Ambient temperature and the occurrence of intradialytic hypotension in patients receiving hemodialysis.

Background: Intradialytic hypotension (IDH) is a common hemodialysis complication causing adverse outcomes. Despite the well-documented associations of ambient temperatures with fluid removal and pre-dialysis blood pressure (BP), the relationship between ambient temperature and IDH has not been adequately studied. Methods: We conducted a cohort study at a tertiary hospital in southern Taiwan between 1 January 2016 and 31 October 2021. The 24-h pre-hemodialysis mean ambient temperature was determined using hourly readings from the weather station closest to each patient's residence. IDH was defined using Fall40 [systolic BP (SBP) drop of ≥40 mmHg] or Nadir90/100 (SBP <100 if pre-dialysis SBP was ≥160, or SBP <90 mmHg). Multivariate logistic regression with generalizing estimating equations and mediation analysis were utilized. Results: The study examined 110 400 hemodialysis sessions from 182 patients, finding an IDH prevalence of 11.8% and 10.4% as per the Fall40 and Nadir90/100 criteria, respectively. It revealed a reverse J-shaped relationship between ambient temperature and IDH, with a turning point around 27°C. For temperatures under 27°C, a 4°C drop significantly increased the odds ratio of IDH to 1.292 [95% confidence interval (CI) 1.228 to 1.358] and 1.207 (95% CI 1.149 to 1.268) under the Fall40 and Nadir90/100 definitions, respectively. Lower ambient temperatures correlated with higher ultrafiltration, accounting for about 23% of the increased IDH risk. Stratified seasonal analysis indicated that this relationship was consistent in spring, autumn and winter. Conclusion: Lower ambient temperature is significantly associated with an increased risk of IDH below the threshold of 27°C, irrespective of the IDH definition. This study provides further insight into environmental risk factors for IDH in patients undergoing hemodialysis.

Characterization of the Pyrroloquinoline Quinone Producing Rhodopseudomonas palustris as a Plant Growth-Promoting Bacterium under Photoautotrophic and Photoheterotrophic Culture Conditions.

Rhodopseudomonas palustris is a purple non-sulfide bacterium (PNSB), and some strains have been proven to promote plant growth. However, the mechanism underlying the effect of these PNSBs remains limited. Based on genetic information, R. palustris possesses the ability to produce pyrroloquinoline quinone (PQQ). PQQ is known to play a crucial role in stimulating plant growth, facilitating phosphorous solubilization, and acting as a reactive oxygen species scavenger. However, it is still uncertain whether growth conditions influence R. palustris's production of PQQ and other characteristics. In the present study, it was found that R. palustris exhibited a higher expression of genes related to PQQ synthesis under autotrophic culture conditions as compared to acetate culture conditions. Moreover, similar patterns were observed for phosphorous solubilization and siderophore activity, both of which are recognized to contribute to plant-growth benefits. However, these PNSB culture conditions did not show differences in Arabidopsis growth experiments, indicating that there may be other factors influencing plant growth in addition to PQQ content. Furthermore, the endophytic bacterial strains isolated from Arabidopsis exhibited differences according to the PNSB culture conditions. These findings imply that, depending on the PNSB's growing conditions, it may interact with various soil bacteria and facilitate their infiltration into plants.

Simultaneous determination of 24 congeners of 2- and 3-monochloropropanediol esters and 7 congeners of glycidyl esters using direct multi-residue analytical LC-MS/MS methods in various food matrices.

Glycidyl esters (GEs) and 2- and 3-monochloropropanediol esters (MCPDEs) are emerging process-generated food contaminants known as possible carcinogens. Herein, a direct method is developed and validated for the first time to simultaneously quantify seven GEs and twenty-four MCPDE congeners of processed foods using liquid chromatography-tandem mass spectrometry in a single sequence without ester cleavage or derivatisation, thereby allowing for the simultaneous analysis of numerous food matrices with high accuracy and precision. Our results show levels of GEs varying from

Investigating the associations between organophosphate flame retardants (OPFRs) and fine particles in paired indoor and outdoor air: A probabilistic prediction model for deriving OPFRs in indoor environments.

Contaminants of emerging concern such as organophosphate flame retardants (OPFRs) are associated with atmospheric fine particles (PM2.5), which pose the greatest health risk in the world. However, few surveys have explored the interaction between PM2.5 and OPFRs in residential paired indoor/outdoor environments. 11 priority OPFRs and PM2.5 were investigated across 178 paired indoor and outdoor air samples taken from 89 children's households in southern Taiwan, across cold and warm seasons. This involved exploring their associations with building characteristics, interior materials, and human activities. We developed a probabilistic predictive model for indoor OPFRs based on the indoor/outdoor (I/O) ratio of contaminants and an air quality index. The significant associations of paired indoor/outdoor OPFRs and PM2.5 were explored. The indoor level of OPFRs was greater than that of outdoor households, contrasting with PM2.5. The I/O OPFRs ratio was higher than 1 (except for TEHP, EHDPP, and TCP), which suggests that the sources of OPFRs were primarily emitted from indoors. Indoor TCEP was significantly positively associated with indoor and outdoor PM2.5. The OPFR level detected in apartments was higher than in houses due to the greater decoration, furniture and electronic devices. However, this was not the case for PM2.5. TCIPP was the dominant compound in paired indoor and outdoor air. The indoor OPFR predictive model obtained a high accuracy with an R2 value of 0.87. The material used in mattresses, the use of purifiers and heaters, and the total material area were the main influencing factors for indoor OPFRs in households. These findings could provide important evidence of the interaction between paired indoor/outdoor OPFRs and PM2.5 and interior equipment in different building types. In addition, it could prevent the potential risks posed by indoor/outdoor air pollutants and eliminate OPFR emissions through the selection of better construction and building materials.

Seasonal and source characteristics of organophosphorus flame retardants in air and house dust in Taiwan residential microenvironments: Implications for young children's exposure and risk assessment using a probabilistic approach.

Organophosphate flame retardants (OPFRs) are prevalent in multiple industries. They have gradually replaced brominated flame retardants in recent years. Eleven OPFRs were collected from indoor air and house dust in two primary activity spaces--bedrooms and living rooms. The aim of the present study was to explore the potential sources of, and health risks associated with, OPFR exposure in young children using integrated and probabilistic approaches. The level of 11 indoor air OPFRs (466 ng/m3) in the bedroom was greater than that measured in the living room (379 ng/m3), and these values contrasted with those detected in dust. The air OPFRs in the warmer season were higher than those measured in the cold season; the inverse was true for those detected in house dust. In both activity spaces, the composition profiles indicated that tris(1-chloro-2-propyl)phosphate in indoor air (39%) and tris(2-butoxyethyl)phosphate in house dust (67%) were the dominant congeners. The average daily exposure dose (ADD) of OPFRs via air inhalation and dust ingestion did not differ significantly between preschool and school-aged children or based on sex. The Monte-Carlo-simulated 95th percentile ADD of the OPFRs in dust ingested by preschool children was 1.4 times higher. The OPFR exposure from air inhalation and dust ingestion in Taiwanese children is currently an acceptable non-carcinogenic risk and a negligible carcinogenic risk to Taiwan residents.

Toxicity prediction: An application of alternative testing and computational toxicology in contaminated groundwater sites in Taiwan.

Groundwater contamination remains a global threat due to its toxic effects to humans and the environment. The remediation of contaminated groundwater sites can be costly, thus, identifying the priority areas of concern is important to reduce money spent on resources. In this study, we aimed to identify and rank the priority groundwater sites in a contaminated petrochemical district by combining alternative, non-animal approaches - chemical analysis, cell-based high throughput screening (HTS), and Toxicological Priority Index (ToxPi) computational toxicology tool. Groundwater samples collected from ten different sites in a contaminated district showed pollutant levels below the detection limit, however, hepatotoxic bioactivity was demonstrated in human hepatoma HepaRG cells. Integrating the pollutants information (i.e., pollutant characteristics and concentration data) with the bioactivity data of the groundwater samples, an evidence-based ranking of the groundwater sites for future remediation was established using ToxPi analysis. The currently presented combinatorial approach of screening groundwater sites for remediation purposes can further be refined by including relevant parameters, which can boost the utility of this approach for groundwater screening and future remediation.

Oxidative/nitrosative stress increased the risk of recurrent pregnancy loss-Taiwan Recurrent Pregnancy Loss and Environmental Study (TREPLES).

OBJECTIVE: Oxidative stress biomarkers (OSBs) may be strongly associated with disease progression and recurrent pregnancy loss (RPL). However, the research on associations of most OSBs (e.g., 8-nitroguanine [8-NO2Gua] and 4-hydroxy-2-nonenal-mercapturic acid [HNE-MA]) with RPL is limited. Therefore, we aimed to investigate the effect of OSBs exposure on RPL risk by performing a case-control study. MATERIAL AND METHODS: We use our established dataset, Taiwan Recurrent Pregnancy Loss and Environmental Study (TREPLES), which included 514 Taiwanese reproductive age women (aged 20-50 years; 397 cases and 117 controls) from National Cheng Kung University Hospital. RPL is clinically defined by a history of two or more consecutive miscarriages, where a miscarriage is defined as the termination of pregnancy before 20 weeks of gestation. The urinary levels of several OSBs (e.g., 8-hydroxy-2'-deoxyguanosine [8-OHdG], 8-NO2Gua, 8-isoprostaglandin F2α [8-isoPGF2α], and HNE-MA) and malondialdehyde (MDA) were measured using isotope dilution liquid chromatography-tandem mass spectrometry and thiobarbituric acid reactive substances, respectively. RESULTS: The median levels of 8-NO2Gua (6.15 vs. 3.76 ng/mL) and HNE-MA (30.12 and 21.54 ng/mL) were significantly higher in the RPL group than in the control group. By categorizing the OSBs data into tertiles, after we adjusted for age and urine creatinine levels discovered that the RPL risk associated with 8-NO2Gua and HNE-MA levels in the third tertile were approximately 2 times higher than those in the first tertile (8-NO2Gua, adjusted OR = 3.27, 95 % CI = 1.66-6.43; HNE-MA, adjusted OR = 1.96, 95 % CI = 1.05-3.64; p < 0.05). These findings suggest that the oxidative stress biomarkers of 8-NO2Gua and HNE-MA are risk factors for RPL. CONCLUSION: Our findings indicate that specific OSBs are associated with an increased RPL risk, suggesting that reducing OSB levels can improve RPL risk. Nevertheless, more studies on preventive medicine are required to understand the exposure sources and adverse outcome pathways of OSBs associated with RPL.

iTRAQ Proteomics Identified the Potential Biomarkers of Coronary Artery Lesion in Kawasaki Disease and In Vitro Studies Demonstrated That S100A4 Treatment Made HCAECs More Susceptible to Neutrophil Infiltration.

Coronary artery lesions (CAL) are a major complication of Kawasaki disease (KD). The early prediction of CAL enables the medical personnel to apply adequate medical intervention. We collected the serum samples from the KD patients with CAL (n = 32) and those without CAL (n = 31), followed by a global screening with isobaric tagging for relative and absolute quantification (iTRAQ) technology and specific validation with an enzyme-linked immunosorbent assay (ELISA). iTRAQ identified 846 proteins in total in the serum samples, and four candidate proteins related to CAL were selected for ELISA validation as follows: Protein S100-A4 (S100A4), Catalase (CAT), Folate receptor gamma (FOLR3), and Galectin 10 (CLC). ELISA validation showed that the S100A4 level was significantly higher in KD patients with CAL than in those without CAL (225.2 ± 209.5 vs. 143.3 ± 83 pg/mL, p < 0.05). In addition, KD patients with CAL had a significantly lower CAT level than those without CAL (1.6 ± 1.5 vs. 2.7 ± 2.3 ng/mL, p < 0.05). Next, we found that S100A4 treatment on human coronary artery endothelial cells (HCAECs) reduced the abundance of cell junction proteins, which promoted the migration of HCAECs. Further assays also demonstrated that S100A4 treatment enhanced the permeability of the endothelial layer. These results concluded that S100A4 treatment resulted in an incompact endothelial layer and made HCAECs more susceptible to in vitro neutrophil infiltration. In addition, both upregulated S100A4 and downregulated CAT increased the risk of CAL in KD. Further in vitro study implied that S100A4 could be a potential therapeutic target for CAL in KD.

The Potential Biomarker of Di(2-ethylhexyl) Phthalate Exposure during Catheterization.

Background: Di(2-ethylhexyl) phthalate (DEHP) may produce toxicity, posing a risk to human health. Medical devices composed of DEHP are frequently used in catheterization, but few studies have investigated DEHP exposure during catheterization. The aim of this prospective series was to characterize the exposure pattern of DEHP during catheterization. Methods: We enrolled 16 patients with congenital heart disease undergoing catheterization. Collection of urine was done to measure DEHP metabolites on hospitalization, before catheterization, after catheterization, and at discharge. The following DEHP metabolites were measured: mono-(2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and the ratio of MEHP to overall metabolites (MEHP%) was determined. DEHP exposure from polyvinyl chloride (PVC)-containing catheter and infusion systems were recorded in detail. Differences in DEHP levels before and after catheterization were analyzed. Results: Urinary levels of MEHP, MEHHP, and MEOHP significantly decreased from before catheterization to after catheterization (all p < 0.01), but did not change significantly from initial hospitalization to before catheterization. Urinary MEHP% significantly decreased from initial hospitalization to before catheterization (p < 0.001), then increased after catheterization (p < 0.001), and decreased gradually at discharge (p = 0.03). Urinary MEHP% after catheterization and at discharge was significantly positively related to the duration of using PVC-containing catheter systems. There was a significant positive correlation between urinary MEHP% and the duration of using PVC-containing infusion system before catheterization, and a borderline significant correlation at both post-catheterization time slots. Conclusions: Our results demonstrated that urinary MEHP% may be a potential biomarker of DEHP contamination from the use of PVC-containing catheters or infusion systems.

Reappraisal of VEGF in the Pathogenesis of Kawasaki Disease.

Vascular endothelial growth factor (VEGF) is an important factor in mediating the inflammation of Kawasaki disease (KD). The literature regarding the relationship between VEGF and KD is sparse. The purpose of this study was to investigate the correlation of VEGF and KD. In a prospective study of 42 Taiwanese KD patients (18.9 ± 12.2 months, M/F 22/20) treated with intravenous immunoglobulin (IVIG), a series of VEGF levels was measured from the acute to convalescent phases. KD patients were classified into two subgroups with (n =20) and without (n = 22) acute coronary artery lesions (CALs). Control samples were obtained from 30 febrile controls (19.1 ± 13.7 months, M/F 13/17). In KD patients, VEGF levels in the pre-IVIG acute phase were significantly higher than those in the subacute and convalescent phases (both p < 0.001). In KD patients with CALs, VEGF levels significantly increased immediately in the post-IVIG phase (p = 0.039), and then significantly decreased in the subacute phase (p = 0.002). KD patients with acute CALs had higher median VEGF levels than those without acute CALs from acute to convalescent phases. In the subacute phase, KD patients with acute CALs had significantly higher VEGF levels (p = 0.022) than those without acute CALs. Our data show that VEGF did not decrease after IVIG treatment, and increased significantly after IVIG treatment in KD patients with acute CALs in acute phase. VEGF might be related to the complications of CALs in KD patients.

Estimations of infiltration factors of diurnal PM2.5 and heavy metals in children's bedrooms.

Children are the sensitive population to fine particulate matter (PM2.5 ) exposure and spend most of their time in bedroom. Infiltration factor (Finf ) can be used to calculate the fraction of total indoor PM2.5 with outdoor origin to increase the accuracy of exposure assessment. However, studies have ignored the diurnal variations of PM2.5 Finf values, and a few studies have estimated Finf values for heavy metals in PM2.5 in children's bedrooms. To calculate the PM2.5 Finf , real-time indoor and outdoor PM2.5 concentrations and occupants' activities were collected in 56 study bedrooms. At 22 of the 56 study bedrooms, PM2.5 samples were also collected for heavy metals analysis. We noted the PM2.5 Finf was higher during the daytime (0.70 ± 0.23) than nighttime (0.54 ± 0.27) during the hot season, and the time of air conditioner use was longer at nighttime. The largest Finf value of heavy metal was V (0.88 ± 0.25), followed by Pb (0.85 ± 0.28), Mn (0.72 ± 0.26), Cr (0.69 ± 0.35), and Zn (0.61 ± 0.32), with a larger variation. Our findings suggest that the estimations of diurnal PM2.5 and heavy metals Finf values are necessary to increase the accuracy of exposure assessment.

Insights into the long-term fates and impacts of polybrominated diphenyl ethers in sediment samples in Taiwan: The national project for background monitoring of the environmental distribution of chemical substances (BMECs).

This study aimed to evaluate the impact factors and effectiveness of management policies on the presence of polybrominated diphenyl ethers (PBDEs) in sediment samples in Taiwan from the last 10 years. Twenty-four PBDE congeners were detected in 838 sediment samples collected from 4 stages (2006-2019) in 30 principal rivers, based on the national project for background monitoring of the environmental distribution of chemical substances. The ΣPBDE concentrations in the 4 stages ranged from 30.00 to 147.10 ng/g dw, 6.03-15.30 ng/g dw, 4.99-7.00 ng/g dw, and 1.20-2.10 ng/g dw in the northern, southern, central, and eastern areas, respectively. The concentrations of PBDEs (e.g., penta-BDE and octa-BDE) in sediment samples notably decreased (-6 to -73%) as the Taiwan Environmental Protection Administration implemented policies banning PBDEs (except deca-BDE). The PBDEs levels of the sediment samples collected in the dry season were higher than those collected in the wet season. The levels of ΣPBDEs in sediment samples were affected by season, the amount of general waste present, and nearby PBDE-related factories and e-waste recycling facilities. Reducing the release of PBDEs, especially deca-BDE, through sound waste management and recycling practices is still needed to improve environmental sustainability in Taiwan.

Reduction of pesticide residues in Chrysanthemum morifolium by nonthermal plasma-activated water and impact on its quality.

This study investigated the efficiency of plasma-activated water (PAW) on the reduction of pesticides, namely, metribuzin and metobromuron, and the effect of PAW treatment on the quality of fresh chrysanthemums. The reduction efficiencies reached 74.3% for metribuzin and 38.2% for metobromuron after 240 s of PAW treatment. Compared with reverse osmosis (RO) water, PAW achieved significantly higher pesticide reductions because of its higher acidity, enhanced oxidizing ability, and increased formation of reactive species. Moreover, when compared with metobromuron, metribuzin was reduced more efficiently irrespective of the RO water or PAW treatments because of its higher water solubility, lower log octanol-water partition coefficient, and more oxidizable chemical structure. Additionally, the PAW treatment did not cause adverse changes to the chrysanthemums' color, total flavonoid content, radical scavenging, or metal chelating activities, but it did cause a slight decrease in the chrysanthemums' aroma compounds and total reducing power. This study successfully demonstrated the effectiveness of PAW for reducing pesticides in herbal flowers like chrysanthemums and reveals PAW's promising potential to treat foods with non-smooth surfaces.

Aggregating exposures and toxicity equivalence approach into an integrated probabilistic dietary risk assessment for perchlorate, nitrate, and thiocyanate: Results from the National food monitoring study and National Food Consumption Database.

Perchlorate, nitrate, and thiocyanate, namely thyroid disrupting chemicals (TDCs), are found ubiquitously in the environment, leading to broad human exposure and primary uptake through the food web and drinking water. TDCs are all competitive inhibitors of thyroid iodide uptake activity, but limited studies have assessed the cumulative risk of dietary exposure to multiple TDCs. Thus, in this study, we analyzed the individual exposure risk from 310 food samples in 11 categories, and also assessed the cumulative health risks from TDCs for the Taiwanese population using a perchlorate equivalent concentration (PEC) approach. Consequently, this study not only demonstrated the non-carcinogenic health risks from individual exposure but also highlighted that the cumulative exposure to these TDCs may adversely affect human thyroid functioning. Vegetables, livestock, fruits, and dairy products are the most susceptible to PEC exposure. We highlighted nitrate as the main contributor to PEC exposure. Finally, controlling the overall TDC concentrations from vegetables, livestock, fruits, and dairy products is emphasized in this study. This is the first study to conduct a cumulative risk assessment of dietary exposure to TDCs using the PEC approach for the Taiwanese population through probabilistic and sensitivity analyses.

Fast and Environment-Friendly GC-MS Method for Eleven Organophosphorus Flame Retardants in Indoor Air, Dust, and Skin Wipes.

Organophosphorus based flame retardants (OPFRs) extensively used as alternatives to banned polybrominated diphenyl ethers and hexabromocyclododecane have been garnering interest due to the possibility that these compounds may have less significant impact on human and environmental health. Long pretreatment time, larger consumption of organic solvents, matrix interferents, and cross-contamination were found in previous studies while assessing OPFRs in indoor environments. We developed and optimized the extraction methods and simultaneous analysis of 11 OPFRs in indoor air, dust and skin wipe samples using the GC-MS approach. The proposed methods were validated using a standard addition approach, dust SRM 2585 and the real samples. Our procedures enabled the analyst to effectively limit coextracted interferences and simultaneous analytical methods of 11 target OPFRs for three matrices were achieved. The validation was performed according to standard guidelines (relative errors were identified by the analytes: -19% to 18% for indoor air, -11% to 14% for house dust, -15% to 16% for skin wipe). Good practices for quality assurance and quality control were well stated. The current high-Eco-scored methods could be categorized as "an excellent green analysis". All analytes for the target OPFRs were detected in the real samples of indoor air, house dust and skin wipe collected from ten Taiwanese homes. Tris(2-butoxyethyl) phosphate, tris(1,3-dichloro-2-propyl)phosphate and tris(chloroisopropyl) phosphate were the most abundant OPFRs. Rapid, green and cost-effective GC-MS methods were developed and validated for the analysis of eleven OPFRs in indoor air, house dust and skin wipes.

Levels of Phthalates, Bisphenol-A, Nonylphenol, and Microplastics in Fish in the Estuaries of Northern Taiwan and the Impact on Human Health.

Due to the sparsity in knowledge, we investigated the presence of various estrogenic endocrine-disrupting chemicals (EEDCs), including phthalates (PAEs), bisphenol-A (BPA), and nonylphenol (NP), as well as microplastics (MPs) in samples of the most widely consumed fish collected from different estuaries in northern Taiwan. We then proceeded to determine the likely contribution that this exposure has on the potential for health impacts in humans following consumption of the fish. Six hundred fish caught from five river estuaries (producing 130 pooled samples) were analyzed to determine how different factors (such as the river, benthic, pelagic, and migratory species) influence EEDCs' contamination and the possible impacts on human health following typical consumption patterns. The predominant EEDCs was diethyl phthalates (DEP), bis (2-ethylhexyl) phthalates (DEHP), and di-iso-nonylphthalate (DINP) in fish, present at 52.9 ± 77.3, 45.3 ± 79.8, and 42.5 ± 79.3 ng/g dry weight (d.w.), respectively. Residual levels of NP, BPA, and MPs in the fish were 17.4 ± 29.1 and 1.50 ± 2.20 ng/g d.w. and 0.185 ± 0.338 mg/g d.w., respectively. EEDCs and MPs levels varied widely among the five river estuaries sampled due, in part, to differences in habitat types and the associated diversity of fish species sampled. For DEP, the Lao-Jie River and pelagic environments produced the most severely contaminated fish species, respectively. DEP residues were also associated with the burden of MPs in the fish. Based on our analysis, we predict no substantial direct human health risk by EEDCs based on typical consumption rates of estuarine fish by the Taiwanese people. However, other sources of EEDC exposure cannot be ignored.

Cumulative risk assessment of phthalates exposure for recurrent pregnancy loss in reproductive-aged women population using multiple hazard indices approaches.

Phthalates, which are commonly used in flexible plastics and consumer products, have been reported to be toxic to reproductive and developmental function in mammals. Past studies have focused on the toxic effects on male reproduction, with only a few studies conducted on the risks that cumulative exposure to phthalates have on the female reproductive system. We recruited 260 patients with recurrent pregnancy loss (RPL) of unknown etiology and 203 controls from the clinics of Obstetrics and Gynecology at a medical center in southern Taiwan from 2013 to 2020. The daily intake of phthalates was estimated from urine samples using the back-calculation method, after which the cumulative risk was determined using multiple hazard indices, including a dose-addition model, a receptor effect model, and a hazard index approach. The patients with RPL had a significantly higher cumulative exposure to phthalates (p < 0.05) than did the controls with a hazard index above one. After adjusted logistic regression analysis, we found that the risk of RPL was strongly related to the higher quartiles of DEHP, the DEHPTEQ for the antiandrogenic effect and adverse effects of the female reproductive system and the ERα binding effect (p < 0.05). Our work suggests that more attentions should be paid to the adverse effects induced by phthalates on female reproduction, especially the effects caused by the cumulative exposure to phthalates in women of reproductive age.

Human biomonitoring reference values and characteristics of Phthalate exposure in the general population of Taiwan: Taiwan Environmental Survey for Toxicants 2013-2016.

Since a 2011 incident involving phthalate-tainted food, Taiwanese people have become concerned with food quality, and they are still being exposed to certain levels of phthalates. However, no nationwide human biomonitoring survey had been conducted to gather information on levels or reference values (RVs) of phthalates in the Taiwanese population. We aimed to establish the urinary levels and RVs of phthalate metabolites and identify exposure characteristics among Taiwan's population. We enrolled 1857 participants 7 years of age and older from the Taiwan Environmental Survey for Toxicants (TESTs) conducted during 2013-2016. Levels of 11 phthalate metabolites in each participant's urine samples were determined using liquid chromatography-tandem mass spectrometry. For all phthalate metabolites except for mono-methyl phthalate (MMP), mono-ethyl phthalate (MEP), and mono-ethylhexyl phthalate (MEHP), urinary median levels were significantly higher in the 7-17-year old group than in the ≧18-year-old group. For most phthalate metabolites and in the general population, the geometric mean decreased with increasing age. Median levels of MEP (19.55 µg/L), mono-benzyl phthalate (MBzP) (2.11 µg/L), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (22.82 µg/L), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEOHP) (16.08 µg/L), ΣDibutyl phthalate metabolites (ΣDBPm) (0.17 nmol/mL), Σdi-(2-ethylhexyl) phthalate metabolites (ΣDEHPm) (0.29 nmol/mL) were higher in participants from central Taiwan than those from other areas. The median level of DBP (ΣDBPm: 0.20 nmol/mL) was significantly higher in participants from harbor areas than those from other urbanization groups. The RV of the 95 percentile (P95) for phthalate metabolites in the 7-17/≧18-year-old groups were 185.95/208.19 µg/L for MMP, 198.46/265.81 µg/L for MEP, 119.85/69.99 µg/L for mono-isononyl phthalate (MiBP), 165.19/204.32 µg/L for Mono-n-butyl phthalate (MnBP), 15.61/11.73 µg/L for MBzP, 62.09/59.23 µg/L for MEHP, 149.70/69.66 µg/L for MEHHP, 112.06/35.07 µg/L for MEOHP, 195.20/93.83 µg/L for mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), 45.66/27.69 µg/L for mono-(2-carboxymethylhexyl) phthalate (MCMHP), and 9.09/12.13 µg/L for mono-iso-nonyl phthalate (MiNP). We concluded that phthalate exposure of the general population in Taiwan varies by sex, age, region, and urbanization level. Exposure by the 7-17-year-old group to DMP, DBP, and DEHP in Taiwan remains higher than that of youth from other countries. RV of phthalate metabolites in Taiwan were established in the current study.

The effects of phthalate ester exposure on human health: A review.

Phthalate esters (PAEs) are one of the most widely used plasticizers in polymer products and humans are increasingly exposed to them. The constant exposure to PAEs-contained products has raised some concerns against human health. Thus, the impacts of PAEs and their metabolites on human health require a comprehensive study for a better understanding of the associated risks. Here, we attempt to review eight main health effects of PAE exposure according to the most up-to-date studies. We found that epidemiological studies demonstrated a consistent association between PAE exposure (especially DEHP and its metabolites) and a decrease in sperm quality in males and symptom development of ADHD in children. Overall, we found insufficient evidence and lack of consistency of the association between PAE exposure and cardiovascular diseases (hypertension, atherosclerosis, and CHD), thyroid diseases, respiratory diseases, diabetes, obesity, kidney diseases, intelligence performance in children, and other reproductive system-related diseases (anogenital distance, girl precocious puberty, and endometriosis). Future studies (longitudinal and follow-up investigations) need to thoroughly perform in large-scale populations to yield more consistent and powerful results and increase the precision of the association as well as enhance the overall understanding of potential human health risks of PAEs in long-term exposure.

Prenatal Phthalates Exposure and Cord Thyroid Hormones: A Birth Cohort Study in Southern Taiwan.

BACKGROUND: The regulation of thyroid hormones in the early stages of gestation plays a crucial role in the outcome of a pregnancy. Furthermore, thyroid hormones are fundamental for the fetal development of all organs, including endocrine hormone changes in uterus. Endocrine disrupting chemicals have been shown to have an effect on thyroid hormone homeostasis in newborns, which affects their later development. Few studies have proposed how phthalates could alter thyroid function through several mechanisms and the possible effects on thyroid hormone homeostasis of phthalates on pregnant women. However, the effects of cord blood phthalates and prenatal phthalate exposure on thyroid hormones in newborns remain unclear. OBJECTIVES: We aim to follow up on our previous established subjects and determine the correlation between phthalate exposure and thyroid hormones in pregnant women and newborns. MATERIALS AND METHODS: We recruited 61 pregnant women from the Obstetrics and Gynecology Department of a medical hospital in southern Taiwan and followed up. High performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was used to analyze urine samples for five phthalate metabolites. Serum levels of thyroid hormones were analyzed using electrochemoluminescence immunoassay (ECLIA) method. We used Spearman and Pearson correlation coefficients to evaluate the correlation between each phthalate metabolites in serum and the thyroid hormone levels in fetus and parturient. Finally, multiple logistic regression was used to explore the relationship between hormones and their corresponding phthalate metabolites in cord blood. RESULTS: High MBP in cord blood was correlated with negative cord serum TSH in newborns (r = -0.25, p < 0.06). By using multiple linear regression after adjusting for potential confounders (gestational and maternal age), cord serum MBP levels showed a negative association with cord serum TSH (ß = 0.217, p < 0.05), cord serum T4 (ß = 1.71, p < 0.05) and cord serum T4 × TSH (ß = 42.8, p < 0.05), respectively. CONCLUSION: We found that levels of cord serum TSH and T4 in newborns was significantly negatively associated with cord serum MBP levels after adjusting for significant covariate. The fall in TSH in newborns may potentially be delaying their development.