PMID- 37619697
OWN - NLM
STAT- Publisher
LR  - 20231011
IS  - 1873-6424 (Electronic)
IS  - 0269-7491 (Linking)
VI  - 336
DP  - 2023 Nov 1
TI  - Persistent organic pollutants exposure and risk of autism spectrum disorders: A 
      systematic review and meta-analysis.
PG  - 122439
LID - S0269-7491(23)01441-0 [pii]
LID - 10.1016/j.envpol.2023.122439 [doi]
AB  - Accumulating number of epidemiological studies has recently proposed that 
      improvement in the risk of autism spectrum disorders (ASD) is associated with 
      persistent organic pollutants (POPs) exposure. However, evidence from current 
      researches is limited and inconsistent. Thus, we conducted a systematic review 
      and meta-analysis to investigate the potential associations comprehensively. We 
      systematically and extensively searched two electronic databases (PubMed and 
      EMBASE) from inception to July 3, 2022 and an updated search was performed before 
      submission. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were 
      derived from stratified random-effects meta-analyses by type of exposure and 
      outcome. We also tested the potential heterogeneity across studies, conducted 
      sensitivity analysis and evaluated publication bias. A total of 20 studies were 
      finally included in our study. Meta-analytical effect estimates indicated a 
      positive association between prenatal exposure to PCB-138, PCB-153 and PCB-170 
      and an increased risk of ASD, with OR of 1.89 (95% CI = 1.21-2.95, I(2) = 0%), 
      1.61 (95% CI = 1.05-2.47, I(2) = 0%) and 1.46 (95% CI = 1.03-2.06, I(2) = 0%) 
      respectively. In contrast, PFDA was found inversely associated with the risk of 
      ASD (OR = 0.70, 95% CI = 0.52-0.94, I(2) = 0%). The level of evidence supporting 
      a link between ASD risk and exposure to PCB-138, PCB-153, PCB-170, and PFDA was 
      respectively categorized as low, low, moderate, and low. In summary, this 
      systematic review and meta-analysis suggest that exposure to PCB-138, PCB-153, 
      and PCB-170 correlates with a heightened risk of ASD, with evidence levels rated 
      as "low", "low", and "moderate", respectively. In contrast, PFDA exposure appears 
      to be inversely associated with ASD risk, with a "low" level of supporting 
      evidence. However, due to the limited number of studies available for each 
      exposure and outcome pairing, these results should be interpreted with caution. 
      Sufficiently powered studies are needed to validate our findings.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Xu, Kexin
AU  - Xu K
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Li, Zhuoyan
AU  - Li Z
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Qiao, Jianchao
AU  - Qiao J
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Wang, Senzheng
AU  - Wang S
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Xie, Pinpeng
AU  - Xie P
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Zong, Zhiqiang
AU  - Zong Z
AD  - Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China.
FAU - Hu, Chengyang
AU  - Hu C
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Anhui 
      Medical University, 81 Meishan Road, Hefei, 230032, China; Department of 
      Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 
      Meishan Road, Hefei, 230032, China. Electronic address: cy.hu@ahmu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230822
PL  - England
TA  - Environ Pollut
JT  - Environmental pollution (Barking, Essex : 1987)
JID - 8804476
SB  - IM
OTO - NOTNLM
OT  - Autism spectrum disorders
OT  - Meta-analysis
OT  - Perfluoroalkyl and polyfluoroalkyl substances
OT  - Persistent organic pollutants
OT  - Polybrominated diphenyl ethers
OT  - Polychlorinated biphenyls
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/08/25 00:42
MHDA- 2023/08/25 00:42
CRDT- 2023/08/24 19:25
PHST- 2022/09/28 00:00 [received]
PHST- 2023/08/09 00:00 [revised]
PHST- 2023/08/21 00:00 [accepted]
PHST- 2023/08/25 00:42 [pubmed]
PHST- 2023/08/25 00:42 [medline]
PHST- 2023/08/24 19:25 [entrez]
AID - S0269-7491(23)01441-0 [pii]
AID - 10.1016/j.envpol.2023.122439 [doi]
PST - ppublish
SO  - Environ Pollut. 2023 Nov 1;336:122439. doi: 10.1016/j.envpol.2023.122439. Epub 
      2023 Aug 22.