International Journal of Hygiene and Environmental Health
Bisphenol A exposure may increase the risk of development of atopic disorders in children
Introduction
Since asthma is one of the most common disorders among children a fuller understanding of its interaction with environmental exposures is essential. Of particular importance are the effects of chemicals with endocrine disrupting properties on allergic diseases (Bonds and Midoro-Horiuti, 2013). Bisphenol A (BPA), an endocrine disruptor, is a component of polycarbonate plastics and epoxy resins, and is used in products ranging from food and beverage containers to thermal-paper receipts. Children's exposure to BPA is through oral, dermal, and respiratory routes (Wilson et al., 2007, Stahlhut et al., 2009). There is increasing health concern regarding common low-level exposure to BPA among the general population (Vandenberg et al., 2013). While BPA is not bio-accumulative, continuous daily exposure (due to numerous sources) leads to an exposure scenario that reminds to that of persistent and bio-accumulative compounds (Chen et al., 2014). Recent BPA data in NHANES suggest longer than expected half-life and substantial non-food exposure (Stahlhut et al., 2009).
Moreover, BPA has been associated with many adverse health effects, including diabetes, obesity, reproductive disorders, cardiovascular diseases, birth defects, chronic respiratory and immune diseases and breast cancer (Rezg et al., 2014). Murine data suggest that exposure to BPA can reduce levels of regulatory T cells, IFN-r, and IL-10, and increase production of IL-4 and antigen-specific IgE (Yan et al., 2008, Sawai et al., 2003). Peri-natal exposure to BPA has been reported to enhance allergic sensitization and bronchial eosinophilic inflammation and responsiveness in a susceptible animal model of asthma (Midoro-Horiuti et al., 2010). However, whether these findings in rodent models are applicable to human subjects remains an open question.
Currently, few studies have examined the association between environmental BPA and allergic diseases in children. For years, human data on the association between BPA exposure and asthma-related outcomes have been limited to case reports of occupational asthma among workers exposed to epoxy resins (Hannu et al., 2009, Kwak et al., 2009). Prenatal BPA exposure has been reported to increase the odds of childhood wheezing while pre-natal and post-natal exposure has been reported to be associated with asthma development (Spanier et al., 2012, Wang and Lin, 2015, Donohue et al., 2013, Gascon et al., 2015). However, the underlying mechanisms for BPA-induced asthma remain to be elucidated. There is a paucity of data on the role of BPA exposure in development of other allergic diseases such as atopic dermatitis (AD) and allergic rhinitis. Moreover, little is known about whether there is any gender difference in these associations.
Since young children are more vulnerable to toxic chemicals due to the immaturity of their organs and increased dosage per unit body surface area, this study was conducted to evaluate (i) the association between postnatal BPA exposure and allergic diseases in pre-school children; (ii) the association between postnatal BPA and IgE levels for the possible disease pathogenesis; and (iii) gender-based differences, if any, in these associations.
Section snippets
Study population
A total of 453 kindergarten children from Childhood Environment and Allergic Diseases Study (CEAS) cohort with urine and blood specimens were recruited in Taiwan (Wang and Lin, 2015). The concentrations of urinary BPA glucuronide (BPAG) were measured at ages 3 and 6 years as an indicator of exposure and serum total IgE levels were determined as an indicator of sensitization. Data on the children's allergic diseases were collected at ages 3 and 6 years. The association of BPAG levels of children
Results
At age 3 years, we included 453 children with all the information required. At age 6 years, after excluding children due to lost to follow-up (n = 84) and those missing blood or urine data (n = 103) or outcome data (n = 66), the final number became 200. Data on the basic demographics of the study population revealed no significant differences between those lost to follow-up and those who completed follow-up except for the higher maternal education among those who completed follow-up (Table 1). At age
Discussion
This study contributes to available literature on the potential association between BPA exposure at different stages and pediatric atopic disorders. Here, BPA exposure, assessed based on urinary BPAG levels, was significantly associated with asthma in girls. The BPAG levels positively associated with IgE levels. Moreover, effects of BPA on asthma may be mediated through alterations in IgE levels. These findings not only help in understanding the etiology and mechanism of allergic diseases, but
Conclusion
Exposure to BPA early in life was associated with IgE and may increase the risk of developing allergic diseases in children. Girls were likely to be more susceptible than boys. Moreover, this is the first study to report effects of bisphenol A on asthma may be mediated through alterations in IgE levels. Preventive measures should be introduced as early as possible for young children to avoid subsequent development of allergic diseases.
Conflict of interest statement
None declared.
Acknowledgements
This study was supported by a grant from the National Science Council in Taiwan (NSC 102-2628-B-192-001-MY3), Ministry of Science and Technology. The authors thank the CEAS study group (Professor Meilien Chen, Pau-Chung Chen, Dr. Wen-Chiuo Wu, and our colleagues for the data collection).
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