Trials and Tribulations of Protecting Children from Environmental Hazards

Society is increasingly aware of the profound impact that the environment has on children’s health. Not surprisingly, there is increasing public scrutiny about children’s exposures to environmental hazards, especially for disadvantaged children. These trends underscore the ethical imperative to develop a framework to protect children from environmental hazards. Such a framework must include regulations to test new chemicals and other potential hazards before they are marketed, a strategy to conduct research necessary to protect children from persistent hazards that are widely dispersed in their environment, stronger regulatory mechanisms to eliminate human exposures to recognized or suspected toxicants, and guidelines about the ethical conduct of research and the role of experimental trials that test the efficacy and safety of interventions to prevent or ameliorate children’s exposure to persistent toxicants or hazards that are widely dispersed in their environment

Human Health Risks from Low-Level Environmental Exposures: No Apparent Safety Thresholds

Wigle and Lanphear argue that for many toxins widely dispersed in the environment, even very low levels pose health risks

The Impact of Clinical and Population Strategies on Coronary Heart Disease Mortality: An Assessment of Rose’s Big Idea

Background: Coronary heart disease (CHD), the leading cause of death worldwide, has declined in many afuent countries but it continues to rise in industrializing countries. Objective: To quantify the relative contribution of the clinical and population strategies to the decline in CHD mortality in afuent countries. Design: Meta-analysis of cross-sectional and prospective studies. Data sources: PubMed and Web of Science from January 1, 1970 to December 31, 2019. Method: We combined and analyzed data from 22 cross-sectional and prospective studies, representing 500 million people, to quantify the relative decline in CHD mortality attributable to the clinical strategy and population strategy. Result: The population strategy accounted for 48% (range=19 to 73%) of the decline in CHD deaths and the clinical strategy accounted for 42% (range=25 to 56%), with moderate inconsistency of results across studies. Conclusion: Since 1970, a larger fraction of the decline in CHD deaths in industrialized countries was attributable to reduction in CHD risk factors than medical care. Population strategies, which are more cost-efective than clinical strategies, are under-utilized

Case Report: High Prenatal Bisphenol A Exposure and Infant Neonatal Neurobehavior

Context: Most of the U.S. population is exposed to the high-production-volume chemical bisphenol A (BPA), but targetable sources of exposure remain to be determined. Animal studies and one human study suggest that BPA is a neurotoxicant

Prenatal urinary triclosan concentrations and child neurobehavior

Background: Exposure to triclosan, an antimicrobial chemical, is ubiquitous among pregnant women and may reduce thyroid hormone levels that are important for fetal neurodevelopment. Few studies have examined the association between prenatal triclosan exposure and children's neurobehavior. Objective: We investigated the relationship of prenatal urinary triclosan concentrations with children's behavior and cognitive abilities at age three years in a prospective pregnancy and birth cohort in Canada. Methods: We measured triclosan in urine samples collected at ~12 weeks of gestation in 794 Canadian women enrolled in a prospective pregnancy and birth cohort study (MIREC) from 2008 to 2011. Around age 3 years, we assessed children's cognitive abilities using the Wechsler Primary and Preschool Scale of Intelligence-III (WPPSIIII), and two scales of the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P). Parents reported children's problem and reciprocal social behaviors using the Behavior Assessment System for Children-2 (BASC-2) and Social Responsiveness Scale-2 (SRS-2), respectively. Results: After adjusting for confounders using multivariable linear regression, triclosan was not associated with most of the 30 examined neurobehavioral scales. Each 10-fold increase in triclosan was associated with better WPPSI-III picture completion scores (β: 0.2; 95% CI: 0,0.5) and BASC-2 externalizing (β: −0.5; 95% CI: −1.1, 0) and hyperactivity (β: −0.6; 95% CI: −1.2, −0.1) scores, suggesting less externalizing and hyperactive behaviors. Child sex did not modify these associations. Conclusions: In this cohort, urinary triclosan concentrations measured once in early pregnancy were not associated with most assessed aspects of neurobehavior and weakly associated with a few others, but not in the hypothesized direction