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Background: Previous epidemiological studies have suggested that phthalate exposure may contribute to neurocognitive and neurobehavioral disorders and decreased muscle strength and bone mass, all of which may be associated with reduced physical performance. Walking speed is a reliable assessment tool for measuring physical performance in adults age 60 y and older. Objective: We investigated associations between urinary phthalate metabolites and slowness of walking speed in community-dwelling adults ages 60-98 y. Methods: We analyzed 1,190 older adults [range, 60-98 y of age; mean [+ or -] standard deviation (SD), 74.81 [+ or -] 5.99] from the Korean Elderly Environmental Panel II study and measured repeatedly up to three times between 2012 and 2014. Phthalate exposure was estimated using the following phthalate metabolites in urine samples: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), and mono-benzyl phthalate (MBzP). Slowness was defined as a walking speed of Results: At enrollment, MBzP levels were associated with an increased odds of slowness [odds ratio (OR) per doubling increase: 1.15, 95% confidence interval (CI): 1.02, 1.30; OR for the highest vs. lowest quartile: 2.20 (95% CI: 1.12, 4.35) with p-trend across quartiles = 0.031]. In longitudinal analyses, MEHHP levels showed an increased risk of slowness [OR per doubling increase: 1.15 (95% CI: 1.02, 1.29), OR for the highest vs. lowest quartile: 1.47 (95% CI: 1.04, 2.06), p- trend = 0.035]; whereas those with higher MnBP showed a reduced risk of slowness [OR per doubling increase: 0.84 (95% CI: 0.74, 0.96), OR in the highest (vs. lowest) quartile: 0.64 (95% CI: 0.47, 0.87), p-trend = 0.006]. For linear regression models, MBzP quartiles were associated with slower walking speed (p-trend = 0.048) at enrollment, whereas MEHHP quartiles were associated with slower walking speed, and MnBP quartiles were associated with faster walking speed in longitudinal analysis (p-trend = 0.026 and Discussion: Urinary concentrations of prevalent phthalates exhibited significant associations with slow walking speed in adults ages 60-98 y. https://doi.org/10.1289/EHP10549, Introduction Walking speed is one of the quickest, most reliable, and simple measurements for monitoring the mobility and physical function of older adults. (1) Along with blood pressure, pulse rate, [...]

(1) Background: Humidifier disinfectant (HD) is a biocidal chemical to keep the water tank inside a humidifier clean. Thousands of Koreans have experienced HD-related lung injuries. Of them, 6.9% were exposed to HD in hospitals. (2) Methods: This study investigated changes of diseases in patients (or caregivers) who experienced HD exposures during hospitalization and also investigated characteristics of hospital exposure using data from all HD-related lung injury enrollment in Korea. (3) Results: Of a total of 162 subjects, 139 subjects were hospitalized for non-lung diseases, and 23 people were hospitalized for lung diseases at the time of hospitalization. During hospital exposure, 99 (71.2%) of those hospitalized with non-lung disease experienced a new-onset of lung disease, and 15 (65.2%) of those hospitalized with lung diseases experienced exacerbation of their existing lung diseases. When we compared their exposure characteristics, those exposed in hospitals (vs. non-hospital, mostly home) were exposed for shorter periods, at closer distances, at higher HD indoor concentrations, constantly all day, and directly in the facial direction. (4) Conclusion: In conclusion, HD exposures in hospital with a high intensity even for a short term were associated with new-onset or exacerbation of lung diseases. Our findings suggest that acute exposures to HD can cause lung diseases. [ABSTRACT FROM AUTHOR]

Vitamin D and fiber intake are nutritional factors that could affect the development of type 2 diabetes (T2D), potentially by reducing insulin resistance. Therefore, we hypothesized that the influence of vitamin D on T2D might depend on fiber intake. This study investigated the association between vitamin D status and T2D according to fiber intake. The present study analyzed data from 9,656 American adults (≥20 years old) who participated in the National Health and Nutrition Examination Survey (NHANES) 2007–2010. The serum concentration of 25-hydroxyvitamin D [25(OH)D] was used as a biomarker for vitamin D status. The T2D classification was based on two criteria: T2Da was identified using only self-reported questionnaire data and T2Db was identified based on both survey and laboratory data. The deficient vitamin D status (<50 nmol/L) was used as the reference group. After controlling for sociodemographic, behavioral, and dietary factors, the odds ratios (ORs) were 0.72 (95% confidence interval [CI]: 0.58, 0.90) for T2Da and 0.60 (0.50, 0.80) for T2Db in the sufficient vitamin D status (≥75 nmol/L). Furthermore, the total vitamin D concentration exhibited dose-dependent associations with lower OR values for T2Da (P for trend = .005) and T2Db (P for trend <.001). Among participants with high-fiber intake, the OR values for T2Db were 0.60 (95% CI: 0.42, 0.90) at suboptimal vitamin D status and 0.49 (95% CI: 0.31, 0.77) at sufficient vitamin D status. Moreover, the significant dose-dependent association persisted in the high-fiber-intake subgroup (P for trend = .004). Therefore, combining vitamin D plus high-fiber intake would help reduce the prevalence of diabetes, although the interaction analysis results were not statistically significant. [ABSTRACT FROM AUTHOR]

Objective: A recent meta-analysis suggested that the association between vitamin D and risk of hypertension was markedly stronger in women aged <55 years in observational data, while the association became null in women aged ≥55 years. We therefore hypothesized that this difference in associations might potentially be caused by the change in oestrogen around menopause. Our objective was to investigate associations between vitamin D status and hypertension risk and to evaluate those associations as they may differ according to menopausal status.Design: A cross-sectional population survey conducted by the US Centers for Disease Control and Prevention, National Center for Health Statistics.Setting: The National Health and Nutrition Examination Surveys (NHANES) 2007-2010 formed the setting for the present study.Participants: We analysed data from 2098 premenopausal women and 2298 postmenopausal women.Results: After adjustment for sociodemographic, behavioural and dietary factors, higher concentrations both of serum total 25-hydroxyvitamin D (25(OH)D) and serum 25-hydroxycholecalciferol (25(OH)D3) revealed significant dose-dependent trends with lower risk of hypertension (Ptrend = 0·005 and 0·014, respectively) in premenopausal women. In those women, 25(OH)D ≥ 50 nmol/l (sufficient; in contrast to deficient, vitamin D < 30 nmol/l) appeared to have a protective effect against hypertension (OR = 0·64, 95 % CI 0·39, 1·02 for total 25(OH)D and OR = 0·60, 95 % CI 0·36, 1·00 for 25(OH)D3). Neither association with hypertension was observed in postmenopausal women.Conclusions: Serum 25(OH)D concentrations were associated with lower risk of hypertension in premenopausal women, but not in postmenopausal women. [ABSTRACT FROM AUTHOR]

Background: The prevalence of hearing loss increases rapidly with aging. Hearing loss is common in all age groups, even in young adults and adolescents. A growing body of evidence has suggested that heavy metals have ototoxic effects, yet few epidemiological studies have investigated the association between heavy metals and hearing loss in a general population that includes adults and adolescents. OBJECTIVES: We examined the association between environmental exposures to lead, mercury, and cadmium and the risk of hearing loss in adults and adolescents while controlling for potential confounding factors, including noise exposures and clinical factors. METHODS: We analyzed cross-sectional data from 5,187 adults and 853 adolescents in the Korean National Health and Nutrition Examination Survey 2010-2012. Pure-tone average (PTA) of hearing thresholds at high frequency (3, 4, and 6 kHz) were computed, and hearing loss was defined as a PTA >25 dB in adults and PTA > 15 dB in adolescents. RESULTS: In adults, the highest (vs. lowest) quartiles of blood lead and cadmium were associated with 1.70 (95% CI: 1.25, 2.31) and 1.47 (95% CI: 1.05, 2.05) odds ratios for high-frequency hearing loss (p-trend CONCLUSIONS: The results of the present study suggest that exposure to environmental lead and cadmium in adults and exposure to environmental cadmium in adolescents may play a role in the risk of hearing loss. https://doi.org/10.1289/EHP565., Introduction Hearing loss is a commonly experienced chronic disorder throughout the world. Although hearing loss is common even in young adults and school-age children, it is highly prevalent in older [...]

Reduced physical performance is an important feature of aging, and walking speed is a valid measure of physical performance and mobility in older adults. Previous epidemiological studies suggest that cadmium exposure, even at low environmental levels, may contribute to vascular, musculoskeletal, and cognitive dysfunction, which may all be associated with reductions in physical performance. To this end, we investigated the associations of blood and urine cadmium concentrations with walking speed in middle-aged and older adults in the U.S. general population. We studied U.S. adults from the National Health and Nutrition Examination Survey 1999 to 2002 who were ≥50 years of age, who had determinations of cadmium in blood or in urine, and who had measurements of the time taken to walk 20 feet. Walking speed (ft/sec) was computed as walked distance (20 ft) divided by measured time to walk (in seconds). The weighted geometric means of blood and urine cadmium were 0.49 [95% confidence interval (CI): 0.47, 0.52] μg/L and 0.37 (95% CI: 0.34, 0.42) ng/mL, respectively. After adjusting for sociodemographic, anthropometric, health-related behavioral, and clinical risk factors and inflammation markers, the highest (vs. lowest) quintile of blood cadmium was associated with a 0.18 (95% CI: 0.10, 0.25) ft/sec reduction in walking speed ( p -Trend <0.001). No association was observed for urine cadmium levels with walking speed. Cadmium concentrations in blood, but not in urine, were associated with slower gait speed. Our findings add to the growing volume of evidence supporting cadmium's toxicity even at low levels of exposure. [ABSTRACT FROM AUTHOR]

The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups. Platelet function was measured using the platelet activation markers CD62P, CD63, and PAC-1 by flow cytometry, and platelet aggregation was measured using the Multiplate® analyzer, after the induction of anesthesia (baseline), at the end of the operation, and 24 and 48 h postoperatively. Findings of conventional coagulation assays, thromboelastography by ROTEM® assays, and postoperative bleeding—related clinical outcomes were compared between groups. No significant change in CD62P, CD63, or PAC-1 was observed at the end of the operation or 24 or 48 h postoperatively compared with baseline in either group. The area under the curve for arachidonic acid—stimulated platelet aggregation, measured by the Multiplate® analyzer, was significantly smaller in the aspirin continuation group (P < 0.01). However, chest tube drainage and intraoperative and postoperative transfusion requirements did not differ between groups. Our study showed that preoperative use of aspirin for OPCAB did not affect perioperative platelet activation, but it impaired platelet aggregation, which did not affect postoperative bleeding, by arachidonic acid. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQOL) represents an individual's perception of physical, mental, and social well-being and is a strong predictor of health status. Few studies have examined associations of sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA) with HRQOL in the general population.Purpose: This study aimed to determine combined associations of objectively measured SB and MVPA on the risk of poor HRQOL in the general US population, after controlling for potential confounding factors.Methods: We analyzed data from 5359 adults from the National Health and Nutrition Examination Survey 2003-2006. HRQOL was measured using a HRQOL-4 consisting of four questions focused on the self-perception of general health, physical health, mental health, and activity limitation. We dichotomized each HRQOL-4 component as good versus poor and defined poor overall HRQOL when participants had any poor HRQOL components. SB and MVPA were measured using an accelerometer. Survey logistic models were examined to estimate the odds ratio (OR) and 95% confidence interval (CI) for poor HRQOL by SB and MVPA as tertiles.Results: When examined as a combination of SB and MVPA, a substantial decrease in the risk of poor overall HRQOL was found in individuals with low SB/high MVPA [OR 0.69 (95% CI 0.51-0.94) and moderate SB/high MVPA (OR 0.56 (95% CI 0.40-0.78)], but no significant decrease was found in individuals with high SB/high MVPA (vs. high SB/low MVPA).Conclusion: Our findings suggest that both increasing MVPA and reducing time spent in SB may be useful strategies to improve HRQOL. [ABSTRACT FROM AUTHOR]

Background: Although biologically plausible, few studies have linked cadmium exposure to depression or muscle strength. Herein, we hypothesized that blood cadmium concentrations are associated with depression and lower handgrip strength in a community-dwelling elderly population.Methods: Data from 983 elderly participants who completed up to 3 surveys between 2012 and 2015 were analyzed. At every survey, we assessed depressive status using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) and measured handgrip strength and blood cadmium levels (mean, 1.24 μg/L). We evaluated the associations of cadmium with depression using generalized linear mixed models, and handgrip strength using linear mixed models. All models were adjusted for sociodemographic factors, lifestyle factors including active and passive smoking, weight, height, and comorbidity status.Results: Interquartile-range increase (0.645 μg/L) in blood cadmium levels was associated with depression defined as SGDS-K score ≥8 (odds ratio = 1.27, 95% confidence interval: 1.06, 1.52) and lower handgrip strength (right hand: β = -0.40, 95% confidence interval: -0.75, -0.09; left hand: β = -0.36, 95% confidence interval: -0.69, -0.04). The association between cadmium levels and handgrip strength was robust after further adjustment for depressive status, although it attenuated in size by 14.7%-18.0%.Conclusions: After adjusting for potential confounders, blood cadmium concentrations were associated with depression and lower handgrip strength in an elderly population. The participants' depressive status partially mediated the association between cadmium levels and handgrip strength. [ABSTRACT FROM AUTHOR]

Background: Decreased muscle strength can lead to adverse health outcomes in the elderly. A potential association between phthalate exposure and muscle strength was suggested previously, but has not been investigated directly. We hypothesized that phthalate exposure is associated with lower handgrip strength and that the association is modified by the dietary omega-6 to omega-3 ratio.Methods: We analyzed 1,228 participants (≥60 years of age) recruited in Seoul and Asan, Republic of Korea. The study participants were surveyed up to three times between 2012 and 2015. At every survey, we collected urine samples and measured handgrip strength twice for each hand. The associations between urine phthalate metabolite concentrations and handgrip strength were evaluated using linear mixed models. Based on dietary information from 391 individuals who participated in the first survey in Seoul, we evaluated the heterogeneity of the association for those with high and low omega-6 to omega-3 ratios, using 8.81 (the 75th quantile) as a cutoff value.Results: Log-transformed creatinine-adjusted concentrations of mono-(2-ethyl-5-oxohexyl phthalate (MEOHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-n-butyl phthalate (MnBP) were inversely associated with all measured handgrip strengths (β = -0.69 to -0.42, all p-values < 0.05). Associations between phthalate biomarkers and handgrip strength did not differ by sex. When the dietary subgroup was stratified by the omega-6 to omega-3 ratio, the associations were stronger among participants with high ratios.Conclusions: We found inverse associations between phthalate biomarkers and handgrip strength in the elderly; this association was modified by the dietary omega-6 to omega-3 ratio. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) is an ubiquitous chemical, which is an endocrine disruptor. Recent epidemiological studies have suggested a relationship between BPA exposure and body weight. However, most of these studies were cross-sectional and not on elderly people. We conducted a panel study with repeated measurements to evaluate the relationship between BPA and overweight in elderly people. A total of 560 elderly participants aged ≥60 years were recruited in Seoul from 2008 to 2010. Urinary BPA levels and body mass index (BMI, kg/m) were measured at every visit. We defined a BMI ≥25 as overweight and examined the relations between urinary BPA and BMI or overweight. Repeated measures analysis was performed after adjusting for age, sex, low-density lipoprotein cholesterol levels, alcohol consumption, regular exercise, total calorie intake, fatty acid intake, urinary cotinine levels, and the status of diabetes mellitus. The geometric mean of BPA was 0.67 μg/g creatinine. The odds ratio (OR) of overweight was 1.17 (95 % confidence interval [CI] 1.04-1.32) per interquartile range increase of log-transformed BPA. When stratified based on sex, we observed a significant association in women (OR 1.25; 95 % CI 1.09-1.45) but not in men (OR 0.97; 95 % CI 0.77-1.22). The ORs of overweight increased with quartiles of BPA in women (quartile 2 vs 1: OR 1.54; 95 % CI 1.02-2.32, 3 vs 1: OR 1.70; 95 % CI 1.10-2.62, and 4 vs 1: OR 1.81; 95 % CI 1.13-2.92). Our results suggest that urinary BPA levels are significantly associated with overweight in elderly women but not elderly men. [ABSTRACT FROM AUTHOR]

Abstract: Background: Benzene is a volatile organic compound present in traffic-related and indoor air pollution. It is of particular concern since it is known to induce oxidative stress, which can affect insulin resistance (IR). We therefore examined the association between exposure to environmental benzene and IR in the elderly. Study Design: Between 2008 and 2010, benzene metabolite levels (urinary trans,trans-muconic acid (t,t-MA)) and homeostatic model assessment index (HOMA-IR) were repeatedly measured in 505 adults aged ≥60years. Linear mixed-effect models and marginal logistic models were used to evaluate associations of t,t-MA concentration with HOMA-IR score and elevated IR, defined as HOMA-IR ≥2.6. Results: After adjustment for sociodemographic and behavioral factors, environmental co-exposures, and metabolic conditions, quartile levels of urinary t,t-MA demonstrated a dose-dependent association with elevated IR (p-trend<0.001) and the level of oxidative stress estimated by urinary malondialdehyde (p-trend<0.001). As compared to the lowest quartile, the upper quartiles of t,t-MA (t,t-MA concentration >0.017mg/g CR) were associated with elevated IR [odds ratio=Q2: 2.00 (95% confidence interval (CI): 1.16–3.46); Q3: 3.33 (95% CI: 1.90–5.84); Q4: 2.07 (95% CI: 1.02–4.22)]. Conclusion: Urinary benzene at levels currently observed in the urban elderly population is associated with IR, independent of traditional risk factors. Reduction of community-level exposure to benzene is therefore important for the effective prevention of IR in older adults. [Copyright &y& Elsevier]

Background: Noise exposure is a well-known contributor to work-related hearing loss. Recent biological evidence suggests that exposure to ototoxic chemicals such as organic solvents and heavy metals may be additional contributors to hearing loss. However, in industrial settings, it is difficult to determine the risks of hearing loss due to these chemicals in workplaces accompanied by excessive noise exposure. A few studies suggest that the effect of noise may be enhanced by ototoxic chemicals. Therefore, this study investigated whether co-exposure to organic solvents and/or heavy metals in the workplace modifies the risk of noise exposure on hearing loss in a background of excessive noise. Methods: We examined 30,072 workers nationwide in a wide range of industries from the Korea National Occupational Health Surveillance 2009. Data on industry-based exposure (e.g., occupational noise, heavy metals, and organic solvents) and subject-specific health outcomes (e.g., audiometric examination) were collected. Noise was measured as the daily 8-h time-weighted average level. Air conduction hearing thresholds were measured from 0.5 to 6 kHz, and pure-tone averages (PTA) (i.e., means of 2, 3, and 4 kHz) were computed. Results: In the multivariate linear model, PTA increment with occupational noise were 1.64-fold and 2.15-fold higher in individuals exposed to heavy metals and organic solvents than in unexposed individuals, respectively. Conclusion: This study provides nationwide evidence that co-exposure to heavy metals and/or organic solvents may exacerbate the effect of noise exposure on hearing loss in workplaces. These findings suggest that workers in industries dealing with heavy metals or organic solvents are susceptible to such risks. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have suggested that air pollution increases various health outcomes through oxidative stress and oxidative stress-related genes modify the relationship between air pollution and health outcomes. Therefore, we evaluated the effect of PM10 on the levels of malondialdehyde (MDA), oxidative stress biomarker, and the effect modification by genetic polymorphisms of eNOS, oxidative stress-related gene, in the 560 Korean elderly. We obtained urine samples repeatedly from participants during five medical examinations between 2008 and 2010 and all ambient air pollutant concentration data from the Korea National Institute of Environmental Research air quality monitoring system. We measured urinary levels of MDA to assess oxidative stress and genotyped eNOS (rs1799983, rs2853796, and rs7830). Mixed-effect model was used to estimate the effect of PM10 on the level of oxidative stress biomarker and their modification by genotypes. PM10 showed apparent positive effect on MDA level after adjusting for age, sex, BMI, cotinine level, temperature, dew point, levels of SO2, O3, NO2, and CO, and season (p =0.0133). Moreover, the association of PM10 with MDA was found only in participants with eNOS GG genotype for rs1799983 (p =0.0107), TT genotype for rs2853796 (p =0.0289), or GT genotype for rs7830 (p =0.0158) and in participants with a set of risky haplotypes (GTT, GTG, GGT, and TGT) (p =0.0093). Our results suggest that PM10 affect oxidative stress in the elderly and eNOS genotype affect the oxidative stress level in regard of exposure to PM10. [Copyright &y& Elsevier]

To date, there have been no well-organized clinical studies evaluating which air pollutants affect dry eye disease (DED). In this study, we investigated changes in the clinical parameters of DED according to exposure to outdoor air pollutants, including PM 2.5 (particulate matter with an aerodynamic diameter of less than 2.5 μm), PM 10 (less than 10 μm), and ozone. A prospective observational study was conducted on 43 DED patients who had used the same topical eye drop treatment between 2016 and 2018 in South Korea. Ocular surface discomfort index (OSDI) score, tear film break-up time (TBUT), corneal fluorescein staining score (CFSS), and tear secretion were measured during each visit. Air pollution data of ambient PM 10 , PM 2.5 , and ozone, based on the patients' address, were obtained, and mean concentrations were computed for one day, one week, and one month before the examination. The relationships between air pollutants and DED were analyzed in single- and multi-pollutant models adjusted for demographic and clinical factors. In the multi-pollutant model, the OSDI score was positively correlated with ozone and PM 2.5 exposure [ozone: β(exposure for 1 day/1 week) = 0.328 (95% CI: 0.161–0.494)/0.494 (0.286–0.702), p < 0.001/<0.001, per 1 ppb increase; PM 2.5 : β(1 day/1 week) = 0.378 (0.055–0.699)/0.397 (0.092–0.703), p = 0.022/ = 0.011, per 1 μg/m3 increase], and tear secretion decreased with increased ozone exposure [ozone: β(1 week/1 month) = −0.144 (−0.238 to −0.049)/-0.164 (−0.298 to −0.029), p = 0.003/ = 0.017, per 1 ppb increase]. Interestingly, increased PM 10 exposure was only associated with decreased TBUT [β(1 day/1 week/1 month) = −0.028(-0.045 to −0.011)/-0.029(-0.046 to −0.012)/-0.023(-0.034 to −0.006), p = 0.001/ = 0.001/ = 0.018, per 1 μg/m3 increase]. Tear secretion and CFSS were not associated with PM 10 exposure. Increased ozone and PM 2.5 exposure led to aggravated ocular discomfort, and increased PM 10 concentration aggravated tear film stability in patients with DED. Thus, each air pollutant may aggravate DED via different mechanisms of action. Image 1 • Air pollution is closely related with dry eye disease (DED). • Few well-designed clinical studies about effects of air pollution on DED. • Higher ozone and PM 2.5 concentration lead to ocular discomfort. • Higher PM 10 concentration aggravated tear film stability. • Mechanisms of adverse effects on DED can be different between air pollutants. [ABSTRACT FROM AUTHOR]

Pyrethroid insecticides have been used widely as replacements for organophosphate insecticides over the past decades. While several animal studies suggest that exposure to pyrethroids can alter glucose homeostasis, there is only limited evidence of the association between environmental pyrethroid exposure and diabetes risk in human populations. Therefore, we examined the National Health and Nutrition Examination Survey (NHANES) 2007–2010 data to determine the association between environmental pyrethroid exposure and the prevalence of diabetes in the general U.S. population. Using data on 2796 participants aged 20–79 years from NHANES 2007–2010, we estimated odds ratios (ORs) and 95% confidence intervals (CI) of the association between diabetes and urinary metabolite concentration of pyrethroids using logistic regression. The weighted prevalence of diabetes was 10.3%. The weighted geometric means and detection rate of 3-phenoxybenzoic acid (3-PBA), the most common nonspecific pyrethroid metabolite, were 0.41 μg/L (95% CI: 0.38, 0.45) and 72.0%, respectively. After adjusting for sociodemographic, behavioral, and metabolic factors, we found a significant dose-response relationship between urinary 3-PBA as quartile and prevalent diabetes (p -trend=0.007). Compared to the lowest quartile of 3-PBA, the highest quartile had OR of 2.18 (95% CI: 1.18, 4.03) for diabetes. Our finding suggests pyrethroid insecticides as a potential risk factor for diabetes. Further studies should be conducted to confirm our finding and to determine if this association is causal. • Synthetic pyrethroids are the insecticide most commonly available to consumers. • Use of pyrethroids has increased as they replace organophosphates in markets. • Animal studies suggest that exposure to pyrethroids can alter glucose homeostasis. • There were few epidemiologic studies for associations of pyrethroid and diabetes. • Our findings support pyrethroid's toxicity, even at current levels of exposure. [ABSTRACT FROM AUTHOR]

Background Lung function is a major predictor of morbidity and mortality. Only a few studies have explored the association between phthalate exposure and lung function. Objective To evaluate the association between phthalate exposure and lung function in the elderly. Methods A total of 3 repeated-measures surveys were conducted in 559 elderly individuals aged ≥60 years in Seoul, Korea, at 1-year intervals (2012–2015). During each survey, urinary mono-(2-ethyl-5-hydrohexyl) phthalate (MEHHP) (geometric mean, 15.68 μg/L), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) (11.97 μg/L), and mono- n -butyl phthalate (MnBP) (2.09 μg/L) levels were measured; moreover, lung function tests and a structured questionnaire interview were performed. We constructed linear mixed models to assess the association between urinary phthalate metabolite levels and lung function. Results A doubling of creatinine-adjusted urinary phthalate metabolite levels was inversely associated with forced expiratory volume in 1 s (L) (β = −0.01, 95% confidence interval [CI]: −0.02, 0.004 for MEHHP; β = −0.02, 95% CI: −0.03, −0.01 for MEOHP; β = −0.01, 95% CI: −0.03, −0.003 for MnBP) and forced vital capacity (L) (β = −0.02, 95% CI: −0.03, −0.001 for MEHHP; β = −0.02, 95% CI: −0.03, −0.004 for MEOHP; β = −0.02, 95% CI: −0.03, −0.001 for MnBP). A doubling of creatinine-adjusted MnBP levels was associated with increased rates of annual decline in forced vital capacity (L/year) (β = −0.01, 95% CI: −0.02, −0.001). Conclusions Urinary phthalate metabolite levels were associated with lower lung function and an increased rate of decline in lung function in an elderly population. [ABSTRACT FROM AUTHOR]