Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants

Jeffrey T. White, Erin Kovar, Tiffany M. Chambers, Kunj R. Sheth, Erin C. Peckham-Gregory, Marisol O’Neill, Peter H. Langlois, Carolina J. Jorgez, Philip J. Lupo and Abhishek Seth
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Jeffrey T. White: Pediatric Urology, Norton Children’s Hospital, Louisville, KY 40207, USA
Erin Kovar: Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Tiffany M. Chambers: Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Kunj R. Sheth: Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
Erin C. Peckham-Gregory: Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Marisol O’Neill: Department Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
Peter H. Langlois: Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX 78751, USA
Carolina J. Jorgez: Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
Philip J. Lupo: Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Abhishek Seth: Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA

IJERPH, 2019, vol. 16, issue 6, 1-13

Abstract: Objective : Investigate whether residential prenatal exposure to heavy metal hazardous air pollutants (HMHAPs) is associated with an increased risk of hypospadias. Methods: Data on non-syndromic hypospadias cases ( n = 8981) and control patients delivered in Texas were obtained from the Texas Birth Defects Registry and matched 1:10 by birth year. Average exposure concentrations of HMHAPs were obtained from the 2005 U.S. Environmental Protection Agency National-Scale Air Toxics Assessment and categorized into quintiles. Odds ratios and 95% confidence intervals were estimated. STROBE reporting guidelines were followed. Results : We observed associations between hypospadias and prenatal HMHAP exposure. Manganese demonstrated significant increased risk of hypospadias at the medium, medium-high and high exposure quintiles; lead in the medium-high and high exposure quintiles. Cadmium, mercury and nickel demonstrated a significant inverted “U-shaped” association for exposures with significant associations in the medium and medium-high quintiles but not in the medium-low and high quintiles. Arsenic and chromium demonstrated a significant bivalent association for risk of hypospadias in a lower quintile as well as a higher quintile with non-significant intermediate quintiles. Conclusions : Using data from one of the world’s largest active surveillance birth defects registries, we identified significant associations between hypospadias and HMHAP exposures. These results should be used in counseling for maternal demographic risk factors as well as avoidance of heavy metals and their sources.

Keywords: congenital malformation; penis development; genitalia; pollutant; teratogen; hypospadias (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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