Prior to Hurricane Maria, Puerto Rico already had 200+ hazardous waste sites, significant contamination of water resources, and among the highest rates of preterm birth in the USA. To address these issues, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Center was formed in 2010 to investigate prenatal environmental exposures, particularly phthalates, and adverse birth outcomes. Recent work from the PROTECT study confirms that in utero exposure to certain phthalates is associated with shorter gestation and increased risk of preterm birth. However, previous research also suggests that pregnant women who experience a natural disaster such as Hurricane Maria are at higher risk of adverse birth outcomes, but it is unknown whether this is due to stress, hazardous exposures, or a combination of factors. Thus, the aim of this analysis was to characterize hurricane-related changes in phthalate exposures and experiences within the PROTECT cohort. Among 176 participants who were pregnant during or within 5 months after Maria, 122 completed a questionnaire on hurricane-related experiences. Questionnaire results and biomarkers of exposure suggest that participants did not have regular access to fresh foods and water during hurricane recovery, and almost half reported structural damage to their home. In addition, biomarker concentrations of phthalates commonly used in food packaging were higher among participants post-hurricane, while phthalates commonly used in personal care products were lower compared to pre-hurricane levels. Hurricane-related increases in phthalate exposure, as well as widespread structural damage, food and water shortages, and long-term absence of electricity and cell phone service, likely increased the risk of adverse birth outcomes among this already vulnerable population.

中文翻译：

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调查飓风玛丽亚对波多黎各正在进行的出生队列的影响


在飓风玛丽亚之前，波多黎各已经有 200 多个危险废物处理场，水资源受到严重污染，并且是美国早产率最高的国家之一。为了解决这些问题，波多黎各污染威胁探索试验场 (PROTECT) 中心于 2010 年成立，旨在调查产前环境暴露（特别是邻苯二甲酸盐）和不良出生结果。 PROTECT 研究的最新工作证实，在子宫内接触某些邻苯二甲酸盐与妊娠期缩短和早产风险增加有关。然而，之前的研究也表明，经历过玛丽亚飓风等自然灾害的孕妇出现不良分娩结果的风险较高，但尚不清楚这是否是由于压力、危险暴露或多种因素造成的。因此，本分析的目的是描述 PROTECT 队列中与飓风相关的邻苯二甲酸盐暴露和经历的变化。在玛丽亚期间或之后 5 个月内怀孕的 176 名参与者中，有 122 人完成了飓风相关经历的调查问卷。问卷结果和暴露生物标志物表明，参与者在飓风恢复期间无法定期获得新鲜食物和水，几乎一半的人报告说他们的房屋受到了结构性损坏。此外，飓风后参与者中食品包装中常用的邻苯二甲酸盐生物标志物浓度较高，而个人护理产品中常用的邻苯二甲酸盐与飓风前的水平相比较低。 与飓风相关的邻苯二甲酸盐接触量增加，以及广泛的结构损坏、食物和水短缺以及长期缺乏电力和手机服务，可能会增加这些本已脆弱的人群的不良出生结果的风险。