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Concentrations of persistent organic pollutants in California children’s whole blood and residential dust Todd P. Whitehead*a, Sabrina Crispo Smithb,c, June-Soo Parkb, Myrto X. Petreasb, Stephen M. Rappaporta, Catherine Metayera a
School of Public Health, University of California, Berkeley, CA USA Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA, USA c Sequoia Foundation, La Jolla, CA, USA
b
Email addresses:
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] Corresponding author: Todd Whitehead 1995 University Ave., Suite 460, Berkeley, CA 94704 Phone: 1-510-643-2404; Fax: 1-510-643-1735; Email:
[email protected] Keywords: Environmental monitoring; house dust; organochlorine pesticides; polybrominated diphenyl ethers; polychlorinated biphenyls
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ABSTRACT
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We evaluated relationships between persistent organic pollutant (POP) levels in the blood of
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children with leukemia and POP levels in dust from their household vacuum cleaners. Blood and
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dust were collected from participants of the California Childhood Leukemia Study at various
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intervals from 1999-2007 and analyzed for two polybrominated diphenyl ethers (PBDEs), two
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polychlorinated biphenyls (PCBs), and two organochlorine pesticides using gas chromatography-
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mass spectrometry. Due to small blood sample volumes (100µL),
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dichlorodiphenyldichloroethylene (DDE) and BDE-153 were the only analytes with detection
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frequencies above 70%. For each analyte, depending on its detection frequency, a multivariable
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linear or logistic regression model was used to evaluate the relationship between POP levels in
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blood and dust, adjusting for child's age, ethnicity, and breastfeeding duration; mother’s country
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of origin; household annual income; and blood sampling date. In linear regression,
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concentrations of BDE-153 in blood and dust were positively associated; whereas, DDE
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concentrations in blood were positively associated with breastfeeding, maternal birth outside the
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U.S., and Hispanic ethnicity, but not with corresponding dust-DDE concentrations. The
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probability of PCB-153 detection in a child’s blood was marginally associated with dust-PCB-
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153 concentrations (p=0.08) in logistic regression and significantly associated with
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breastfeeding. Our findings suggest that dust ingestion is a source of children’s exposure to
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certain POPs.
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INTRODUCTION
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Persistent organic pollutants (POPs) are stable and widespread in the environment; they
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accumulate in fatty tissue of biota; and they are toxic to humans and wildlife. Three important
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classes of POPs are organochlorine (OC) pesticides, polychlorinated biphenyls (PCBs), and
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polybrominated diphenyl ethers (PBDEs). Organochlorine pesticides, such as DDT [i.e.,
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dichlorodiphenyltrichloroethane], were used to control insects on agricultural crops and to
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control insect-borne diseases; PCBs were used in electrical, heat transfer, and hydraulic
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equipment; and PBDEs were used as chemical flame retardants to treat plastics (e.g.,
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polyurethane foam) and textiles in consumer products. DDT, PCBs, and PBDEs have been used
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extensively worldwide, with a global production volume in excess of 1 million metric tons for
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each.1, 2 In the U.S., DDT and PCBs have been banned since the 1970s, whereas the
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manufacture and import of the three PBDE commercial mixtures have been phased out more
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recently (as of January 1, 2005 for Penta-BDE and Octa-BDE; as of December 31, 2013 for
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Deca-BDE).3
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Humans are exposed to POPs through various routes, including consumption of
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contaminated food, inhalation of contaminated air, and accidental ingestion of settled dust.
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Because consumer goods that have been treated with PBDEs can still be found readily in U.S.
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homes4, PBDE levels in settled dust remain high (e.g., median concentrations > 1 ppm for BDEs
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47, 99, and 209 in 20105). Accordingly, it has been suggested that dust ingestion is a major route
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of exposure to PBDEs for U.S. adults6 and positive relationships have been observed between
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PBDE levels in matched samples of dust and serum in U.S. adults7, 8. Due to their tendency to
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make hand-to-mouth contact and their proximity to the floor, young children are expected to
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receive a relatively large proportion of their total PBDE intake via settled dust compared to
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adults9 and a positive relationship has been observed between PBDE levels in matched samples
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of dust and serum in one investigation of toddlers from North Carolina10.
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In contrast, levels of DDT and PCBs are relatively low in settled dust compared to PBDE
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levels (e.g., median concentrations < 10 ppb for PCBs 138 and 153 in 201011) and dust ingestion
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is hypothesized to be a minor contributor to total intake of these POPs for U.S. adults compared
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to inhalation or diet12. However, one study of 26 adults from Wisconsin reported a positive
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relationship between PCB concentrations in dust and serum, after adjusting for fish
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consumption.13 As with PBDEs, young children are expected to receive a relatively large
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proportion of their total PCB intake via settled dust compared to adults.12 However, no previous
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study has evaluated the relationship between PCB levels in the blood of young children and in
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settled dust from their homes.
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Exposures to DDT14-17, PCBs18, 19, and PBDEs20, 21 have been associated with poorer
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neurodevelopment in young children. We previously demonstrated that dust concentrations of
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certain PCBs (PCBs 118, 138, and 153)22 and PBDEs (BDES 196, 203, 206, and 207)23 were
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positively associated with the risk of acute lymphoblastic leukemia in California children. Our
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current objective is to evaluate the relationship between POP concentrations in blood from
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California children and POP concentrations in settled dust from their homes, after accounting for
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additional covariates, such as breastfeeding. By identifying determinants of POP exposures, it is
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possible to design strategies that may limit children’s exposure to these harmful chemicals. Our
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analysis will also assess the utility of dust-POP measurements as surrogates for POP exposure in
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epidemiological studies of children’s health.
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MATERIALS AND METHODS
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Study population. The California Childhood Leukemia Study (CCLS) is a case–control
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study conducted in the San Francisco Bay area and the California Central Valley that seeks to
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identify genetic and environmental risk factors for childhood leukemia. From 1995 through
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2008, a total of 997 cases 0–14 years of age were ascertained from clinical pediatric oncology
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centers and pre-treatment whole blood samples leftover from diagnostic testing were available
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for chemical analysis in approximately 85% of the case children (no blood was collected from
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controls). In addition, vacuum-cleaner-dust samples were collected from a subset of
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participants’ homes from 2001 to 2007. Children eligible for dust sampling were 0-7 years old at
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diagnosis date and living in the diagnosis residence at the time of dust sampling. We obtained
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written informed consent from participating parents and study protocols were approved by the
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institutional review board at the University of California, Berkeley.
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For the current analysis, we selected a group of 191 cases enrolled from 1999 through
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2007 with available blood samples that represented a diverse combination of income level,
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Hispanic ethnicity, and location within the study area. Of those, 64 cases had a vacuum-cleaner-
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dust sample previously analyzed for POPs.5, 11 Participant selection was not based on anticipated
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levels of chemical exposure.
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POPs analysis in whole blood. After diagnostic testing, approximately 0.5 mL of
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unused whole blood was available from each case for chemical analysis. Blood samples were
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collected in sodium-heparin green-top vacutainer tubes, regardless of fasting state, and stored at -
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20°C or colder prior to analysis. The blood sample preparation protocol was adapted from
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Rogers et al.,24 as described in the Supporting Information (Figure S1) and below. Briefly, after
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thawing, 100 µL of whole blood was spiked with internal standards (PCB-165 and BDE-139),
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denatured with acetic acid, and extracted with 6 mL of a 1:9 mixture of methylene
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chloride:hexane. Extracts were concentrated to 0.5 mL using an automated nitrogen evaporation
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system (TurboVap LV, Biotage; Uppsala, Sweden). Concentrated extracts were purified by
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solid-phase extraction using acidified silica gel, solvent exchanged into isooctane, and
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concentrated to 20 µL. Finally, 13C12-labeled PCB-209 was added as an injection standard.
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Materials used for chemical analysis were previously described.25
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Samples were analyzed for OC pesticides, PCBs, and PBDEs using gas chromatography
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(7890 GC, Agilent Technologies; Sunnyvale, CA)-triple quadrupole mass spectrometry (7000B
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Series, Agilent Technologies; Sunnyvale, CA). Chromatographic conditions included pulsed
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splitless injection (20 psi for 1 min) at 250°C, helium carrier gas at 1 mL/min, and a 30-m DB-
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5ms column with 0.25-mm diameter and 0.25-µm film thickness (Agilent Technologies;
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Sunnyvale, CA). The GC temperature program was initiated at 90 °C, held for 1 min, ramped at
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50 °C/min to 150 °C, held for 1min, ramped at 8 °C/min to 225 °C, held for 6.5min, ramped at14
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°C/min to 310 °C, and finally held for 6 min. The mass spectrometer was operated in electron
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impact ionization mode using multiple ion detection, source temperature of 275°C, ionization
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energy of 70 eV, and mass resolution of 1.2 amu. Retention times, precursor masses, product
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masses, and collision cell energies for analytes, internal standards, and the injection standard
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were previously described.25 The above analytical protocol can be used to quantify a broad array
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of OC pesticides, PCBs, and PBDEs25; however, given the limited sample volume (~100 µL)
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available for analysis, we report concentrations for only the two most prevalent blood
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contaminants in each class: dichlorodiphenyldichloroethylene (p,p'-DDE, the major metabolite
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of DDT), trans-nonachlor (a component of the insecticide chlordane), PCBs 138 and 153, and
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BDEs 47 and 153.
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Blood samples were analyzed in batches of 12 (100 µL each), including 9 field samples, a
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bovine serum (HyClone bovine serum, Thermo Fisher Scientific, Inc; Waltham, MA) method
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blank, a bovine serum blank spiked with each target analyte as a positive laboratory control, and
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a standard reference material of human serum (National Institute of Standards and Technology
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SRM 1958; Gaithersburg, MD). Table S1 in the Supporting Information shows that in 22 SRM
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replicates, we generally observed suitable method accuracy (i.e., average percent errors of 2%,
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6%, 1%, and −1% for p,p'-DDE, trans-nonachlor, PCB-138, and PCB-153, respectively) and
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precision (i.e., coefficients of variation of 7%, 20%, 21%, 16%, 23%, and 29%, for p,p'-DDE,
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trans-nonachlor, PCB-138, PCB-153, BDE-47, and BDE-153, respectively), although the assay
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tended to overestimate PBDE concentrations in SRM samples (i.e., average percent errors of
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44% and 67% for BDE-47 and BDE-153, respectively). Not surprisingly, when compared to the
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1 mL replicates of NIST SRM 1958 that we previously characterized25, the SRM replicates of a
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smaller sample volume (100 µL), yielded larger coefficients of variation. There was no evidence
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of a difference in assay precision between sample matrices when comparing whole blood
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samples (the matrix used for this study) and human serum SRMs (the matrix used for quality
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control samples), as shown in the Supporting Information (Table S2). Table S3 in the
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Supporting Information shows results from 23 method blanks. The average BDE-47 mass in the
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method blanks was 26 pg per sample, which represented a large proportion of the total analyte
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mass observed in a typical field sample. As such, we subtracted the average concentration of
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each analyte in 23 method blanks from the concentration in each field sample. Subsequently, the
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method detection limit (MDL) for each analyte was defined as three times the standard deviation
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of analyte concentrations in 23 method blanks.
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POPs analysis in dust. Dust samples collected from participants’ vacuum cleaners were
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previously analyzed for PCBs11 and PBDEs5 as has been described. Briefly, dust particles
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smaller than 150 µm were obtained with a 100-mesh sieve and 0.2-g portions were spiked with
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13
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column chromatography and gel permeation chromatography, concentrated to 250 µL, solvent
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exchanged into tetradecane, and spiked with a non-overlapping set of 13C12-labeled injection
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standards. Samples were analyzed for p,p'-DDE, 15 PCBs (including PCBs 138 and 153), and
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22 PBDEs (including BDEs 47 and 153) by isotope-dilution/gas chromatography−high
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resolution mass spectrometry. Concentrations of trans-nonachlor were not quantified in dust
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samples. Quality control measures for dust samples were analogous to those described above for
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blood samples, i.e., method blanks, positive laboratory controls, and standard reference materials
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were employed, as previously described.5, 11 Concentrations of PBDEs5 and PCBs11 in dust
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samples collected from the CCLS have been previously described. For the subset of dust
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measurements used in this analysis, detection frequencies for p,p'-DDE, PCBs 138 and 153, and
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BDEs 47 and 153 were greater than 80% and PBDEs were found at the highest concentrations
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(see Supporting Information, Table S4 for summary statistics).
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C12-labeled internal standards, extracted via accelerated solvent extraction, purified by silica
Questionnaire information. We used information from three questionnaires
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administered on separate occasions (see Supporting Information, Figure S2). Shortly after
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leukemia diagnosis (2000-2008), participating mothers completed a structured in-home interview
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designed to ascertain information about a wide variety of topics that are potentially relevant to
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childhood leukemia etiology. Relevant information collected at the primary interview included
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the child’s Hispanic ethnicity and breastfeeding duration, as well as the mother’s age and place
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of birth, and the household annual income. During the dust sampling visit (2001-2007),
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participating mothers were interviewed a second time to ascertain information relevant to
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chemical exposures in the home, including the construction date of the residence. Finally, during
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a telephone interview in 2010, participating mothers answered questions designed to identify
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possible PBDE sources in the home, including the presence of upholstered furniture with
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crumbling or exposed foam.
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Blood collection and the three interviews were each conducted at separate times. The
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average interval between the date of diagnosis/blood collection and the date of primary interview
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was 5 months (range: 1 to 28 months). The average interval between the date of diagnosis/blood
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collection and the date of dust collection was 12 months (range: 5 to 37 months). The average
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interval between the date of diagnosis/blood collection and the date of the third interview was 6.0
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years (range: 3.7 to 9.8 years). The average interval between dust collection and the third
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interview was 5.0 years (range: 2.8 to 8.5 years). The average age of the child at diagnosis/blood
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collection was 4.6 years (range: 0.2 to 14.4 years). For the subset of participants with dust-POP
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data (N=64), the average age of the child at diagnosis/blood collection was 4.3 years (range: 1.5
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to 7.8 years).
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Statistical analysis. Parallel statistical approaches were employed for two groups of
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POPs based on detection frequency (±50%). For each POP with a detection frequency of 50% or
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greater and for all participants (N=191), bivariate relationships between potential explanatory
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factors and wet-weight POP concentrations (i.e., pg/mL of blood) were evaluated using non-
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parametric Spearman rank correlation coefficients (for continuous and ordinal factors) and
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Kruskal-Wallis tests (for categorical and dichotomous factors). Subsequently, for each POP with
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a detection frequency of 50% or greater and for the subset of participants with dust-POP data
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(N=64), we evaluated a multivariable linear regression model of natural-log transformed wet-
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weight blood-POP concentrations. The following factors were considered for inclusion in each
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POP model: child's age at blood collection (continuous, years), child's sex (male or female),
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child's ethnicity (Hispanic or not), child's breastfeeding duration (continuous, weeks), household
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annual income (ordinal,