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Int. J. Environ. Res. Public Health 2019, 16(6), 930; https://doi.org/10.3390/ijerph16060930

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

1
Pediatric Urology, Norton Children’s Hospital, Louisville, KY 40207, USA
2
Department of Urology, University of Louisville School of Medicine, Louisville, KY 40202, USA
3
Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
4
Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
5
Division of Pediatric Urology, Department of Surgery, Texas Children’s Hospital, Houston, TX 77030, USA
6
Department of Pediatrics, Texas Children’s Hospital, Houston, TX 77030, USA
7
Department Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
8
Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX 78751, USA
*
Authors to whom correspondence should be addressed.
Received: 6 December 2018 / Revised: 7 March 2019 / Accepted: 8 March 2019 / Published: 15 March 2019
(This article belongs to the Special Issue Maternal and Child Environmental Health and Disease)
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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. View Full-Text
Keywords: congenital malformation; penis development; genitalia; pollutant; teratogen; hypospadias congenital malformation; penis development; genitalia; pollutant; teratogen; hypospadias
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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White, J.T.; Kovar, E.; Chambers, T.M.; Sheth, K.R.; Peckham-Gregory, E.C.; O’Neill, M.; Langlois, P.H.; Jorgez, C.J.; Lupo, P.J.; Seth, A. Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants. Int. J. Environ. Res. Public Health 2019, 16, 930.

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