Gestational PBDE concentrations, persistent externalizing, and emerging internalizing behaviors in adolescents: The HOME study

Kim M Cecil; Yingying Xu; Aimin Chen; Jane Khoury; Mekibib Altaye; Joseph M Braun; Andreas Sjodin; Bruce P Lanphear; Nicholas Newman; Jeffrey R Strawn; Ann M Vuong; Kimberly Yolton

doi:10.1016/j.envres.2024.118981

Gestational PBDE concentrations, persistent externalizing, and emerging internalizing behaviors in adolescents: The HOME study

Environ Res. 2024 Apr 23;252(Pt 3):118981. doi: 10.1016/j.envres.2024.118981. Online ahead of print.

Authors

Affiliations

¹ Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: kim.cecil@cchmc.org.
² Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
³ Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
⁴ Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
⁵ Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁶ Department of Health Sciences, Simon Fraser University, Burnaby BC, Canada.
⁷ Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁸ Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV, USA.

PMID: 38663667
DOI: 10.1016/j.envres.2024.118981

Abstract

Background: Polybrominated diphenyl ethers (PBDEs) are ubiquitous environmental chemicals used as flame retardants in commercial and consumer products. Gestational PBDE concentrations are associated with adverse behaviors in children; however, the persistence of these associations into adolescence remains understudied.

Objective: We estimated the association of gestational PBDE serum concentrations with early adolescent self- and caregiver-reported behaviors at age 12 years and determined the consistency with previously observed associations in childhood with caregiver-reported behaviors in a prospective pregnancy and birth cohort.

Methods: We measured maternal serum concentrations of five individual PBDE congeners and created a summary exposure variable (∑₅BDE: 28, -47, -99, -100 and -153) during pregnancy. At age 12 years, we assessed behaviors for 237 adolescents using self- and caregiver-reports with the Behavioral Assessment System for Children-3 (BASC3). We used multivariable linear regression models to estimate covariate-adjusted associations of lipid standardized, log₁₀-transformed gestational PBDE concentrations with BASC3 scores. We obtained estimates and 95% confidence intervals through a bootstrapping approach. We evaluated potential effect measure modification (EMM) of adolescent sex by examining sex-stratified regression models and estimating the EMM p-values.

Results: Gestational PBDE concentrations were positively associated with adolescent-reported BASC3 composite indices for inattention & hyperactivity (BDE-28, -47, -99, -100, ∑₅BDE), internalizing problems (BDE-28, -47, -99), functional impairment (BDE-28, ∑₅BDE), and emotional symptoms (BDE-28). Gestational PBDE concentrations were positively associated with caregiver-reported BASC3 composite indices for externalizing problems (BDE-28, -47, -99, -100, -153, ∑₅BDE) and behavioral symptoms (BDE-99). For caregiver reported behaviors, we observed stronger associations with gestational BDE concentrations among males, especially for executive functioning (BDE-28, -47, -99, -100, ∑₅BDE).

Discussion: Gestational PBDE serum concentrations were associated with self-reported internalizing and externalizing behavior problems in early adolescence. Caregiver-reported externalizing behaviors recognized during childhood remain associated with gestational PBDE concentrations and persist into early adolescence. Internalizing behaviors were less recognized by caregivers.

Keywords: Adolescent; Attention; Externalizing behaviors; Gestational; Internalizing behaviors; Polybrominated diphenyl ether flame retardants.