BACKGROUND:Bisphenol A (BPA) exposure has been linked to adverse childhood neurodevelopment, but little is known about whether BPA substitutes exposures are also related to childhood neurodevelopment.OBJECTIVES:To investigate the associations of exposure to BPA and its substitutes with infant neurodevelopment at 12 months.METHODS:A total of 420 infants at 12 months were included from the Laizhou Wan (Bay) Birth Cohort in Shandong, China. Urinary concentrations of BPA and its substitutes including bisphenol S (BPS), bisphenol B (BPB), bisphenol AF (BPAF), bisphenol AP (BPAP), bisphenol P (BPP) and bisphenol Z (BPZ) were measured. Developmental quotient (DQ) scores based on the Gesell Development Schedules (GDS) were used to evaluate infant neurodevelopment. The multivariable linear regression and weighted quantile sum (WQS) regression were applied to estimate the associations of exposure to individual bisphenols and their mixtures with DQ scores, respectively. Sex-stratified analyses were also performed.RESULTS:BPA was detected in most infants (89.05%) and had the highest median concentration (0.709 ng/mL) among all bisphenols. BPA substitutes except BPZ were ubiquitous in infants' urine samples (>70%), and BPS showed the highest median concentration (0.064 ng/mL) followed by BPAP (0.036 ng/mL), BPAF (0.028 ng/mL), BPP (0.015 ng/mL) and BPB (0.013 ng/mL). In multivariable linear regression, only BPAF exposure was inversely associated with social DQ scores among all infants (β = -0.334; 95% CI: -0.650, -0.019). After sex stratification, this inverse association was significant in girls (β = -0.605; 95% CI: -1.030, -0.180). Besides, BPA exposure was negatively related to gross motor DQ scores in boys (β = -1.061; 95% CI: -2.078, -0.045). WQS analyses confirmed these results.CONCLUSIONS:Our study suggests that bisphenol exposure during infancy may be associated with poor infant neurodevelopment, and BPAF as a commonly used BPA substitute contributing the most to this adverse association deserves more attention.

Bisphenol A (BPA) substitutes, such as bisphenol S (BPS) and bisphenol AF (BPAF), are increasingly used due to restrictions on BPA usage, a known endocrine disrupting chemical and putative obesogen. However, little is known about the obesogenic effects of exposure to BPA substitutes in children. A total of 426 children aged 7 years old originally recruited from Laizhou Wan Birth Cohort in Shandong, China, during 2010–2013 participated in the 2019–2020 survey. Urinary BPA and its substitutes including BPS, BPAF, bisphenol B (BPB), bisphenol AP (BPAP), bisphenol Z (BPZ), and bisphenol P (BPP) were determined. Anthropometric measures including height, weight, waist circumference, and body fat percentage were assessed, and overweight/obesity was defined as BMI z-score ≥ 85th percentile. Linear and logistic regressions were used on continuous and binary obesity measures, respectively, and weighted quantile sum (WQS) regression was further used to estimate the mixture effects of exposure to diverse bisphenols, and sex-stratified analysis was performed. BPA substitutes were widely detected (> 75

ObjectiveTo investigate the prevalence of allergic and infectious diseases in children， and to assess the influence of indoor and outdoor environmental factors on these two common diseases in children.MethodsA questionnaire was used to investigate the prevalence of allergic and infectious diseases in 140 children of 7 years old in Laizhou Bay， Shandong Province. Logistic regression was used to analyze the associations between indoor and outdoor environmental factors and children’s allergic and infectious diseases， respectively.ResultsThe prevalence of previous eczema and other allergic diseases for the past year in children was 37.9% and 15.0%， respectively， and the prevalence of infectious diseases for the past year was 35.7%. As for allergic diseases， eye irritation due to outdoor air （OR=2.977； 95%CI： 1.407‒6.296） and nose irritation due to outdoor air （OR=5.147； 95%CI： 1.272‒20.827） were the risk factors for previous eczema in children. Indoor musty taste increased the risks of urticaria （OR=4.306； 95%CI： 1.062‒17.454） and previous eczema （OR=3.853； 95%CI： 1.080‒13.743）. The use of cockroach killers indoors increased the risk of rhinitis （OR=6.102； 95%CI：1.297‒28.697）. As for infectious diseases， having outdoor pollution sources increased the risk of gastrointestinal infection （OR=4.937； 95%CI： 1.050‒23.216）， and the use of mosquito coils and clothing mothproofing agents increased the risks of respiratory （OR=6.333； 95%CI： 1.397‒28.714） and gastrointestinal infections （OR=3.218； 95%CI： 1.074‒9.644）， respectively. However， we did not find associations between indoor passive smoking and allergic or infectious diseases.ConclusionExcept outdoor passive smoking， all the other indoor and outdoor environmental factors increase the risks of children’s allergies and infectious diseases.

BACKGROUND:Epidemiological studies suggested that triclosan (TCS) exposure was ubiquitous among children and could affect their physical growth. However, most studies relied on TCS exposure at single time point, and the impacts of multiple time points TCS exposure were unclear. OBJECTIVES:To estimate the associations between repeated TCS measurements in childhood (at ages 1, 2, 5, and 7 years) and physical growth at 7 years. METHODS:This study included 206 children from Laizhou Wan Birth Cohort (LWBC), China. Urinary TCS concentrations were detected at age of 1, 2, 5, and 7 years, and physical growth including height, weight, waist circumference, and fat percentage was measured at 7 years. Multiple informant models were applied to examine the relationships of repeated TCS measurements in childhood with physical growth, and stratified analysis by gender was performed. RESULTS:The detection rates of TCS at age of 1, 2, 5, and 7 years were above 60%, with median declining from 0.89 to 0.33 μg/g creatinine. We found TCS at 5 years was positively associated with waist-to-height ratio, and TCS at 7 years was positively associated with physical growth, including weight z-score, BMI z-score, waist circumference, waist-to-height ratio, and fat percentage. Moreover, the above associations for weight z-score, BMI z-score, and fat percentage significantly varied by the period of exposure (pint ˂ 0.05). After stratified by gender, positive associations were only found among boys. CONCLUSIONS:In our study, TCS levels decreased as children's age increased. TCS exposures at age of 5 and 7 years were positively associated with physical growth at 7 years, and these associations were only significant in boys. Given the relatively small sample size, our findings should be interpreted with caution until confirmed by further investigation.

BackgroundHeavy metals are widely present in the environment, difficult to degrade, and bioaccumulative. Children's physical development are not mature, and exposure to heavy metals which may cause irreversible harm to them. However, the current research conclusions are still inconsistent. Therefore, it is very important to pay attention to the impact of heavy metal pollutants on physical development.ObjectiveTo detect the level of heavy metal exposure of school-age children in Laizhou Wan, Shandong Province, and to explore the relationship between heavy metal exposure level and physical development indexes of school-age children.MethodsThe subjects of this study were 318 children born to pregnant women recruited from Laizhou Wan Birth Cohort in Shandong Province from September 2010 to December 2013. The school-age children at age 7 were followed up from July to September 2019. Their urine samples were collected and the levels of arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg) in urine were detected by inductively coupled plasma mass spectrometry (ICP-MS). At the same time, the height, weight, body mass index (BMI), waist circumference, and body fat percentage of the children were evaluate to analyze the relationship between the four heavy metals in children's urine and the indicators related to children's physical development.ResultsAmong the 318 school-age children with an age (\begin{document}$\bar x \pm s $\end{document}) of (7.77±0.67) years, the median (P25, P75) levels of As, Cd, Pb, and Hg in urine were 73.98 (44.81, 124.61), 0.40 (0.27, 0.58), 1.20 (0.71, 1.72), and 2.38 (1.32, 4.80) µg·g−1 (of creatinine), respectively. The children’s urinary Cd level was positively correlated with their weight, BMI, and waist circumference (P<0.05), and corresponding regression coefficients (b) and its 95% confidence intervals (CI) were 0.99 (0.14-1.83), 0.43 (0.06-0.81), and 1.35 (0.27-2.42), respectively; while the other heavy metals were not related to the above physical development indicators (P>0.05). After sex stratification, it was found that boys’ urinary Cd level was positively correlated with their height, weight, BMI, and waist circumference (P <0.05) with associated b (95%CI) of 1.73 (0.53-2.93), 2.03 (0.60-3.47), 0.75 (0.11-1.38), and 2.66 (0.85-4.47), respectively; such associations were not found in girls. After further stratification of boys’ BMI according to normal, overweight, and obesity, it was found that a higher urinary Cd level was correlated with an increased risk of obesity in boys (P<0.05), and the associated b (95%CI) was 2.34 (1.02-5.36).ConclusionThe level of urinary Cd exposure of boys in Laizhou Wan, Shandong Province is positively correlated with their height, weight, BMI, and waist circumference, and may be related to obesity in boys.

[背景]新烟碱类杀虫剂是一类被广泛应用的新型杀虫剂.现有研究表明该类杀虫剂具有内分泌干扰效应,可影响性激素稳态,但有关儿童青少年的流行病学研究较少.[目的]评估儿童青少年新烟碱类杀虫剂的暴露水平及其与性激素水平的相关性.[方法]本研究基于美国国家健康与营养调查(NHANES)的公开数据(2015—2016年),选取6～20岁儿童青少年中同时具有基本特征信息、6种新烟碱类杀虫剂[包括吡虫啉(IMI)、啶虫脒(ACE)、噻虫啉(THD)、噻虫胺(CLO)、N-去甲基啶虫脒(N-DMA)、5-羟基吡虫啉(5-OH-IMI)]、3种性激素[包括雌二醇(E2)、睾酮(T)及性激素结合蛋白(SHBG)]数据的人群(n=599).采用高效液相色谱质谱串联法检测尿中新烟碱类杀虫剂浓度,液相色谱质谱串联法检测血清T和E2水平,电化学发光免疫法检测血清SHBG浓度.由于仅N-DMA检出率较高,故研究对象按N-DMA水平log10对数值分成3组(Q1～Q3),采用广义线性模型分析儿童青少年N-DMA暴露对性激素的影响,并分析性别修饰效应.[结果]6种新烟碱类杀虫剂检出率[N-DMA(40.7％)、5-OH-IMI(17.9％)、CLO(7.7％)、IMI(4.3％)、ACE(0.5％)、THD(0.3％)]均低于50％.N-DMA质量浓度仅P75(0.39μg·L-1)和P95(1.15μg·L-1)高于其检出限(0.2μg·L-1);5-OH-IMI质量浓度仅P95(1.10μg·L-1)高于其检出限(0.4μg·L-1);CLO质量浓度仅P95(0.40μg·L-1)高于其检出限(0.2μg·L-1);IMI、ACE和THD四分位数均低于检出限(0.4μg·L-1、0.3μg·L-1、0.03μg·L-1).N-DMA、5-OH-IMI和CLO检出浓度存在季节性差异,夏秋季高于冬春季(P<0.05).广义线性模型显示,以Q1组为参照,N-DMA在Q3组中与血清T呈负相关(b=-0.12,95％CI:-0.22～-0.02),在Q2和Q3组中与血清SHBG均呈正相关(b=0.05,95％CI:0～0.09;b=0.08,95％CI:0.04～0.13),且均存在剂量-反应关系(P趋势=0.023、<0.001).性别分层后,N-DMA在男性Q3组中与血清T呈负相关(b=-0.15,95％CI:-0.29～0)、与血清E2呈负相关(b=-0.07,95％CI:-0.13～0),且均存在剂量-反应关系(P趋势=0.042、0.032).N-DMA在男性Q2和Q3组中与血清SHBG均呈正相关(b=0.06,95％CI:0.01～0.11;b=0.07,95％CI:0.02～0.13),且存在剂量-反应关系(P趋势=0.010).在女性中未观察到这些关联.[结论] 美国儿童青少年新烟碱类杀虫剂暴露水平较低,其中代谢物检出率高于原物.ACE代谢物N-DMA暴露与儿童青少年血清T下降、SHBG水平上升有关,且存在性别差异,提示新烟碱类杀虫剂暴露可能影响儿童青少年体内的性激素水平.

[背景]双酚A (BPA)作为一种典型的环境内分泌干扰物,可能影响儿童体格发育.幼儿期是体格发育的关键期,可能对BPA暴露的潜在风险更为易感.[目的]了解山东菜州湾地区2岁幼儿尿BPA水平及其对儿童早期体格发育的影响.[方法]以山东莱州湾出生队列中参与随访的2岁幼儿为研究对象,共采集219名幼儿尿液并检测尿液中BPA水平,采用问卷收集母亲人口学信息、孕期健康影响因素以及幼儿基本信息和膳食信息,现场测量井记录幼儿身长、体重、头围、胸围,计算体重指数(BMI).将BPA暴露水平按四分位数分为Q1～Q4,采用广义线性模型分析BPA暴露与体格发育的关联,并按性别分层分析.[结果]2岁幼儿尿液BPA质量浓度中位数为0.26 μg·L-1,肌酐校正值为1.07 μg·g1.广义线性模型结果显示,幼儿BPA暴露水平与胸围呈正相关趋势(b=0.152,95％ CI:0.028～0.275,P趋势=0.016).与Q1组相比,Q2、Q3组幼儿身长、体重出现下降(P＜0.05),Q2组身长、体重下降值及其95％CI分别为1.29 (2.25～0.32) cm、0.49 (0.94～0.03)kg,Q3组身长、体重下降值及其95％CI分别为1.32 (2.30～0.35) cm、0.49 (0.95～0.03)kg,但趋势性检验无统计学意义(P趋势＞0.05),其他指标变化无统计学意义.性别分层后,与Q1组男童相比,Q2组男童身长、体重、BMI下降(P＜0.05),Q3组所有体格指标均下降(P＜0.05);但男童BPA暴露水平与各指标趋势性检验均无统计学意义(P趋势＞0.05).与Q1组女童相比,Q2、Q4组女童BMI增加(P＜0.05),但BPA暴露水平与女童BMI值之间无相关趋势;女童BPA暴露水平与胸围呈正相关趋势(b=0.173,95％CI:0.012～0.333,P趋势=0.035),但与身长、体重、头围未发现关联(P趋势＞0.05).[结论]2岁幼儿尿液BPA暴露水平与其体格发育存在关联且有性别差异.BPA暴露水平与幼儿胸围呈正相关,其中与女童胸围呈正相关,而与男童各体格发育指标呈一定的非线性关系,中高水平BPA暴露会减缓体格发育.

BACKGROUND:Osteoporosis is a chronic disease whose prevention is more effective than treatment, but it may be necessary to change people's self-efficacy to prevent this condition. This article aimed to study the pathway among information, beliefs and self-efficacy in osteoporosis prevention, and support further intervention. METHODS:A cross-sectional study was conducted among community residents over 40 years old from two volunteer communities in urban Shanghai, China. Of 450 middle-aged and older community residents who volunteered to participate in the study, 421 (93.5%) finished the field survey effectively. RESULTS:62.9% of the residents were females. Their mean age was 64.4 ± 11.2 years. The residents showed low knowledge of osteoporosis-related information, and the mean percentage of correct response was just 61.2%. In univariate analysis, information (univariate β = 0.27, 95% CI = 0.15-0.38) and beliefs (univariate β = 0.31, 95% CI = 0.25-0.38) were associated with self-efficacy. Multivariate analysis showed that information (multiple β = 0.19, 95% CI = 0.09-0.36) and belief (multiple β = 0.30, 95% CI = 0.23-0.36) remained significant. And in the path analysis, self-efficacy was significantly predicted by beliefs (β = 0.81, p<0.001). CONCLUSIONS:The study highlighted the urgency of conducting the osteoporosis preventive health promotion among middle-aged and older people as their lack of information and low level of beliefs and self-efficacy about osteoporosis prevention. Future interventions should focus on improving beliefs, especially perceived benefits, perceived threats, and action clues, on osteoporosis prevention in this group.

骨质疏松是一种全身性代谢性骨疾病,一旦发生,难以逆转,并且会带来很多严重的并发症,如骨痛、骨折等.药物治疗存在一定的局限性,难以根治骨质疏松.在干预中,规范骨质疏松患者的行为可以在很大程度上防止骨质疏松的发生及恶化.国内外研究多致力于骨质疏松的治疗和三级预防.目前,应用于骨质疏松患者干预的理论模型有知识、信念、行为(KAP)模式,健康信念模式(HBM)和动机性访谈(MI).信息—动机—行为(IMB)技巧模型与以往的健康相关行为改变模式相比,从合理行为理论借鉴了对“动机”的理解,从社会思考理论中引入“自我效能”概念.构建IMB模型既能分析各变量的独立影响,又能分析其通过何种路径作用于最后的行为,为将来骨质疏松的干预提供切入点,对不同人群提出更有针对性干预措施,在骨质疏松患者行为干预方面拥有巨大前景.