Children's Environmental Health Proceedings of a Workshop (2023) / Chapter Skim
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3 Environmental Influences on Children's Health Across the Life-Span and Generations
3 Environmental Influences on Children's Health Across the Life-Span and Generations
Pages 23-40
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From page 23... ...
Frederica Perera, Columbia Center for Children's Environmental Health, discussed biomarkers to air pollution and children's health and development. Niels Erik Skakkebæk, Rigshospitalet and the University of Copenhagen, described testicular cancer as a late symptom of testicular dysgenesis syndrome.
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From page 24... ...
. • It is important to disentangle heterogeneous health outcomes to ensure s tudies can demonstrate the effects of chemical exposures.
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Health equity is achieved when every person can "attain his or her full health potential," and no one is "disadvantaged from achieving this potential because of social position or other socially determined circum stances," described Juarez. Public health aims to achieve health equity by eliminating health disparities and achieving optimal health for all Americans.
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From page 26... ...
Next, Juarez suggested aligning external exposures and internal biomarkers of exposure, effect, and disease. It is important to look at multiple or cumulative exposures with interactive effects over the life course, which needs development on a conceptual or theoretical level, to test those theories.
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From page 27... ...
. Air toxics are associated with infant mortality, preterm birth, low birth weight, new and exacerbated cases of asthma, decreased lung function, immune disorders, neuro developmental effects (intelligence loss, autism spectrum disorder, and attention deficit and hyperactivity disorder)
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There is also evidence that exposures before birth can impact later generations through epigenetic changes. Physical and psychosocial toxic exposures during the fetal period impact brain development.
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. Confirmed links between exposure, a biomarker of preclinical effect, and a health outcome include: • Decreased mitochondrial DNA, a potential marker of oxidative stress production, has been associated with exposure to NO2, PM2.5, and PM10; and also to lower birth weight (Clemente et al., 2015; Janssen et al., 2012)
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From page 30... ...
The observed effects of prenatal exposure to PAHs (measured by personal air samples or PAH-DNA adducts) include behavioral problems, anxiety and depression symptoms, ADHD, decreased emotional regulation, autistic traits, reduced birth weight, and reduced head circumference and IQ.
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From page 31... ...
Echoing comments by Landrigan, Burke, Woodruff, and others, Perera commented that environmental health professionals need more research that shows the benefits of regulation and other public health interventions and is more focused on pregnant women and children in environmental justice communities. TESTICULAR CANCER AS A LATE SYMPTOM OF TESTICULAR DYSGENESIS SYNDROME6 Industrialized countries have had birth rates below sustainability levels for several decades and are now facing declining populations, said Skakkebæk.
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From page 32... ...
During and after puberty, the germ cells differentiate into spermatocytes, spermatids, and sperms. According to the current model for the pathogenesis of testicular germ cell tumors, an arrest of cell differentiation at the fetal gonocyte stage due to poor Leydig or Sertoli cell functions will lead to the proliferation of gonocytes into germ cell neoplasia in-situ (see Figure 3-3)
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From page 33... ...
Testicular germ cell cancer may be just one symptom of testicular dysgenesis syndrome due to dysfunction of fetal Sertoli and Leydig cells, said Skakkebækk. The dysgenesis of the Sertoli and Leydig cells and impaired germ cell differentiation may also lead to reduced semen quality and androgen insufficiency (see Figure 3-4)
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. Skakkebækk concluded that the testicular germ cell cancer rate, which is linked to the maldevelopment of fetal gonads and male infertility, is a FIGURE 3-5 Global trends in testicular cancer diagnosis.
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Birth outcomes associated with later life disease include preterm birth and low birth weight, which both capture heterogeneous disease etiologies. Environmental toxicities are typically very specific, which dilutes the association with these heterogeneous outcomes.
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From page 36... ...
phthalate were associated with increased odds of preterm birth in adjusted models. Ferguson summarized that exposure to several phthalates is associated with preterm birth, but the spontaneous preterm birth associations were greater in magnitude.
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Exposure to replacement chemicals will also be important, as exposure patterns change over time, such as for pesticides, flame retardants, and PFAS; new recruitment into cohorts is needed to understand the consequences of these new exposures. PRENATAL EXPOSURES AND BIOMARKERS AS MARKERS FOR AUTISM RISK8 "What role does the environment play in precision medicine?
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From page 38... ...
Teeth and hair can be used to reconstruct prenatal exposures because both matrices have incremental markings that mark time. Using baby teeth, which have rings like a tree to mark different developmental periods, weekly measures of lead exposure can be estimated going all the way back to the prenatal period (Arora et al., 2021)
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From page 39... ...
In one of his s tudies, Skakkebæk found that the best predictor of male semen quality was testosterone levels at 3 months. Arora said that an important goal over the next 25 years would be to make progress on climate change.
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