Watkins Deborah J, Torres Zayas Héctor Ramón, Vélez Vega Carmen M, Rosario Zaira, Welton Michael, Agosto Arroyo Luis D, Cardona Nancy, Díaz Reguero Zulmarie J, Santos Rivera Amailie, Huerta-Montañez Gredia, Brown Phil, Alshawabkeh Akram, Cordero José F, Meeker John D
University of Michigan, Department of Environmental Health Sciences - Ann Arbor, Michigan.
University of Puerto Rico - Medical Sciences Campus, School of Public Health - San Juan, PR.
Popul Environ. 2020 Sep;42(1):95-111. doi: 10.1007/s11111-020-00345-7. Epub 2020 Mar 17.
Prior to Hurricane Maria, Puerto Rico already had 200+ hazardous waste sites, significant contamination of water resources, and among the highest rates of preterm birth in the US. To address these issues, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Center was formed in 2010 to investigate prenatal environmental exposures, particularly phthalates, and adverse birth outcomes. Recent work from the PROTECT study confirms that in utero exposure to certain phthalates is associated with shorter gestation and increased risk of preterm birth. However, previous research also suggests that pregnant women who experience a natural disaster such as Hurricane Maria are at higher risk of adverse birth outcomes, but it is unknown whether this is due to stress, hazardous exposures, or a combination of factors. Thus, the aim of this analysis was to characterize hurricane-related changes in phthalate exposures and experiences within the PROTECT cohort. Among 176 participants who were pregnant during or within 5 months after Maria, 122 completed a questionnaire on hurricane-related experiences. Questionnaire results and biomarkers of exposure suggest that participants did not have regular access to fresh foods and water during hurricane recovery, and almost half reported structural damage to their home. In addition, biomarker concentrations of phthalates commonly used in food packaging were higher among participants post-hurricane, while phthalates commonly used in personal care products were lower compared to pre-hurricane levels. Hurricane-related increases in phthalate exposure, as well as widespread structural damage, food and water shortages, and long-term absence of electricity and cell phone service, likely increased the risk of adverse birth outcomes among this already vulnerable population.
在玛丽亚飓风来袭之前，波多黎各就已经有200多个危险废物场地，水资源受到严重污染，并且早产率在美国位居前列。为了解决这些问题，波多黎各污染威胁探索试验场（PROTECT）中心于2010年成立，以调查产前环境暴露情况，尤其是邻苯二甲酸盐暴露与不良出生结局之间的关系。PROTECT研究的最新成果证实，子宫内接触某些邻苯二甲酸盐与妊娠期缩短及早产风险增加有关。然而，此前的研究也表明，经历过玛丽亚飓风等自然灾害的孕妇出现不良出生结局的风险更高，但尚不清楚这是由于压力、有害暴露还是多种因素共同作用所致。因此，本分析的目的是描述PROTECT队列中与飓风相关的邻苯二甲酸盐暴露及经历的变化情况。在玛丽亚飓风期间或过后5个月内怀孕的176名参与者中，有122人完成了一份关于飓风相关经历的问卷调查。问卷调查结果和暴露生物标志物表明，在飓风恢复期间，参与者无法正常获取新鲜食物和水，近半数人称其房屋受到结构损坏。此外，飓风过后，参与者体内食品包装中常用邻苯二甲酸盐的生物标志物浓度较高，而个人护理产品中常用邻苯二甲酸盐的浓度则低于飓风前水平。与飓风相关的邻苯二甲酸盐暴露增加，以及普遍存在的结构损坏、食物和水短缺，还有长期停电和手机服务中断等情况，可能增加了这个本就脆弱的人群出现不良出生结局的风险。
