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Project 4: Arsenic Epidemiology, Biomarkers & Exposure Assessment in New Hampshire

Project 4: Arsenic Epidemiology, Biomarkers & Exposure Assessment in New Hampshire. Arsenic passes through the placenta. Among Andean women exposed to 200 mg/L of arsenic in drinking water median arsenic levels in maternal blood (11 mg/L) were nearly as high in infant cord blood (9 mg/L)

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Project 4: Arsenic Epidemiology, Biomarkers & Exposure Assessment in New Hampshire

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  1. Project 4:Arsenic Epidemiology, Biomarkers & Exposure Assessment in New Hampshire

  2. Arsenic passes through the placenta Among Andean women exposed to 200 mg/L of arsenic in drinking water • median arsenic levels in maternal blood (11 mg/L) were nearly as high in infant cord blood (9 mg/L) • Concentrations of arsenic in placental tissue also elevated. Concha et al, 1998

  3. Arsenic – Fetal/Infant Effects • In utero/early life exposure to arsenic via drinking water contamination, observed to increase risk of: • Adverse fetal outcomes: • fetal and neonatal mortality, spontaneous abortion and stillbirths • low birth weight and preterm delivery • Decline in childhood intellectual function • Cancer risk later in life, in particular liver and lung cancers

  4. Arsenic & Birth weight Decreased birth weight < 100 mg/L urinary As of 1. 7 g per mg/L No data on these outcomes in a US population Rahman et al., 2009

  5. Dietary Mercury • Much of the data pertain to unique study populations (e.g.- those who subsist primarily on whale and seal meat), which are not generalizable to women in the United States. • New England has the highest atmospheric levels of mercury in the country and mercury has contaminated pristine lakes and accumulated in local fish populations. • Due to increased dietary reliance on fish and shellfish in coastal states, New Hampshire provides an excellent opportunity to assemble a birth cohort where both the effects of arsenic in drinking water and mercury in seafood can be assessed.

  6. Specific Aims • To test whether in utero arsenic is associated with reduced birth weight, fetal growth and gestational age (i.e., premature births). • Whether nutritional or genetic factors modify these associations. • To test whether in utero methylmercury exposure influences fetal growth and gestational age. • To evaluate the reliability of multiple measures of metal exposure (e.g., drinking water, hair, nails and urine concentrations) in mothers and in mother-infant pairs.

  7. Pregnancy Cohort

  8. Elevated exposures 20% of pregnant women enrolled in our study – tap water exceeds the MCL of 10 mg/L As Birth Cohort Study Area

  9. Enrollment Status • Enrollments started January 1, 2009 at 3 Concord Clinics • April 2010: Enrollment expanded to include an OB/GYN clinic in Concord • July 2010: Enrollment expanded to include a family clinic in Warner • December 2010: Enrollment expanded to include DHMC Lebanon • To date we have enrolled 321 subjects, • 70-80% response rate

  10. Status of Sample Collection 309 302 263 Maternal:146(PN) 162 (PP) Infant:145 154 277 Cord blood: 203 Meconium: 148 Placenta: 151

  11. Urinary Arsenic MetabolismAs3 a As5 a MA a DMA

  12. 2nd Step 1st Step

  13. Emily Baker, DHMC Judy Rees, DMS Rebecca Troisi, NCI, DMS Susan Korrick, Harvard Karl Kelsey, Brown Victoria Flanagan, DHMC Vicki Sayarath, DMS Jennifer Egner, DMS Caitie Dayman, DMS Stephanie Jackson, DMS Nadia Gorman, DMS Tom Caldwell, DMS Diane Gilbert –Sullivan (postdoc) Elizabeth Kamai (presidential scholar) Ongoing Project 4 Collaborative Work: Angeline Andrew, DMS Jason Moore, DMS Brian Jackson, DMS Scot Zens, DMS George Li, DMS Carmen Marsit, Brown, Jay Gandolfii and others Dartmouth Superfund Cores, and Projects Obstetricians throughout the State The New Hampshire Birth Cohort Study Learning how the environment affects the health of your baby

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