Prenatal exposure to DDE and PCB 153 and respiratory health in early childhood: a meta-analysis.
BACKGROUND
Persistent organic pollutants may affect the immune and respiratory systems, but available evidence is based on small study populations. We studied the association between prenatal exposure to dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyl 153 (PCB 153) and children's respiratory health in European birth cohorts.


METHODS
We included 4608 mothers and children enrolled in 10 birth cohort studies from 7 European countries. Outcomes were parent-reported bronchitis and wheeze in the first 4 years of life. For each cohort, we performed Poisson regression analyses, modeling occurrences of the outcomes on the estimates of cord-serum concentrations of PCB 153 and DDE as continuous variables (per doubling exposure) and as cohort-specific tertiles. Summary estimates were obtained through random-effects meta-analyses.


RESULTS
The risk of bronchitis or wheeze (combined variable) assessed before 18 months of age increased with increasing DDE exposure (relative risk [RR] per doubling exposure = 1.03 [95% confidence interval = 1.00-1.07]). When these outcomes were analyzed separately, associations appeared stronger for bronchitis. We also found an association between increasing PCB 153 exposure and bronchitis in this period (RR per doubling exposure = 1.06 [1.01-1.12]) but not between PCB 153 and wheeze. No associations were found between either DDE or PCB 153 and ever-wheeze assessed after 18 months. Inclusion of both compounds in the models attenuated risk estimates for PCB 153 tertiles of exposure, whereas DDE associations were more robust.


CONCLUSIONS
This large meta-analysis suggests that prenatal DDE exposure may be associated with respiratory health symptoms in young children (below 18 months), whereas prenatal PCB 153 levels were not associated with such symptoms.
From the aCentre for Research in Environmental Epidemiology, Barcelona, Spain; bCIBER Epidemiología y Salud Pública, Spain; cIMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; dUniversitat Pompeu Fabra, Barcelona, Spain; eUniversity of Valencia, Spain; fCenter for Public Health Research (CSISP-FISABIO), Valencia, Spain; gSubdirección de Salud Pública de Gipuzkoa, Departamento de Sanidad del Gobierno Vasco, Spain; hBiodonostia, Donostia Ospitalea, Donostia-San Sebastián, Basque Country, Spain; iDepartment of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; jDepartment of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece; kINSERM, U1085 IRSET, University of Rennes I, Rennes, France; lNorwegian Institute of Public Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; mEnvironmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium; nNational Institute for Health and Welfare, Department of Environmental Health, Chemical Exposure Unit, Finland; oRuhr University Bochum, Department of Hygiene, Social and Environmental Medicine, Bochum, Germany; pIUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; qSlovak Medical University, Faculty of Public Health, Bratislava, Slovak Republic; rDepartment of Epidemiology and Public Health, University Hospital, Rennes, France; sLaboratory of Environmental Toxicology, Norwegian School of Veterinary Science, Oslo, Norway; and tDepartment of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; and uArea de Salud de Menorca, IB-SALUT, Menorca, Spain.
Mireia
M
Gascon
Jordi
J
Sunyer
Maribel
M
Casas
David
D
Martínez
Ferran
F
Ballester
Mikel
M
Basterrechea
Jens Peter
JP
Bonde
Leda
L
Chatzi
Cécile
C
Chevrier
Merete
M
Eggesbø
Ana
A
Esplugues
Eva
E
Govarts
Kiviranta
K
Hannu
Jesús
J
Ibarluzea
Monika
M
Kasper-Sonnenberg
Claudia
C
Klümper
Gudrun
G
Koppen
Mark J
MJ
Nieuwenhuijsen
Lubica
L
Palkovicova
Fabienne
F
Pelé
Anuschka
A
Polder
Greet
G
Schoeters
Maties
M
Torrent
Tomas
T
Trnovec
Maria
M
Vassilaki
Martine
M
Vrijheid
D000293:Adolescent; D000328:Adult; D001991:Bronchitis / Q000139:chemically induced / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D003633:Dichlorodiphenyl Dichloroethylene / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016012:Poisson Distribution; D011078:Polychlorinated Biphenyls / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology; D012135:Respiratory Sounds / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
D003633:Dichlorodiphenyl Dichloroethylene; D011078:Polychlorinated Biphenyls; C014024:2,4,5,2',4',5'-hexachlorobiphenyl