified a five-factor latent structure as the best-fit model for GWI symptoms, and latent class analysis classified Veterans into seven symptom classes. The network of GWI symptoms showed that fatigue had the largest closeness and betweenness and had more edges in deployed Veterans. Younger age, female sex, non-European descent, lower educational attainment, enlisted rank, and GW deployment, as well as multiple GW-related exposures in deployed Veterans, were associated with increased GWI symptom burden. Genetic liability to multiple health-related outcomes, including type 2 diabetes (T2D) and posttraumatic stress disorder (PTSD), showed putative causal effects on GWI-symptom factors, with the T2D effect being larger in deployed Veterans and the PTSD effect being larger in non-deployed Veterans. CONCLUSIONS: The present findings demonstrate differences in symptom onset between deployed and non-deployed GW Veterans. They also reinforce the importance of symptom clusters of relevance to GWI, associations between deployment-specific exposures and symptom burden, and different genetic linkages underlying symptoms for deployed and non-deployed groups. TRIAL REGISTRATION: Not applicable.
Air pollution and disease progression among patients with primary glomerular disease: an expanded study with extended follow-up.
Troost JP, Kshirsagar AV, Smoyer WE … +10 more , Klein J, Merchant ML, Helmuth M, Mariani LH, Kretzler M, Smith AR, Lacey F, Engel LS, Trachtman H, O'Lenick CR
Environ Health · 2026 Jun · PMID 42243965 · Full text
BACKGROUND: Air pollution is increasingly recognized as a risk factor for progression of kidney disease; however, few studies have examined its impact among patients with primary glomerular disorders. To address this kno...
BACKGROUND: Air pollution is increasingly recognized as a risk factor for progression of kidney disease; however, few studies have examined its impact among patients with primary glomerular disorders. To address this knowledge gap, we previously reported positive associations between fine particulate matter ≤ 2.5μm in aerodynamic diameter (PM) and black carbon with kidney disease progression in an observational cohort of children and adults (n = 925) with primary glomerular diseases, namely minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy. In the current study, we leverage the same cohort to (1) identify additional air pollutants that may be associated with kidney disease progression using data from the National Center for Atmospheric Research (NCAR); (2) determine whether the association between baseline air pollution exposure and kidney disease progression is maintained over a longer follow-up period; and (3) assess whether associations identified in our previously published findings remain when using NCAR pollutant data. METHODS: In this retrospective cohort study, we obtained air pollutant concentration data from NCAR based on participant residential census tract at enrollment. For each census tract and pollutant, we aggregated daily pollutant concentrations to annual averages. We used Cox proportional hazards models to estimate associations between average baseline pollutant exposure and time to kidney disease progression, defined as a 40% decline in estimated glomerular filtration rate (eGFR) or occurrence of kidney failure (eGFR) < 15 ml/min/1.73 m) during follow-up. Hazard ratios (HR) represented a doubling of exposure. RESULTS: Use of NCAR data supported our previous findings of adverse effects of PM and black carbon on the progression of glomerular disease. Moreover, using the NCAR data we identified novel associations with NO exposure, HR 1.12 [1.01, 1.26] and specific components of PM, including organic matter, HR 1.17 [1.01, 1.37] and an increased risk of disease progression. When considering a longer follow-up period, associations between baseline exposures and kidney outcomes persisted, but were attenuated suggesting a need for recent, interval-specific risk assessment, inclusion of acute exposures, and enhanced spatial resolution of exposures. CONCLUSION: Our findings highlight the importance of the systematic assessment including spatial and temporal variation of a broad range of air pollution components to determine the impact of exposure on short- and long-term outcomes in patients with primary glomerular disease (word count: 368).
Not just splitting hairs-monitoring environmental chemical exposures, their biological effects and their social determinants with hair shafts and follicles: a narrative review.
Robert M, Iglesias-González A, Nour R … +4 more , Zhou K, Appenzeller BMR, Bellanger M, Vidi PA
Environ Health · 2026 Jun · PMID 42237147 · Full text
Humans encounter a wide range of natural and synthetic chemicals throughout their lifespan and these exposures have a complex impact on health outcomes. Epidemiological studies provide compelling evidence linking chemica...
Humans encounter a wide range of natural and synthetic chemicals throughout their lifespan and these exposures have a complex impact on health outcomes. Epidemiological studies provide compelling evidence linking chemical exposure to neurological disorders and various cancers. However, establishing causality between specific pollutants, or their mixtures, and health outcomes is challenging due to long disease latencies. Functional biomarkers in exposed subjects provide rapid predictions of the impact of environmental exposures. Notably, genome alterations, including DNA breaks and epigenetic modifications, are hallmark features of cancers, premature aging, and neurological diseases. Biomonitoring studies show that individual chemical exposures are specific. These differences highlight disparities across socioeconomic groups. They also present opportunities to associate specific environmental factors and disease development, as well as socioeconomic determinants of exposures and their consequences. This review focuses on biomonitoring environmental chemical exposures and their effects with hair and hair follicles. Pollutants detected in the hair matrix reflect cumulative internal exposures over specific time periods, while biomarkers can be analyzed in plucked hair follicles. These mini organs contain proliferating and stem/progenitor cells, which are critical to understanding the onset of various diseases. We propose an integrated approach that combines socioeconomic indicators, chemical analyses in hair, and biological assessments of matching hair follicles to evaluate the exposome and its effects on the genome. We discuss the state of the art of these approaches, their current limitations, and the perspectives they offer.
Placental CYP450 gene dysregulation by maternal PFAS: a novel mechanism linking prenatal exposure to altered toddler growth.
Song X, Zhang Z, Zhou X … +7 more , Liang H, Chen Y, Zhu W, Yuan W, Du J, Wang Z, Miao M
Environ Health · 2026 Jun · PMID 42231393 · Full text
BACKGROUND: Maternal per- and polyfluoroalkyl substances (PFAS) exposure has been linked to adverse health effects on offspring, but the mechanisms remain unclear. The present study investigates the relationship between...
BACKGROUND: Maternal per- and polyfluoroalkyl substances (PFAS) exposure has been linked to adverse health effects on offspring, but the mechanisms remain unclear. The present study investigates the relationship between maternal PFAS exposure and the expression of placental cytochrome P450 enzymes (CYP19A1, CYP2J2, and CYP2E1), and explores the potential role of these enzymes in linking maternal PFAS exposure to offspring development. METHODS: We included 350 mother-infant pairs from the Jiashan birth cohort. Thirteen PFAS compounds were measured in maternal plasma collected at 8-16 weeks of gestation, while the expression levels of the three CYP genes were quantified in placental tissues collected at delivery. Offspring weight and length were measured at birth and at 1, 3, 6, 8, 12, and 24 months of age, and their ponderal index (PI) was computed. Multivariable linear regression was used to examine associations between plasma concentrations of individual PFAS and placental CYP gene expression. Quantile-based g-computation was used to examine the association of the PFAS mixture with placental CYP gene expression. A linear mixed model was used to examine the associations of maternal PFAS and placental CYP expression levels with repeated PI measurements from birth to 24 months. Multilevel mediation analysis was conducted to explore the potential mediating role of CYP genes. RESULTS: Consistent inverse associations between maternal PFAS exposure and the three placental CYP genes expression in female placentas were observed. Specifically, statistically significant decreases were observed in the associations between all PFAS compounds and CYP2J2 expression with β- estimates for the highest exposure versus the lowest from -0.255 to -0.174, as well as between the highest exposure of perfluorotridecanoic acid (PFTrDA) and CYP19A1 expression (β = -0.279, 95% CI: -0.55, -0.007). In contrast, for male fetuses, significant associations were found between the highest exposure of perfluorohexane sulfonate (PFHxS) and increased CYP19A1 expression (β = 0.404, 95%CI: 0.131,0.677), and between the middle of perfluoroundecanoic acid (PFUdA), perfluorododecanoic acid (PFDoA), PFTrDA, and perfluoroheptanoic acid (PFHPA) and decreased CYP2E1 expression (β = -0.286, 95% CI: -0.511,-0.061; β = -0.270, 95% CI: -0.495,-0.045;β = -0.236, 95% CI: -0.466,-0.006; and β = -0.344, 95% CI: -0.571,-0.117, respectively). The PFAS mixture was associated with decreased the three CYP genes expression in the placenta of female fetuses, but no association was observed in male placentas. Additionally, placental CYP19A1 expression was associated with a decrease in girls' PI and an increase in boys' PI, respectively. However, no mediating role of CYP19A1 in the relationship between PFTrDA and PI in girls or between PFHxS and PI in boys was observed, as the indirect effect was not statistically significant. CONCLUSIONS: These results indicate that maternal PFAS exposure may disrupt placental CYP expression and the implications of these disruptions for offspring development warrant further investigation.
Preconception and early-pregnancy exposure to ambient air pollution and trajectories of depressive symptoms during pregnancy.
Hu Y, Yang T, Eckel SP … +15 more , Chen X, Niu Z, Toledo-Corral CM, Pavlovic N, Lurmann F, Grubbs B, Al-Marayati L, Garcia E, Morales S, Johnston J, Dunton GF, Habre R, Farzan SF, Breton C, Bastain TM
Environ Health · 2026 Jun · PMID 42231384 · Full text
BACKGROUND: Prenatal depression shows diverse patterns in severity and progression. While air pollution has been linked to depression risk, its impact on the course of prenatal depression remains understudied. The study...
BACKGROUND: Prenatal depression shows diverse patterns in severity and progression. While air pollution has been linked to depression risk, its impact on the course of prenatal depression remains understudied. The study objectives were to (1) identify distinct trajectories of depressive symptoms across pregnancy, and (2) to evaluate whether preconception and early-pregnancy air pollution exposure impacts membership in trajectory groups. METHODS: This study followed 542 predominantly low-income Hispanic/Latina participants in the MADRES cohort. We assessed depressive symptoms using the Center for Epidemiologic Studies-Depression (CES-D) scale at 1st, 2nd, and 3rd trimester visits. Daily residential concentrations of PM, PM, NO, and O were estimated using inverse-distance squared spatial interpolation from monitoring data. We used latent growth mixture modeling (LGMM) to identify trajectory classes and multinomial logistic regression to estimate adjusted relative risk ratios (RRRs) of membership in each class relative to the lowest group with averaged air pollution levels over preconception and early pregnancy. RESULTS: We identified four distinct trajectories: moderate-to-high symptoms (7.4%), consistently-moderate symptoms (14.6%), moderate-to-low symptoms (34.7%), and consistently-low symptoms (43.4%). Higher proportions of Black mothers and those not cohabitating were found in the two highest symptom trajectories. Participants with an interquartile range higher early-pregnancy NO (10.28 ppb) had a 3.82-fold higher relative risk (95% CI: 1.50-9.73) of following the moderate-to-high versus consistently-low-symptom trajectory. Similar elevated risks were observed for PM (RRR = 1.61; 95%CI: 1.08-2.40) and PM (RRR = 1.84; 95% CI: 1.01-3.35). CONCLUSION: Early-pregnancy exposure to ambient air pollution is associated with increased risk of moderate-to-high depressive symptoms across pregnancy.
Lessons learned from longitudinal biomonitoring and birth cohort studies: informing the future of reproductive health research in Canada.
Ashley-Martin J, Fisher M, Khoury C … +26 more , Sathiyamoorthy A, Borghese MM, England-Mason G, Pollock T, Arbuckle TE, A Wise L, Braun JM, Metcalfe A, Buckley JP, Palmert MR, Ricci C, Phipps E, Banerjee G, Fuller E, Booij L, Hopperton K, Weiler H, MacFarlane AJ, Bertinato J, Rawn DFK, Lavigne E, Timmermann A, Oken E, Wolfson C, Brandlistuen RE, Shutt R
Environ Health · 2026 May · PMID 42210361 · Full text
Longitudinal biomonitoring studies during preconception, pregnancy and early childhood are highly valuable tools for assessing environmental chemical exposures during sensitive windows and their effects on health and dev...
Longitudinal biomonitoring studies during preconception, pregnancy and early childhood are highly valuable tools for assessing environmental chemical exposures during sensitive windows and their effects on health and development. For the past 15 years, the Maternal-Infant Research on Environmental Chemicals (MIREC) Research Platform has been Canada's flagship study of the long-term effects of early life exposure to environmental chemicals. In light of the evolving scientific and legislative landscapes and need to address emerging research questions, MIREC Platform researchers at Health Canada consulted with scientific investigators of other cohort studies to inform the development of a future preconception or pregnancy longitudinal biomonitoring study. This effort included 1) hybrid consultation meetings on Dec 6, 2024 (Toronto, ON) and Jan 21, 2025 (Ottawa, ON) and 2) a virtual seminar series from October 2024 to June 2025 hosted by the Health Canada MIREC team. Our objective here is to share lessons learned from this consultation. We report on key lessons learned related to the themes of: 1) participant engagement, recruitment and retention, 2) validity and causal inference, and 3) study longevity. While the ultimate goal of this consultation was to inform future longitudinal biomonitoring studies in Canada, the content is largely generalizable and relevant to others planning, modifying, or evaluating observational research in reproductive and environmental epidemiology.
Relevance and challenges of exposome studies for environmental health research.
Slama R, Siroux V, Vrijheid M … +1 more , Basagaña X
Environ Health · 2026 May · PMID 42210260 · Full text
The exposome encompasses all environmental exposures humans undergo from conception. We frame exposome studies according to four broad aims essential for environmental health research. First, a descriptive aim, consistin...
The exposome encompasses all environmental exposures humans undergo from conception. We frame exposome studies according to four broad aims essential for environmental health research. First, a descriptive aim, consisting in assessing exposure patterns, including correlations between exposures and their within-subject variability. This descriptive aim includes "environmental justice" studies of associations between the exposome and sociodemographic factors. A second - etiologic - aim is to describe the subclinical and clinical effects of the exposome (hazard identification). A third aim is the quantification of the exposome health impact (e.g., in life years lost at the population level) and the ranking of exposures in terms of population disease burden (exposome disease burden or risk assessment). A fourth (intervention) aim corresponds to the identification of approaches to modify the exposome, as a way to improve health. With the large increase in the number of chemicals quantifiable in a small volume of a biospecimen, the main challenge of descriptive exposome studies is population representativeness. Regarding the etiologic aim, by simultaneously showing associations of a given biological parameter with hundreds of exposures, exposome studies effectively limit publication bias and selective reporting of results, which are a strong concern in single-exposure studies. They nonetheless face several challenges, related to the curse of dimensionality, the correlation between exposures, the breadth vs. depth tension… Increasing the number of exposures considered implies to simultaneously increase study population sizes, aiming for cohorts of 100,000 subjects or more. The accuracy of exposure assessment should simultaneously be improved, e.g., by collecting repeated biospecimens within each subject, assessing exposures at various ages and decreasing limits of quantification. Classical exposome statistical designs such as ExWAS (exposome-wide association studies) are subject to a high false positive rate. Models adapted to sparse data allowing to control for confounding by co-exposures appear more efficient. The results from exposome descriptive and etiologic studies can be combined to feed exposome disease burden assessments. These can in turn help prioritize exposures for which efficient interventions need to be identified. The approaches outlined in this work could help exposome research contribute more strongly to environmental health research and to the associated risk management decisions.
Understanding residential socioeconomic and behavioral patterns for home air radon testing: a population-based intervention study in New Hampshire and Vermont (USA).
Hasson RM, Fay KA, Weiss JE … +7 more , Clement LM, Thompson ME, Schiffelbein JE, Hoopes PJ, Chidawanyika T, Tosteson ANA, Rees JR
Environ Health · 2026 May · PMID 42192410 · Full text
BACKGROUND: Radon is a known environmental carcinogen associated with thousands of lung cancers each year. Understanding characteristics associated with testing is critical to design interventions to increase acceptance...
BACKGROUND: Radon is a known environmental carcinogen associated with thousands of lung cancers each year. Understanding characteristics associated with testing is critical to design interventions to increase acceptance and promote mitigation. The objective of this study was to evaluate socioeconomic factors and cancer beliefs associated with previous home air radon testing, mitigation, and-for those who had not yet tested-acceptance of a free test. METHODS: A population-based survey was administered to adults residing in New Hampshire and Vermont to understand previous home air radon testing and mitigation patterns, and among those who had not previously tested, acceptance of information on how to request a free test. The proportions of test kits requested and returned are reported. RESULTS: Of 1,717 survey respondents, 513 (29.7%) had previously tested for radon, 767 (44.7%) had not, and 437 (25.5%) did not know. Those who had not previously tested (767/1,280; 60%) had lower educational attainment, were less likely to be married, were less likely to be homeowners, and were more likely to express negative attitudes towards cancer prevention than those who had. Of 108 respondents whose previous test had shown levels ≥2.0 pCi/L, only 59 (55%) had installed a new mitigation system. Of those with a steady place to live, 996 had not previously tested for radon or did not know. Those 996 were offered information on how to obtain a free test kit and 66% accepted (659/996); 49% of those (324/659) used the information to request a kit, and 38% of those (124/324) returned the kit for testing. In multivariable models, not previously testing the home for radon was significantly associated with being divorced/separated, household income <$150,000, and lack of employment-based health insurance. Among those without a prior test, declining information for a free radon test was significantly associated with educational attainment of high school or less, and inversely associated with being divorced/separated. CONCLUSIONS: Resident differences in socioeconomic factors and cancer beliefs regarding home air radon testing may offer potential opportunities for targeted interventions designed to decrease radon-associated lung cancer deaths.
Climate vulnerability factors for temperature-related respiratory mortality: a nationwide two-stage time-series study from 2008 to 2021.
Yang HY, Chen SC, Chang HY … +1 more , Wang YY
Environ Health · 2026 May · PMID 42177497 · Full text
BACKGROUND: Taiwan is one of the fastest-warming regions globally. As climate change intensifies, understanding how vulnerability influences health outcomes critical. This study aimed to identify regional vulnerability f...
BACKGROUND: Taiwan is one of the fastest-warming regions globally. As climate change intensifies, understanding how vulnerability influences health outcomes critical. This study aimed to identify regional vulnerability factors for temperature-related respiratory mortality and effective region-specific adaptation policies. METHODS: A two-stage time-series study was conducted using daily respiratory mortality counts aggregated by county and day. This study employed a distributed lag non-linear model to estimate the temperature-attributable mortality burden from respiratory diseases across all counties and cities in Taiwan. A two-stage meta-analysis was conducted to estimate temperature-mortality associations and quantify cold- and heat-related mortality burdens by county. Meta-regression was used to identify regional vulnerability factors modifying temperature-related mortality risk, and geographically weighted regression (GWR) was applied to characterize the spatial heterogeneity of these effects across counties. RESULTS: Cold exposure was linked to a higher burden of respiratory disease mortality (attributable fraction [AF]: 2.03%, 95% CI: 1.10-2.95) than heat exposure (AF: 1.02%, 95% CI: 0.65-1.40). For cold-related AFs, higher proportions of Indigenous populations (3.27, 0.79-5.75), low-income populations (2.11, 0.67-3.55), greater population density (2.21, 0.46-3.96), and children (0.98, 0.35-1.61) were significantly associated with increased risk, suggesting vulnerability factors. GWR further showed that hospital bed availability had statistically significant protective effects against cold-related AF in 10 of 19 counties (β = - 5.24 to - 6.78), most pronounced in remote mountainous counties (Hualien, Taitung, Kaohsiung). CONCLUSION: Higher proportions of Indigenous populations, low-income population, and children amplify cold-related respiratory mortality. Hospital bed availability confers the strongest protection against cold-related mortality in remote, mountainous counties. Climate adaptation policies for cold-related respiratory health should therefore be tailored to local vulnerability profiles, prioritizing healthcare expansion in geographically remote counties rather than applying uniform investment across all regions.
Chemical mixtures and birth weight: comparison of multipollutant models in the Maternal-Infant Research on Environmental Chemicals (MIREC) study.
MacPherson S, Ashley-Martin J, Braun JM … +2 more , Oulhote Y, Arbuckle TE
Environ Health · 2026 May · PMID 42174534 · Full text
Fetal growth is a critical health outcome influenced by prenatal exposure to environmental chemicals, particularly endocrine-disrupting chemicals (EDCs). Studies have shown that pregnant women are simultaneously exposed...
Fetal growth is a critical health outcome influenced by prenatal exposure to environmental chemicals, particularly endocrine-disrupting chemicals (EDCs). Studies have shown that pregnant women are simultaneously exposed to multiple chemicals, illustrating the need for methods that can examine the health effects of cumulative exposures. We compared four statistical methods-Principal Component Analysis (PCA), k-means clustering, Weighted Quantile Sum Regression (WQSR), and Bayesian Kernel Machine Regression (BKMR), -to identify associations between the mixture of chemicals and birth weight z-scores, including phthalate metabolites, bisphenol A, bisphenol A alternatives, triclosan, organophosphate pesticides, arsenic species, glyphosate and its breakdown product aminomethylphosphonic acid (AMPA), solvent metabolites, organophosphate flame retardants, fluoride, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), organochlorine pesticides (OCs), cotinine, per- and polyfluoroalkyl substances (PFAS), and five metals. Our complete case analysis investigated the potential effects of a mixture of 46 chemicals on birth weight z-score, using 1127 mother-infant pairs from the Maternal-Infant Research on Environmental Chemicals (MIREC) study. PCA showed a significant inverse association between birth weight z-score and a component with loadings highest for PCBs (-0.035, 95%CI: (-0.068, -0.002)) using multivariable linear regression. The k-means analysis revealed distinct clusters of chemical profiles associated with lower birth weight z-score (-0.17, 95% CI: (-0.34, -0.01)) using multivariable linear regression, and primarily composed of arsenic (As), mercury (Hg), lead(Pb), ΣOC Chlordane and the PCBs, WQSR showed an inverse association with the overall mixture index (-0.065; CI: (-0.171, 0.04) driven mostly by Aroclor 1260, ΣOC Chlordane, glyphosate, and PCB180. BKMR highlighted that the birth weight z-score was 0.054 (-0.100, 0.209)when all chemicals in the 25percentile were compared to their medians, which decreased to -0.04 (-0.219, 0.14)when all chemicals in the 75th percentile were compared to their median values. After stratification by infant sex, associations tended to be larger in magnitude in females. We observed, according to all four approaches, that ΣOC Chlordane, ΣOC Insecticides, Aroclor 1260, dimethylarsinic acid, Pb, PCB170 and PCB180 were most often associated with decreased birth weight. These findings underscore the potential adverse effects of chemical mixtures on birth weight, the usefulness of using multiple methods, and suggest the need for continued research for evaluating cumulative environmental exposures in prenatal health outcomes.
Green space exposure and risk of amyotrophic lateral sclerosis: a population-based case-control study in Northern Italy.
Sarti A, Mandrioli J, Costanzini S … +14 more , Balbo GX, Malagoli C, Martini N, Despini F, Violi F, Malavolti M, Martinelli I, Giacchino M, Donelli G, Canali E, Zinno L, Teggi S, Vinceti M, Filippini T
Environ Health · 2026 May · PMID 42169130 · Full text
BACKGROUND: The contribution of environmental determinants in the etiology of amyotrophic lateral sclerosis (ALS) is still unclear. Among the various environmental factors, exposure to green spaces, also known as greenne...
BACKGROUND: The contribution of environmental determinants in the etiology of amyotrophic lateral sclerosis (ALS) is still unclear. Among the various environmental factors, exposure to green spaces, also known as greenness, is attracting considerable interest as many studies have reported its beneficial associations to health outcomes, particularly to neurodegenerative diseases. METHODS: To investigate the relation between greenness and ALS risk, we conducted a population-based case-control study in a Northern Italy population (from Modena, Reggio Emilia and Parma provinces), including 499 cases of ALS newly-diagnosed from 1998 to 2011 and 1,935 sex-, age-, and province-matched controls randomly selected from study provinces residents. We evaluated the association between greenness in the proximity of residence and ALS risk, assessing exposure through multiple satellite-based and land-use derived indices, both conventional and novel devised, for a total of six indices, each providing specific information, including annual and seasonal Normalized Difference Vegetation Index (NDVI), NDVI-weighted to green areas, green cover ratio, accessibility index, and their combined Green Exposure Index (GEI). We used conditional logistic regression models to evaluate disease risk for increasing exposure through both fixed-categories and non-linear restricted cubic splines. RESULTS: We observed a non-linear U-shaped association between greenness and ALS risk with increased odds ratios at both low and high levels. Results were more defined when using NDVI-based indices, while the associations were smoother when considering GEI. The higher risk at low levels may be related to lower accessibility to green spaces with lower physical activity and higher exposure to outdoor air pollutants, whilst elevated greenness may reflect higher exposure to neurotoxic pesticides. These results were confirmed also after adjustment for potential confounders, namely magnetic fields and light at night. Sex stratified analysis yielded similar results, except for more distinct associations in females for GEI. CONCLUSIONS: Despite the limitations due to possible unmeasured confounding and exposure misclassification related to the use of residential data, our results provide evidence of an inverse association between intermediate residential greenness and ALS risk, and may have public health implications including disease prevention and urban planning.
Association between volatile organic compound concentrations in daycares and child wheeze: the French CRESPI study.
Sakellaris IA, Mandin C, Bright F … +6 more , Orsi L, Amat F, Bonnet P, Siroux V, Moual NL, Dumas O
Environ Health · 2026 May · PMID 42129817 · Full text
BACKGROUND: Concern is increasing about of the role of poor indoor air quality in respiratory disorders especially in children. While the deleterious respiratory health impact of some volatile organic compounds (VOCs) in...
BACKGROUND: Concern is increasing about of the role of poor indoor air quality in respiratory disorders especially in children. While the deleterious respiratory health impact of some volatile organic compounds (VOCs) in the home environment has been suggested, daycares have never been investigated. This study aims to investigate the association between VOCs concentrations in daycare facilities and children's respiratory health. METHODS: This cross-sectional study included 532 children (mean age: 22.3 months; 47.4% female) of the French CRESPI cohort (100 daycares, 2019-2022). VOC/aldehyde (n = 54) concentrations were measured on a one-day active sampling in daycares. They were studied individually in 4 categories based on quartiles and grouped in factors using principal component analysis. Wheezing outcomes - ever wheeze, recurrent wheeze (≥ 3 times), and ever wheeze with inhaled corticosteroid (ICS) use - were evaluated by parental questionnaire. Associations between daycare VOC concentrations/ factors and wheezing outcomes were analyzed with Generalized Estimating Equations to account for a possible daycare effect, and adjusted for child age, parental smoking status and education level. RESULTS: After correction for multiple testing, higher concentrations of methylisobutylketone (Odds-Ratio for Q4 vs. Q1, 95%CI: 2.40, 1.46-3.92; p-trend < 0.001, FDR-adjusted p = 0.02) and 1-methoxy-2-propylacetate (2.58, 1.54-4.33; p-trend < 0.001, FDR-adjusted p = 0.02) were associated with recurrent wheeze. Associations were further suggested for 1,2,4-trimethylbenzene (2.70, 1.34-5.45; p-trend = 0.01) and decamethylcyclopentasiloxane (2.27, 1.09-4.71; p-trend = 0.02) but were not significant after correction for multiple testing. Similar findings were observed for all wheezing outcomes. Using factor analysis, three identified factors were associated with wheezing outcomes, including a 'care/cleaning-products' factor associated with ever wheeze with ICS (OR: 1.22, 1.00-1.47). CONCLUSIONS: Daycare exposure to specific VOCs was associated with wheeze in children. Their identification and control in daycares may reduce potential health risks. TRIAL REGISTRATION: The CRESPI protocol was registered in the clinical trials register - NCT no 04170881.
Night shift work and epigenetic modifications: cardiovascular-related miRNA expression within a European cohort of night shift workers.
Harding BN, Jiang Z, Pineda D … +4 more , Swift SL, Kogevinas M, Albin M, Broberg K
Environ Health · 2026 May · PMID 42129779 · Full text
BACKGROUND: The major pathways contributing to cardiovascular disease among night shift workers remain poorly understood. MicroRNAs (miRNAs) have been identified as novel regulators of cardiovascular risk factors. Our ob...
BACKGROUND: The major pathways contributing to cardiovascular disease among night shift workers remain poorly understood. MicroRNAs (miRNAs) have been identified as novel regulators of cardiovascular risk factors. Our objective was to examine whether night shift work was associated with altered expression of five cardiovascular-related miRNAs in night and day shift workers. METHODS: RNA was extracted from plasma of 106 night and 89 day shift healthcare workers, followed by deoxyribonuclease treatment, cDNA synthesis, and quantitative real-time PCR using target-specific assays for five miRNAs (miR-122-5p, miR-107, miR-155-5p, miR-21-5p, and miR-103a-2-5p). In adjusted linear regression models, we examined associations between night shift exposure and the relative expression of miRNAs. We predicted target genes of the miRNAs under study and preformed enrichment analyses to examine related functions and pathways. RESULTS: Participants were on average 43 years of age and mostly female (94%). Results were suggestive of higher miRNA expression levels among night shift workers, most notably for miR-155-5p (coefficient 0.46, 95%CI -0.03, 0.94) and miR-103a-2-5p (coefficient 0.45, 95%CI -0.06, 0.96), however results did not reach statistical significance. In dose-response analyses, for each additional year of prior night shift work duration history, the relative expression of several miRNAs was higher. Increased duration of night shift work was significantly associated with higher levels of miR-22-5p (coeff 0.03, 95%CI 0.00, 0.05), miR-107 (coeff 0.04, 95%CI 0.01, 0.06), miR-21-5p (coeff 0.04, 95%CI 0.01, 0.07) and miR-103a-2-5p (coeff 0.02, 95%CI 0.00, 0.05). The enrichment analyses identified several pathways and functions (e.g. lipid and atherosclerosis) related to cardiometabolic risk. CONCLUSIONS: Night shift work appeared to be associated with an elevated expression of cardiovascular-related circulating miRNAs. The pathway analyses of downstream target genes provided evidence of their involvement in a variety of cardiometabolic disease mechanisms. This study presented new evidence linking night shift work exposure to cardiometabolic markers via epigenetic regulation.
Building the model: a review of input structures in extreme temperature-health.
D'Ausilio D, Ellena M, Reder A … +2 more , Pugliese A, Mercogliano P
Environ Health · 2026 May · PMID 42098811 · Full text
BACKGROUND: The health impacts of extreme temperatures have been extensively studied through epidemiological models. However, limited attention has been paid to the specification of these models, particularly regarding i...
BACKGROUND: The health impacts of extreme temperatures have been extensively studied through epidemiological models. However, limited attention has been paid to the specification of these models, particularly regarding input structure and model selection. Although exposure metrics and statistical techniques have evolved over time, a comprehensive synthesis of the variables included in these models, and the rationale behind their inclusion, is still lacking. This gap limits the comparability of studies and may compromise the robustness of temperature-health evidence. METHODS: We conducted a systematic review of peer-reviewed studies published between 2014 and 2024 that employed quantitative epidemiological models to estimate the association between extreme temperatures and health outcomes. Following PRISMA guidelines, we selected 119 studies through searches conducted in Scopus, PubMed, and Web of Science. Each study was analysed in terms of spatial coverage, modelling framework, and model inputs. Inputs were classified into six functional groups: thermal exposures; environmental covariates (including both non-thermal meteorological variables and air pollutants); temporal controls; socio-demographic factors; health system indicators; and built environment characteristics. RESULTS: Substantial heterogeneity was observed in both input selection and model specification. Daily mean temperature was the dominant exposure metric, though rarely justified over alternatives. Environmental covariates were inconsistently included: while relative humidity was frequent, other meteorological modifiers and air pollutants were often omitted without clear rationale. Temporal adjustments were common but heterogeneous. Distributed lag non-linear models were the prevailing framework, varying greatly in lag structure, spline specification, and covariate integration. Socio-economic, health, and infrastructural indicators appeared in less than one third of studies, typically as effect modifiers in meta-regression analyses, highlighting uneven integration of contextual determinants. No consensus currently exists on what constitutes a minimum model specification necessary to ensure reliable and interpretable effect estimates. CONCLUSIONS: Current temperature and health modelling remains fragmented, with notable variability in input specification and transparency. Strengthening methodological coherence through clearer guidance on input selection is essential. Greater integration of socio-economic and infrastructural variables would further enhance models' capacity to capture contextual vulnerability. To ensure reliability and policy relevance, future research should develop shared guidelines for input specification, define minimum modelling standards, and promote transparent reporting of analytical decisions.
Long-term effect of early-life arsenic exposure on morning plasma cortisol in adults from Antofagasta, Chile.
de la Rosa R, Steinmaus C, Nardone A … +5 more , Silveira A, Acevedo J, Ferreccio C, Smith MT, Sillé FCM
Environ Health · 2026 May · PMID 42087152 · Full text
Over 100,000 people were exposed to arsenic-contaminated drinking water in Antofagasta, Chile from 1958-1970. Individuals born during this high exposure period have elevated rates of cancer, lung and cardiovascular disea...
Over 100,000 people were exposed to arsenic-contaminated drinking water in Antofagasta, Chile from 1958-1970. Individuals born during this high exposure period have elevated rates of cancer, lung and cardiovascular disease, and hypertension. However, the mechanisms of long-term arsenic toxicity remain unclear. We investigated whether early-life arsenic exposure was associated with altered glucocorticoid levels in adulthood. This study included 114 individuals born in Antofagasta during the high exposure period and 118 individuals born in other Chilean cities with lower exposure. Arsenic exposure metrics were constructed based on residential histories and included: concentration at birth, peak and highest 5-year average between ages 0-10 years, and highest lifetime 5-year average, and lifetime cumulative exposure. Morning plasma cortisol concentrations were measured using a cell-based bioassay. Individuals in the highest quartile of highest lifetime 5-year average of arsenic exposure had approximately 11% lower mean log cortisol levels than those in the lowest quartile of exposure (β = -0.116; 95% CI: -0.229, -0.003). In sex-stratified analyses, associations were stronger among female participants. For example, female participants in the highest quartile of cumulative exposure had 22.0% lower cortisol levels compared to those in the lowest quartile (β = -0.248; 95% CI: -0.444, -0.053) and the test for interaction by sex was statistically significant (p = 0.036). This study is the first to show that early-life arsenic exposure may suppress HPA axis activity decades after exposure has ceased. These findings support endocrine disruption as a potential mechanism underlying long-term health effects of arsenic and highlight early development as a critical exposure window.
In utero and childhood exposure to organochlorines and perfluorinated chemicals in relation to sperm aneuploidy in adulthood.
Perry MJ, Meddis A, Young HA … +7 more , Robbins CR, Budtz-Jørgensen E, Jørgensen N, Halling J, Weihe P, Grandjean P, Petersen MS
Environ Health · 2026 May · PMID 42067914 · Full text
BACKGROUND: Sperm chromosomal abnormalities are linked to infertility and may be caused by endocrine disrupting chemical exposures during development. OBJECTIVES: We examined whether exposure to organochlorine compounds...
BACKGROUND: Sperm chromosomal abnormalities are linked to infertility and may be caused by endocrine disrupting chemical exposures during development. OBJECTIVES: We examined whether exposure to organochlorine compounds (OC), including polychlorinated compounds (PCBs), and perfluorinated compounds (PFASs) measured repeatedly since birth predicted sperm chromosomal abnormalities in young adulthood. METHODS: Aneuploidy was determined in semen samples obtained from 96 Faroese young men aged 22-24 years who were members of a birth cohort created in 1986-1987. Their current and previous serum as well as cord blood were analyzed for DDE, major PCB congeners (118, 138, 153, and 180), and PFAS (PFOA, PFOS, PFNA, PFDA, and PFHxS). Incidence rate ratios between the exposures and the risk of an extra sex chromosome in adult sperm were assessed as indication of meiotic errors. The mixture effect for overall exposures (PCBs and/or PFASs) was estimated as the change in the percentage of each type of disomy for a doubling of the exposures for two individuals within the same smoking status and abstinence time group. RESULTS: Higher concentrations of organochlorines in cord blood and in serum at ages 7, 14 years and 22 years were associated with increased proportions of chromosomal disomies. The PCB concentration in cord blood was associated mainly with having an extra Y chromosome (p-value: 0.006), while PFAS concentrations at adulthood were consistently associated with XX18 and YY18 disomies (p-values < 0.05). DISCUSSION: These findings provide new evidence that fetal and subsequent chemical exposures can have enduring influence into adulthood on the formation of male germ cells.
Long-term association between phthalate exposure in pregnancy and midlife bone mineral density among women in Mexico City.
Yao M, Tamayo-Ortiz M, Meeker JD … +8 more , Tamayo-Orozco J, Trejo-Valdivia B, Torres-Olascoaga LA, Mercado A, Trejo-Reyes R, Téllez-Rojo MM, Peterson KE, Watkins DJ
Environ Health · 2026 Apr · PMID 42050653 · Full text
BACKGROUND: Phthalates are widespread endocrine-disrupting chemicals (EDCs) that may affect bone metabolism, though human studies remain limited. This study investigated the long-term associations between measures of pht...
BACKGROUND: Phthalates are widespread endocrine-disrupting chemicals (EDCs) that may affect bone metabolism, though human studies remain limited. This study investigated the long-term associations between measures of phthalate exposure during pregnancy, a period of heightened bone activity, and midlife bone mineral density (BMD). METHODS: Participants were women in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort who had gestational phthalate measurements and midlife BMD assessments (n = 180), including 60 who received calcium supplementation during pregnancy and first year postpartum as part of a clinical trial. Nine phthalate metabolites were measured in urine samples collected at up to three pregnancy trimesters, corrected for specific gravity, and a molar sum was calculated for di-2-ethylhexyl phthalate metabolites (ΣDEHP). BMD of the spine, hip, and forearm were assessed using dual-energy X-ray absorptiometry (DXA) at a mean age of 50.1 years. We used linear models to estimate differences in BMD per doubling of geometric mean concentrations of individual phthalates across pregnancy, adjusting for perinatal calcium supplementation status, age at midlife and pre-pregnancy BMI. Effect modification by perinatal calcium supplementation was tested through interaction terms and sensitivity analyses additionally adjusted for menopausal status. Quantile-based g-computation was used to evaluate the overall effect of the phthalate mixtures. RESULTS: Most phthalate metabolites were inversely associated with spine and hip BMD, whereas some showed significant positive associations with forearm BMD. Perinatal calcium supplementation significantly modified associations between phthalate metabolites and spine BMD, showing consistent negative trends in the placebo group and positive trends in the supplementation group (ΣDEHP, p-interaction = 0.03). For example, a doubling in ΣDEHP was associated with 0.12 lower spine BMD in the placebo group (95%CI= -0.27, 0.03) and 0.28 higher spine BMD in the supplementation group (95%CI: -0.03, 0.59). Similar patterns were seen for hip BMD. Mixture analysis results aligned with single-pollutant findings. CONCLUSIONS: Phthalate exposure during pregnancy was associated with midlife BMD in a site-specific manner. Calcium supplementation in pregnancy and first year postpartum modified these associations at the spine and hip, suggesting a potential protective role.
Occupational heat exposure and chronic kidney disease risk under climate warming: a retrospective cohort study of petrochemical workers with mechanistic insights.
Li M, Zhang Y, Zhang Z … +7 more , Du S, Xu R, Zu Q, Lv Z, Zheng W, Ye W, Xiang J
Environ Health · 2026 Apr · PMID 42046109 · Full text
BACKGROUND: The modifying role of climate warming in the association between occupational heat exposure and chronic kidney disease (CKD), and the related biological mechanisms, remains incompletely understood among petro...
BACKGROUND: The modifying role of climate warming in the association between occupational heat exposure and chronic kidney disease (CKD), and the related biological mechanisms, remains incompletely understood among petrochemical workers. METHODS: We conducted a retrospective cohort study of 2,649 petrochemical workers in southeastern China between 2013 and 2022. Occupational heat exposure was assessed using on-site wet-bulb globe temperature (WBGT) measurements, reflecting the overall workplace thermal load arising from ambient temperature, process-related heat sources, humidity, and air movement. Incident CKD was defined according to the 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Long-term ambient temperature data were incorporated to evaluate effect modification by climate warming and ambient temperature background. In addition, mediation analyses of blood-based biomarkers and a nested case–control metabolomics study were conducted to explore potential biological mechanisms. RESULTS: During a median follow-up of 7.1 years, 386 incident CKD cases were identified. Occupational heat exposure was significantly associated with an increased risk of CKD (HR = 1.40, 95% CI: 1.13–1.71). This association was significantly amplified under conditions of greater climate warming and higher annual mean ambient temperatures (P-interaction < 0.001). Mediation analyses indicated that uric acid, hemoglobin, and albumin partially mediated the association between occupational heat exposure and CKD risk. Metabolomic analyses further revealed shared metabolic alterations related to the accumulation of gut-derived uremic toxins and disturbances in amino acid metabolism. CONCLUSIONS: Occupational heat exposure was associated with an elevated risk of CKD among petrochemical workers, and this risk is likely further intensified in the context of ongoing climate warming. These findings highlight the importance of incorporating climate context into occupational heat-related health risk assessments and suggest that integrating routine biomarkers with metabolomic features may enhance early identification and prevention of CKD among occupational heat-exposed workers.
Air pollution and mortality in a University of Michigan amyotrophic lateral sclerosis cohort: a survival analysis.
Pedde M, Adar SD, Jang DG … +2 more , Feldman EL, Goutman SA
Environ Health · 2026 Apr · PMID 42035155 · Full text
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a rare, fatal, neurodegenerative disease. With limited treatment options, identifying modifiable risk factors that impact ALS survival is an important goal. Air pollutio...
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a rare, fatal, neurodegenerative disease. With limited treatment options, identifying modifiable risk factors that impact ALS survival is an important goal. Air pollution may be one such risk factor, yet the research on this topic is limited. METHODS: We assessed survival for ALS patients at the University of Michigan Pranger ALS Clinic who were recruited to participate in a prospective cohort study between 2009 and 2022. Participants’ personal characteristics were linked with residential air pollutant levels of fine particulate matter mass (PM2.5), nitrogen dioxide (NO2), and ozone (O3), as well as several particle components, including black carbon (BC), nitrate, sulfate, and sea-salt (as a negative control) over follow-up. To assess the role of air pollution on ALS mortality we used time-dependent Cox proportional hazards models with days from diagnosis as the time axis, adjusted for potential confounders and co-pollutants. RESULTS: Across the 1,276 total years of person-time during follow-up (2.7 ± 2.5 years per participant) there were 329 deaths. In fully adjusted multi-pollutant models, one interquartile range (IQR) (2.1 µg/m3) higher 1-year average PM2.5 was associated with a 66% (HR 1.66 per IQR; 95% CI 1.03–2.68) increase in the hazard of death. The other pollutants were not associated with death in participants with ALS . CONCLUSIONS: This finding suggests a seven month longer median survival for a 2.1 µg/m3 decrease in 1-year average PM2.5, which is significant given that ALS lacks a cure and that existing treatments only extend survival by a few months.
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