Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.
Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, Jiangsu, China.
Ecotoxicol Environ Saf. 2023 Dec;268:115726. doi: 10.1016/j.ecoenv.2023.115726. Epub 2023 Nov 22.
Exposure to metal mixtures may affect children's health but the conclusions are controversial. We aimed to investigate the associations of metal mixture exposure with children's physical and behavioral development. 15 metals were detected in the urine samples of 278 preschoolers aged 3-6 years from eastern China. Multiple linear models and restricted cubic splines were used to evaluate dose-response relationships between single metal and children's physical and behavioral development. The Bayesian Kernel Machine Regression (BKMR) models, the weighted quantile sum (WQS) models and Quantile G-Computation were applied to evaluate the joint effects of metal mixtures. The results showed that arsenic (As) was negatively associated with z score of height for age (HAZ) in individual-metal models [β (95%CI): - 0.22 (-0.38, -0.06), P = 0.006]. Concerning children's behavioral development, multiple-metal models demonstrated a negative association with strontium (Sr) [β (95%CI): - 0.82 (-1.38, -0.26), P = 0.004], and a positive association with tin (Sn) [β (95%CI): 0.69 (0.16, 1.21), P = 0.010]. Notably, these associations remained significant or suggestive even after adjustments for multiple tests, sensitivity analyses, and application of different statistical models, including BKMR, WQS, and Quantile G-Computation. Furthermore, the study identified a negative joint effect of the metal mixture on HAZ, as demonstrated by BKMR and Quantile G-Computation models, with As playing an irreplaceable role in this observed impact. In summary, exposure to As appears to have adverse effects on HAZ, while exposure to Sn may hinder children's behavioral development. Conversely, exposure to Sr may have a protective effect on children's behavioral development. Additionally, the combined impact of metal mixtures is implicated in potentially impairing children's physical development, particularly in terms of HAZ.
金属混合物的暴露可能会影响儿童的健康,但结论存在争议。我们旨在研究金属混合物暴露与儿童身体和行为发育之间的关联。在中国东部,对 278 名 3-6 岁学龄前儿童的尿液样本进行了 15 种金属检测。使用多元线性模型和受限立方样条来评估单一金属与儿童身体和行为发育之间的剂量-反应关系。应用贝叶斯核机器回归(BKMR)模型、加权分位数和(WQS)模型和分位数 G 计算(Quantile G-Computation)来评估金属混合物的联合效应。结果表明,在个体金属模型中,砷(As)与身高年龄别 Z 评分(HAZ)呈负相关[β(95%CI):-0.22(-0.38,-0.06),P=0.006]。关于儿童行为发育,多金属模型显示锶(Sr)与 Sr 呈负相关[β(95%CI):-0.82(-1.38,-0.26),P=0.004],与锡(Sn)呈正相关[β(95%CI):0.69(0.16,1.21),P=0.010]。值得注意的是,即使在进行了多次测试、敏感性分析以及应用不同的统计模型(包括 BKMR、WQS 和 Quantile G-Computation)调整后,这些关联仍然具有统计学意义或提示意义。此外,研究还发现金属混合物对 HAZ 的联合效应呈负相关,BKMR 和 Quantile G-Computation 模型表明,As 在这一观察到的影响中起着不可替代的作用。总之,暴露于 As 似乎对 HAZ 有不良影响,而暴露于 Sn 可能会阻碍儿童的行为发育。相反,暴露于 Sr 可能对儿童的行为发育有保护作用。此外,金属混合物的综合影响可能会损害儿童的身体发育,特别是 HAZ。
Ecotoxicol Environ Saf. 2023-12
Environ Sci Pollut Res Int. 2023-1