Association between exposure to airborne endocrine disrupting chemicals and asthma in children or adolescents: A systematic review and meta-analysis

Hatem, Georges; Faria, Ana Margarida; Pinto, Mariana Bessa; Teixeira, João Paulo; Salamova, Amina; Costa, Carla; Madureira, Joana

http://hdl.handle.net/10400.18/10978

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Various studies have explored the association between Endocrine Disrupting Chemicals (EDCs) exposure and children's and adolescents' respiratory health, showing potential long-term effects and links to asthma. This systematic review explores the association between exposure to seven EDC groups during school age and adolescence and asthma onset or exacerbation while highlighting the predominant compounds underlying these potential associations. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched with no time restriction. The risk of bias and heterogeneity across the included studies were assessed using the Newcastle Ottawa scale and I2 test, respectively. Pooled Odds Ratios (OR) and their 95% Confidence Intervals (CI) were calculated using the random effect model, and the quality of evidence for each outcome was measured using the GRADE approach. The review included 64851 children and adolescents from 61 observational studies, most with a low risk of bias in the studied domains. The pooled OR for asthma onset was significant for phthalates in dust samples (OR:1.21, CI:1.02; 1.44). Due to limited studies, the overall pooled effects for the other groups were not computed. Individual compounds demonstrating significant associations with asthma onset included airborne nickel (OR:1.10, CI:1.03; 1.18) and zinc (OR:1.13, CI:1.11; 1.15), urinary Bisphenol S (OR:1.40, CI:1.13; 1.73), Bisphenol A (OR:1.57, CI:1.02; 2.40) and arsenic (OR:2.08, CI:1.33; 3.26), and DiBP (OR:1.41, CI:1.08; 1.82), DEHP (OR:1.89, CI:1.00; 3.57), and TBOEP (OR:2.61, CI:1.08; 6.30) in the dust. Individual compounds with significant associations with greater asthma exacerbation odds comprised airborne nickel (OR:1.08, CI:1.01; 1.16) and zinc (OR:1.09, CI:1.01; 1.17), and urinary MEHHP (OR:1.24, CI:1.02; 1.51), MECPP (OR:1.30, CI:1.07; 1.57), MEOHP (OR:1.30, CI:1.09; 1.55), and MCOP (OR:1.32, CI:1.11; 1.57). Exposure to EDCs was significantly associated with asthma onset and exacerbation in children and adolescents, namely for phthalates, bisphenols A and S, arsenic, nickel, and zinc. Further research is recommended to focus on the impact of synergistic and co-exposure to other indoor air pollutants.

Highlights: - Limited evidence led to pooling the effect only for phthalates among 7 EDC groups. - Higher phthalates levels in dust were associated with 1.21 higher asthma onset odds. - Higher DEHP, DiBP, TBOEP, BPA, BPS and Arsenic levels linked with asthma onset odds. - Higher MCOP, MECPP, MEHHP, MEOHP, Ni and Zn levels linked to exacerbation odds. - Insignificant associations with OH-pyrene, formaldehyde, and triclosan with asthma.

Palavras-chave

Asthma Exacerbation Childhood Asthma Endocrine Disruptors Environmental Exposure Meta-analysis Systematic Review Ar e Saúde Ocupacional Avaliação do Risco Toxicologia