Lea A Cupul-Uicab1, Efraín A Terrazas-Medina2, Mauricio Hernández-Ávila2, Matthew P Longnecker3. 1. Center for Population Health Research, National Institute of Public Health, Cuernavaca 62100, Morelos, Mexico; Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS/USA, Research Triangle Park, NC 27709, USA. Electronic address: lea.cupul@insp.mx. 2. Center for Population Health Research, National Institute of Public Health, Cuernavaca 62100, Morelos, Mexico. 3. Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS/USA, Research Triangle Park, NC 27709, USA.
Abstract
BACKGROUND: Prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE), the major breakdown product of DDT, has been associated with recurrent lower respiratory tract infections (LRTIs) in infants. However, epidemiological investigations are limited. OBJECTIVE: To assess the association of prenatal exposure to p,p'-DDE and p,p'-DDT with the occurrence of LRTI in boys from Chiapas, a highly exposed area of Mexico. METHODS: We analyzed data from 747 singleton boys whose prenatal exposure to p,p'-DDE and p,p'-DDT was determined in maternal serum drawn at delivery (2002-2003). LRTI (i.e., pneumonia, bronchiolitis, and other illness of the bronchi) experienced by the children were reported by their mothers during in-person interviews. The median age of the children when they were last seen was 21.4 months (quartiles 19.1 and 25.3 months). RESULTS: Median exposure to p,p'-DDE in this population was higher (2.7 µg/g lipid) than recent U.S. levels (0.20 µg/g). There were 0.19 episodes of LRTI per child-year. After adjusting for potential confounders, children in the highest category of p,p'-DDE (>9.00 µg/g) exposure compared to those in the lowest (≤ 3.00 µg/g) had an adjusted incidence rate ratio (aIRR) of LRTI of 0.77 (95% confidence interval [CI], 0.41-1.46). The corresponding aIRR for p,p'-DDT (≥ 2.00 µg/g compared to ≤ 0.25 µg/g) was 0.65 (95% CI: 0.30-1.39). CONCLUSION: An association of prenatal exposure to p,p'-DDE and p,p'-DDT with LRTI during childhood was not supported in this population with relatively high levels of exposure.
BACKGROUND:Prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE), the major breakdown product of DDT, has been associated with recurrent lower respiratory tract infections (LRTIs) in infants. However, epidemiological investigations are limited. OBJECTIVE: To assess the association of prenatal exposure to p,p'-DDE and p,p'-DDT with the occurrence of LRTI in boys from Chiapas, a highly exposed area of Mexico. METHODS: We analyzed data from 747 singleton boys whose prenatal exposure to p,p'-DDE and p,p'-DDT was determined in maternal serum drawn at delivery (2002-2003). LRTI (i.e., pneumonia, bronchiolitis, and other illness of the bronchi) experienced by the children were reported by their mothers during in-person interviews. The median age of the children when they were last seen was 21.4 months (quartiles 19.1 and 25.3 months). RESULTS: Median exposure to p,p'-DDE in this population was higher (2.7 µg/g lipid) than recent U.S. levels (0.20 µg/g). There were 0.19 episodes of LRTI per child-year. After adjusting for potential confounders, children in the highest category of p,p'-DDE (>9.00 µg/g) exposure compared to those in the lowest (≤ 3.00 µg/g) had an adjusted incidence rate ratio (aIRR) of LRTI of 0.77 (95% confidence interval [CI], 0.41-1.46). The corresponding aIRR for p,p'-DDT (≥ 2.00 µg/g compared to ≤ 0.25 µg/g) was 0.65 (95% CI: 0.30-1.39). CONCLUSION: An association of prenatal exposure to p,p'-DDE and p,p'-DDT with LRTI during childhood was not supported in this population with relatively high levels of exposure.
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