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Relationship between urine dichlorophenol levels and asthma morbidity

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  • Relationship between urine dichlorophenol levels and asthma morbidity

    Jerschow E, Parikh P, McGinn AP, et al. Relationship between urine dichlorophenol levels and asthma morbidity. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2014;112(6):511-518.e1. doi:10.1016/j.anai.2014.03.011. The publisher's final edited version of this article is available at Ann Allergy Asthma Immunol

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    Westernized life style is associated with a higher prevalence of allergies and asthma and this is thought to be related at least in part to decreased microbial exposure.1,2 This westernized life style is also associated with widespread exposure to pesticides. The US Environmental Protection Agency reported finding 800 pesticide active ingredients in about 21,000 different consumer products.3 Pesticide exposure has been reported to be associated with asthma and rhinitis.4?7
    One specific group of organochlorine pesticides, dichlorophenols, are compounds with potent bactericidal effects.8 They are typically used as herbicides, fungicides, and disinfectants9?11 and can be found in contaminated water, air, and in pesticide-treated crops.9?12 In addition, chlorine-based cleaning agents can react with wood and paper leading to generation of dichlorophenols in packing materials, containers, and storage boxes,13 resulting in contamination of milk, cocoa powder, fruit juices, and dried fruits.9,13?15
    Recent studies have indicated that organochlorine compounds may play a role in the increased incidence of atopic diseases because of their immunomodulatory effects.16 Previous research showed that exposure to dichlorodiphenylethylene was linked to a higher total immunoglobulin E level and to an increased risk of asthma in children.16,17 Higher dichlorophenol levels in urine were associated with increased allergic sensitization to foods.18 In addition, previous reports suggested that certain organochlorines preferentially induce the production in vitro of Th2- cytokines associated with increased allergic reactivity such as interleukin-4, and suppress the production of TH-1 cytokines that tend to block allergic reactivity, such as interferon-γ, interleukin2-, and interleukin-10.19,20
    In addition to these immunomodulatory effects, dichlorophenols are also upper and lower airway irritants.2

    Our results indicate that atopic wheezers with urinary dichlorophenol levels in the upper tertile are more likely to have doctor-diagnosed asthma, to miss days from work or school due to wheezing, to require medications for wheezing, or to have wheezing with exercise. There were no significant associations with these outcomes in non-atopic wheezers. In addition, we found a positive direct association between 2,4- and 2,5-dichlorophenol and total serum IgE levels. Atopic asthmatics with urinary dichlorophenol levels in the upper tertile were also more likely to miss work or school due to wheezing.
    These findings are consistent with several previous reports on atopic disorders and pesticides. Exposure to several insecticides and herbicides was reported to be associated with the presence of allergic rhinitis and atopic asthma4,5,7 and dichlorophenols were associated with increased allergic sensitization to foods.18...


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