Evidence map›Paper›PMID 42259932›Full record

ArticleJournal of exposure science & environmental epidemiology2026

Evaluation of integrated, multimedia biomarkers of prenatal metals exposure in association with child neurodevelopment in Puerto Rico.

Savannah M Sturla Irizarry, Amber L Cathey, Emily Zimmerman, Wei Hao, Yi-Ting Lin, Bhramar Mukherjee, Zaira Y Rosario Pabón, Gredia Huerta Montañez, Carmen M Vélez Vega, Akram N Alshawabkeh and 3 more

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Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Savannah M Sturla IrizarryDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
Amber L CatheyDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
Emily ZimmermanDepartment of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA.
Wei HaoDepartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Yi-Ting LinDepartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Bhramar MukherjeeDepartment of Biostatistics and Department of Chronic Disease Epidemiology, Yale University, New Haven, CT, USA.
Zaira Y Rosario PabónDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
Gredia Huerta MontañezDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
Carmen M Vélez VegaDepartment of Social Sciences, Doctoral Program in Social Determinants of Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA.
Akram N AlshawabkehDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
José F CorderoDepartment of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA.
John D MeekerDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
Deborah J WatkinsDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA. debjwat@umich.edu.ORCID http://orcid.org/0000-0002-6692-2206

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBiomarkers can be measured in various media, including urine or blood, which represent different biological compartments and toxicokinetic pathways, resulting in potential biases when estimating the internal dose of an environmental exposure. Integrating measurements across multiple media as a multimedia biomarker (MMB) may better characterize an exposure, allowing for improved assessment of exposure-outcome relationships.

objectiveThis study utilized concentrations of 10 metals in urine, blood, and as MMBs, integrated using intraclass correlation coefficients (MMB

methodsWe examined log-transformed geometric mean prenatal metal concentrations (in urine, blood, or as MMBs) in association with repeatedly measured CBCL scores for ages 1.5-5 years, in 284 mother-child pairs in the PROTECT birth cohort in Puerto Rico. Summary scores were modeled as log(CBCL + 1). Associations were assessed as single-pollutants and as a mixture, using linear mixed-effects models, adaptive elastic net, and Bayesian kernel machine regression, adjusted for sex, maternal education level, maternal age, and child age at assessment.

resultsIn single-pollutant models, prenatal urinary As and Co; blood Cd and Mn; MMB SIGNIFICANCE: The results of this study can inform future research on optimizing biomarker assessment and reducing measurement error to assess the effect of metal mixtures on child neurodevelopment. IMPACT STATEMENT: Combining multiple biomarker media may better capture health effects compared to single-media biomarker analyses, especially for the effects of exposure to metals with varied toxicokinetic properties. Our findings provide insight to potential approaches for combining blood and urine biomarkers and to the selection of preferred media for toxic and essential metals, with the goal of reducing measurement error and accounting for toxicokinetics. Future research should explore the integration of other commonly utilized biomarkers to compare their performance and efficacy as integrated MMBs in larger sample sizes.

Indexed as

Children’s healthExposure assessmentMetalsMixturesMulti-media studiesNeurodevelopment

Identifiers

PMID42259932

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.