Blood and urinary biomarkers of prenatal exposure to disinfection byproducts and oxidative stress: A repeated measurement analysis

Chong Liu; Yi-Xin Wang; Ying-Jun Chen; Yang Sun; Li-Li Huang; Ying-Hui Cheng; Er-Nan Liu; Wen-Qing Lu; Carmen Messerlian

doi:10.1016/j.envint.2020.105518

Blood and urinary biomarkers of prenatal exposure to disinfection byproducts and oxidative stress: A repeated measurement analysis

Environ Int. 2020 Apr:137:105518. doi: 10.1016/j.envint.2020.105518. Epub 2020 Feb 1.

Authors

Chong Liu¹, Yi-Xin Wang², Ying-Jun Chen³, Yang Sun⁴, Li-Li Huang⁵, Ying-Hui Cheng⁶, Er-Nan Liu⁷, Wen-Qing Lu⁸, Carmen Messerlian⁴

Affiliations

¹ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
² Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: yixinwang@hsph.harvard.edu.
³ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁵ School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁶ Department of Gynecology and Obstetrics, Xiaonan Maternal and Child Care Service Centre, Xiaogan City, Hubei, PR China.
⁷ Wuhan Center for Disease Prevention and Control, Wuhan, Hubei, PR China.
⁸ Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China. Electronic address: luwq@mails.tjmu.edu.cn.

PMID: 32018134
DOI: 10.1016/j.envint.2020.105518

Abstract

Background: Toxicological studies have demonstrated that disinfection by-products (DBPs) can induce oxidative stress, a proposed mechanism that is relevant to adverse birth outcomes.

Objective: To examine the associations of blood trihalomethanes (THMs) and urinary haloacetic acids (HAAs) with urinary biomarkers of oxidative stress among pregnant women.

Methods: From 2015 to 2017, a total of 4150 blood and 4232 urine samples were collected from 1748 Chinese women during pregnancy. We determined concentrations of 4 blood THMs [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] and 2 urinary HAAs [dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA)]. The summary measures of exposure for brominated THMs (Br-THMs; a molar sum of BDCM, DBCM, and TBM) and total THMs (TTHMs; a molar sum of TCM and Br-THMs) were also calculated. Associations of categorical (i.e., tertiles) and continuous measures of DBPs with urinary concentrations of oxidative stress (OS) biomarkers, 8-hydroxy-2-deoxyguanosine (8-OHdG), 4-hydroxy-2-nonenal-mercapturic acid (HNE-MA), and 8-iso-prostaglandin F_2α (8-isoPGF_2α), were assessed using linear mixed regression models.

Results: After adjusting for relevant confounding factors, we observed positive dose-response relationships between blood Br-THM tertiles and urinary HNE-MA (P for trend < 0.001). We also found positive associations between tertiles of blood TCM and TTHMs and urinary 8-OHdG and HNE-MA (all P for trend < 0.05). Urinary HAAs were also positively associated with 8-OHdG, HNE-MA, and 8-isoPGF_2α in a dose-response manner (all P for trend < 0.001). These associations were further confirmed when we modeled DBP exposures as continuous variables in linear mixed regression models, as well as in penalized regression splines based on generalized additive mixed models.

Conclusions: Exposure to DBPs during pregnancy may increase maternal OS status.

Keywords: Blood THMs; disinfection by-products; oxidative stress; pregnancy; urinary HAAs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Disinfectants*
Disinfection
Female
Humans
Oxidative Stress*
Pregnancy
Prenatal Exposure Delayed Effects*
Trichloroacetic Acid*
Trihalomethanes* / blood
Water Pollutants, Chemical*

Substances

Biomarkers
Disinfectants
Trihalomethanes
Water Pollutants, Chemical
Trichloroacetic Acid