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Elevated exposure to multiple trace metals can be neurotoxic even at relatively low levels. These findings are primarily evident from adult occupational studies as well as in children exposed prenatally or in early childhood. Less research has focused on the neurodevelopmental impacts of exposure to metals among school-aged children. We examined associations between exposure to a mixture of four metals (arsenic, cadmium, manganese, lead) measured in hair and markers of cognition, attention, and behavior among 222 6–12 year old children who participated in a 2009–2010 neurodevelopmental follow-up to the C8 Health Project. Using quantile-based g-computation we estimated the adjusted overall metal mixture effect ψ (95 % CI) as the change in outcome per decile increase in all metals in the mixture. Hair metal levels varied by metal, with cadmium being lowest (median 0.007, interquartile range (IQR) 0.013 μg/g) and lead the highest concentration (median 0.152, IQR 0.252 μg/g). Children’s cognitive skills and development, attention/impulsivity, and behavior were all close to standardized population means. Each decile increase in all metals was associated with a Full Scale IQ reduction of 1.01 points (95 % confidence interval (CI) –1.88, –0.15) and Verbal IQ reduction of 1.11 points (95 % CI –1.97, –0.25), adjusted for child age, sex, secondhand smoke exposure, HOME score, maternal education, maternal IQ, and examiner. Maternal report of ADHD-like behaviors and executive functioning also showed adverse associations with the metal mixture. Our findings suggest that similar to exposure during prenatal and early childhood periods, recent exposure to metals during middle childhood is associated with adverse neurodevelopmental consequences. Middle childhood may also be a developmental window of susceptibility to the negative consequences of exposure to environmental neurotoxicants.

Background:Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are immunotoxic in laboratory studies. Human studies of immune effects are inconsistent. Using the US National Health and Nutrition Examination Survey (NHANES), we examined PFAS serum concentration and indicators of prevalent immune function among 12–19-y-old children.Methods:In this cross-sectional study, we examined PFAS serum concentration in relation to measles, mumps, and rubella antibody concentrations in NHANES 1999–2000 and 2003–2004 (n = 1,191) and to allergic conditions and allergic sensitization in NHANES 2005–2006 (n = 640).Results:In adjusted, survey-weighted models, a doubling of perfluorooctane sulfonate (PFOS) concentration among seropositive children was associated with a 13.3% (95% confidence interval (CI): -19.9, -6.2) decrease in rubella antibody concentration and a 5.9% decrease in mumps antibody concentration (95% CI: -9.9, -1.6). We observed no adverse association between exposure and current allergic conditions, including asthma. Children with higher PFOS concentration were less likely to be sensitized to any allergen (odds ratio (OR): 0.74; 95% CI: 0.58, 0.95).Conclusion:Increased exposure to several PFAS was associated with lower levels to mumps and rubella antibody concentrations, especially among seropositive individuals. These lower antibody concentrations may indicate a less robust response to vaccination or greater waning of vaccine-derived immunity over time.

In animal studies, perfluorinated compounds affect fetal growth, development, viability, and postnatal growth. The limited epidemiologic findings on child neurobehavioral development are mixed.

We assessed the association between perfluorooctanoic acid (PFOA) and pregnancy outcome in an area with elevated exposure to PFOA from drinking water contaminated by chemical plant releases.

Objectives. The 1998 Master Settlement Agreement (MSA) between 46 states and four major tobacco companies increased tobacco control funding and restricted tobacco marketing. In 2002, New York City (NYC) began a comprehensive tobacco control program that raised the price of cigarettes, banned indoor workplace smoking, and increased access to cessation treatment. We examined the temporal pattern of smoking during pregnancy, including ethnic variation in smoking prevalence, relative to the implementation of the MSA and NYC's comprehensive tobacco control program using birth certificate data.Methods. Using multiple logistic regression, we analyzed NYC birth certificate data to examine prenatal smoking during three time periods: 1995–1998 (pre-MSA), 1999–2002 (post-MSA, pre-NYC tobacco control), and 2003–2005 (post-MSA, post-tobacco control).Results. Overall, 3.0% of 1,136,437 births included were to smoking mothers. The proportion of smoking mothers declined from 4.5% in 1995–1998 to 1.7% in 2003–2005. Compared with non-Hispanic white women, African American women had 2.46 increased odds (95% confidence interval [CI] 2.36, 2.55) of smoking during 1995–1998, and 3.63 increased odds (95% CI 3.39, 3.88) of smoking during 2003–2005, despite an absolute reduction in smoking from 10.4% to 5.0%. Puerto Rican women also smoked considerably more than non-Hispanic white women.Conclusions. These findings document a striking temporal decline in prenatal smoking in NYC concurrent with changing tobacco control policies. Targeted efforts may be required to address the increasing disparity in prenatal smoking between non-Hispanic white and African American and Puerto Rican women.

Introduction:In the United States (U.S.), 18% of women age 18-44 years report at least one physical, sensory, or cognitive disability. Compared to the general population, women with disabilities are more likely to have multiple comorbidities and experience adverse pregnancy outcomes. Diet and physical activity are important and modifiable lifestyle behaviors for women’s preconception and long-term health, as well as the health of their offspring. This study examined diet quality, physical activity, and related lifestyle factors among women of reproductive age by disability status and disability type.Hypothesis:Diet quality, physical activity, and other lifestyle factors will differ across disability status.Methods:Data were from the U.S. National Health and Nutrition Examination Survey 2013-2018 (n=3,409). Disability status was determined by the Washington Group on Disability Statistics questions regarding difficulty hearing, seeing, concentrating, walking, dressing, or running errands alone. Diet quality was evaluated using the Healthy Eating Index (HEI) 2015, with higher scores indicating better diet quality. Self-reported physical activity, food security, and fast food and ready-to-eat food consumption were also assessed. Chi-square tests and generalized linear regression evaluated differences across disability status and disability type.Results:Compared to women with no disabilities, women with any self-reported disabilities had lower HEI-2015 scores (46.8 and 50.5, respectively; p<0.05), were more likely to report low/very low food security (48% and 18%, respectively; p<0.05), and were less likely to report meeting physical activity recommendations of ≥150 minutes/week of moderate/vigorous activities (27% and 43%, respectively; p<0.05). Differences were also observed by disability type, such that women with self-reported vision difficulty consume more fast food meals in one week compared to women with no disabilities.Conclusions:Women of reproductive age with disabilities report lower diet quality, food security, and physical activity. Future research should focus on identifying and improving modifiable lifestyle behaviors among this population to reduce disparities in maternal and child health outcomes.