Frederica Perera, DrPH Professor, School of Public Health Director, Columbia Center for Children’s Environmental Health Mailman School of Public Health - Columbia University April 20, 2007 Effects of Environmental Pollutants on Women’s Reproductive Health and Child Health and Development

2 Need for Prevention Low birth weight Asthma Child developmental disorders Cancer Obesity Adult chronic diseases

3 Environmental toxicants Psychosocial factors Nutritional deficiencies Genes

4 Differential exposure Greater absorption and retention of toxics Lower efficiency in detoxification/repair Higher rate of cell proliferation Time for cancer to develop Maternal and Fetal/Child Susceptibility to Environmental Toxicants

5 Study Populations: NYC, Poland, and China Cohorts Young, healthy pregnant women recruited during pregnancy Non-smokers; some passive smokers Subject to varying levels of environmental toxicants

6 Coal burning Diesel Environmental tobacco smoke (ETS) Pesticides Outdoor and Indoor Air Pollution

7 Pregnancy Through Age 11 Pesticides Phthalates Cotinine Lead, Mercury PAH-DNA Adducts Chromosomal Aberrations Immune Changes Gene Expression Proteomic Pattern Genetic Polymorphisms Antioxidant Vitamins Asthma Cancer Risk (chromosomal abnormalities) Growth & Neurobehavioral Development Monitoring Questionnaire Psychosocial factors GIS Exposure Assessment Biomarkers of Exposure/ Effect/Susceptibility Outcomes

8 The Mother and Fetus are Exposed to Multiple Toxicants in Air Air Monitoring/Questionnaire: Air Sampler 100% of pregnant mothers exposed over a wide range: Polycyclic aromatic hydrocarbons (PAHs) Organophosphate pesticides Pyrethroid pesticides Phthalates Whyatt et al.; Perera et al.; Horton et al. 40% exposed to ETS

9 Biomarkers in Mothers and Newborns PAH-DNA adducts detected in 40% to 70% of maternal and newborn cord bloods higher in newborns than mothers relative to estimated dose Chlorpyrifos, diazinon, and/or propoxur detected in 100% of maternal and cord blood samples 8 phthalate metabolites detected in urine of 100% of women Tang et al.; Perera et al.; Whyatt et al.

10 Biomarkers of Effect in Newborns Associated with PAH Exposure Genetic changes Chromosomal aberrations Epigenetic changes Gene methylation changes (pilot data) Bocskay et al.; Ho et al.

11 Prenatal Exposures Adversely Affect Reproductive Outcomes PAHs/PAH-DNA adducts: reduction in birth weight and/or head circumference and child growth Chlorpyrifos: reduction in birth weight ETS: reduction in birth weight Perera et al.; Whyatt et al.; Rauh et al.

12 Prenatal Exposures Adversely Affect Child Development PAHs/PAH-DNA adducts: lower developmental scores and higher risk of developmental delay in young children Chlorpyrifos: lower developmental scores, higher risk of developmental delay, ADHD and other attentional deficits ETS: lower developmental scores, developmental delay Tang, Perera, et al.; Rauh, Whyatt, et al.

13 Prenatal Exposures Increase Risk of Childhood Asthma Over 30% of children have asthma Combined prenatal PAHs and postnatal ETS associated with asthma diagnosis at ages 2 and 5 Miller et al.

14 Conclusions Exposures to pollutants during pregnancy are associated with: - reduced fetal growth - childhood asthma - developmental disorders - a biomarker of increased cancer risk Pollutants can interact to worsen effects

15 Environmental toxicants Opportunities for Prevention Better health outcomes

16 Acknowledgements Special thanks to: The women and children participating in the studies CCEH Key Investigators: H. Andrews, K. Bocskay,, R. Garfinkel, M. Horton, P. Kinney, R. Miller, V. Rauh, D. Tang, R. Whyatt, CUMC Genetics Lab: D. Warburton NCI: S. Chanock University of Cincinnati: S. M. Ho, W. Tang CDC: D. Barr, T. Bernert, R. Schleicher, L. Needham, J. Pirkle SWRI: D. Camann Funding: NIEHS, EPA New York Community Trust, Gladys & Roland Harriman Foundation, Bauman Family Foundation, Educational Foundation of America, New York Times Company Foundation, The Horace W. Goldsmith Foundation, JMF, Beldon Foundation,Johnson Family Foundation, Rockefeller Brothers, Rockefeller Financial Services, Blanchette Hooker Rockefeller, National Philanthropic Trust

17 Changing residential insecticide exposure: Pre- and post- regulation of OPs Change in levels of insecticides (ng/m 3 ) detected in 48-hr personal air samples collected from pregnant African American and Dominican women living in New York City between ** p < 0.05 p = 0.15