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  • California wildfire smoke exposure during pregnancy may be linked to autism risk in children

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    Pregnant women’s exposure to wildfire smoke — particularly in the third trimester — may increase the risk of autism in their children, according to new research, which looked at hundreds of thousands of births in Southern California.

    The study, published Tuesday in the journal Environmental Science & Technology, is the first to examine a potential link between prenatal wildfire smoke exposure and autism. Earlier research has suggested that pregnant women’s exposure to air pollution more broadly, including smog spewed by vehicles, smoke stacks and lead, may be linked to the developmental disorder.

    The new research focused on exposures to PM 2.5, tiny particles in wildfire smoke that can lodge deep in the lungs and enter the bloodstream, which has raised major health concerns. To estimate smoke exposure, researchers used a model to estimate levels of PM 2.5 at each individual’s home address during their pregnancy.

    “This paper supports other scientific research that links prenatal exposure to air pollution, particularly PM 2.5 to autism,” said Alycia Halladay, chief science officer at the nonprofit Autism Science Foundation, who was not involved in the study. “The size of the risk is not huge, but it is consistent with other research and adds to a body of scientific literature linking air pollution and autism.”

    “Both autism and wildfires are on the rise, and this study is just the beginning of investigating links between the two,” said senior study author Mostafijur Rahman, an assistant professor of environmental health sciences at Tulane University’s Celia Scott Weatherhead School of Public Health and Tropical Medicine.

    How big is the risk?

    The study analyzed health records of more than 200,000 births in Southern California from 2006 through 2014. California, the researchers said, leads the country in both yearly acres burned by wildfire and rates of childhood autism diagnoses.

    The increased risk was strongest when mothers were exposed to wildfire smoke during the third trimester (the last three months of pregnancy), especially during stretches of multiple smoky days, rather than from overall average pollution levels alone, the study found.

    The risk of autism diagnosis was about 10% higher for children whose mothers experienced 1 to 5 smokey days in the third trimester, 12% higher with 6 to 10 days and 23% higher with more than 10 days.

    The association was clearest among women who didn’t change residences during pregnancy, suggesting that sustained exposure in the same location — not just occasional smoke — may play an important role.

    The study, however, doesn’t explain why wildfire smoke may increase autism risk.

    Rahman said wildfire smoke is quite different from other pollutants, such as traffic pollutants, that people are exposed to on an almost everyday basis.

    Stanford University researchers now say wildfire smoke is our highest and most dangerous climate-related threat.

    “Wildfire smoke has a unique chemical composition,” he said, “including higher levels of carbon compounds, metal, toxic byproducts, and it tends to occur in intense and short term spikes.”

    The third trimester is a critical period in a fetus’s development, said lead study author David Luglio, a post-doctoral fellow with the Celia Scott Weatherhead School.

    “In terms of the brain, and the late trimester, this is when the brain really grows in size and develops its main centers,” he said. He added that the findings shouldn’t cause alarm, noting that autism isn’t limited to environmental factors, but is also believed to have a strong genetic component.

    Halladay said exposure to high levels of PM 2.5 have already been linked to lower birthweight, higher levels of preterm births, asthma and obesity.

    “So close monitoring, as well as mitigation of air pollution, should be a priority for regulatory agencies going forward,” she said.

    More research is needed

    Autism spectrum disorder — characterized by challenges with social and communication skills and by repetitive behaviors — affects 1 in 31 school-aged children in the United States, according to the Centers for Disease Control and Prevention.

    The disorder is believed to be “multifactorial,” said Dr. Akhgar Ghassabian, an associate professor of pediatrics and population health at the NYU Grossman School of Medicine, with several environmental factors “shown to be involved, particularly if these environmental exposures happen during early life.”

    Health and Human Services Secretary Robert F. Kennedy Jr., with the backing of President Donald Trump, has made autism a high-profile research priority, saying that health officials want to better understand the condition’s “root causes,” including potential environmental causes, such as air pollution, chemicals and medicine. Kennedy has also promoted unproven treatments, including leucovorin, a synthetic form of vitamin B9 or folate, which the body needs to make healthy blood cells.

    In September, Trump claimed without new evidence that acetaminophen — the active ingredient in the pain reliever Tylenol — was a cause of autism, a statement that drew intense pushback from OB-GYNs, autism advocacy groups and international health organizations, like the World Health Organization. A large new analysis found no link between acetaminophen and autism.

    President Trump said his administration is issuing a warning to doctors not to recommend acetaminophen for pregnant women, claiming it may be linked to autism in children.

    David Mandell, a psychiatry professor at the University of Pennsylvania, said the idea that wildfire smoke exposure could raise autism risk is broadly consistent with previous research linking air pollution exposure during the mother’s pregnancy to poorer neurodevelopmental outcomes in children.

    But he said that he was cautious about how the study’s findings were interpreted, noting that the observed effects were small and that the highest exposure group did not show a clear increase in risk.

    “They do see a more elevated risk at the second-highest exposure level in the third trimester among nonmovers, but not at the highest exposure level,” Mandell said. “This lack of a dose response makes me skeptical about the findings. I’d definitely want to see a replication before I put a lot of stock in it.”

    The authors note the study has limitations: Exposure estimates were based on outdoor air, and researchers don’t know how much smoke people were exposed to indoors, or whether they used air filters, wore masks or altered their behavior during a wildfire event. Rahman said further studies are still needed.

    The findings, he said, “reinforce the importance of minimizing smoke exposure during a wildfire event when possible and following the public health guidance.”

    Mandell said that he hopes an administration “truly interested in improving child outcomes would strengthen” the Environmental Protection Agency and strengthen the Federal Emergency Management Agency “to reduce pollution and help families cope.”

    “This administration seems to be going in the absolute opposite direction,” he said.

    Rahman said he is also curious whether prevention — such as masks or air purifiers — may reduce the risk seen in the study.

    “Wildfire smoke is a potentially preventable environmental exposure,” he said.

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    Berkeley Lovelace Jr. | NBC News

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  • Does HPV affect men’s fertility? Study finds a link to sperm quality

    Does HPV affect men’s fertility? Study finds a link to sperm quality

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    Scientists have long considered that the world’s most common sexually transmitted infection, human papillomavirus, or HPV, may be a driver of infertility.

    Most research about HPV’s potential impact on fertility has focused on women. But in recent years, researchers have increasingly expanded their focus to include the infection’s association with male fertility.

    A new study from Argentinian researchers has found that the strains of HPV considered high risk because of their links to cancer were not only more common than low-risk strains in a small study population of men, they also appeared to pose a greater threat to sperm quality.

    The study, published Friday in Frontiers in Cellular and Infection Microbiology, found that high-risk HPV appears to suppress key components of the immune system in the male genital tract. This could hamper the body’s ability to clear HPV, a process that typically takes about six months to a year after infection, while raising the risk of other infections that may also compromise male fertility.

    “Individuals often have no symptoms or signs, yet still carry HPV in the male genital tract,” said the study’s senior author, Virginia Rivero, a professor of immunology at the National University of Córdoba in Argentina.

    A 2020 systematic review of 50 studies found that 21% of infertile men had HPV-positive semen, compared with 8% in the general male population. Even after accounting for female infertility, men with HPV in their semen had three-fold greater odds of being infertile than those without the virus.

    There are over 200 known strains of HPV. The riskiest handful can cause multiple cancers, including, in the U.S., about 26,000 diagnoses in women and 21,000 in men each year, according to the Centers for Disease Control and Prevention. The most common HPV-driven malignancy is cervical cancer, with about 13,800 invasive cases annually. Research suggests that most people are unaware that the virus can also cause vulval, anal, throat, vaginal and penile cancer.

    A vaccine for HPV has been available since 2006, when it was initially recommended just for girls; the recommendation was expanded to boys in 2011. The current version, which is given in a two- or three-dose series, prevents nine of the riskiest HPV strains, including those that cause genital warts.

    The CDC recommends routine HPV vaccination for all boys and girls at 11 or 12 years old — children can receive it at as young as age 9 — and for those through age 26 who were not previously fully vaccinated. Experts consider the vaccine exceptionally safe.

    CDC study published Thursday found that for adolescents born in 2007, about 65% were fully vaccinated for HPV by age 15, compared with 60% of those born in 2008. The CDC attributes this statistically significant difference to disruptions from the Covid pandemic, beginning when the younger group turned 12.

    Vaccination at older ages typically provides less benefit, since so many people contract at least one strain of HPV after becoming sexually active. But the CDC suggests that people up to age 45 may still discuss potential vaccination with their doctors. 

    High-risk HPV lowers immune cells

    In her new study, Rivero and her colleagues studied the ejaculate samples of 205 men, none of whom were vaccinated for HPV. The men, who had a median age of 35, sought a fertility assessment or treatment for urinary-tract problems from 2018 to 2021 at a urology clinic in Argentina.

    Thirty-nine, or 19%, of the men tested positive for HPV. Researchers were able to identify 20 men among them who had high-risk strains and seven men with low-risk HPV.  

    On the surface, the investigators didn’t find any notable differences in the semen quality between the men with either type of HPV and a group of 43 men who tested negative for the virus. When they examined the semen more closely with highly sensitive tools, they found clues suggesting how high-risk HPV strains might be influencing male infertility.

    The men with high-risk HPV had a lower level of certain immune cells in their semen, suggesting the virus had hampered the body’s ability to fight it off. This suppression of immune cells might also have raised the men’s risk of other infections that could further compromise their ability to conceive.

    There was also evidence that the sperm of the men with high-risk HPV were sustaining damage from what’s known as oxidative stress. This could explain why these men had a higher level of dead sperm compared with those who didn’t have the virus.

    Dr. Eugenio Ventimiglia, an oncologist in the unit of urology at the Università Vita-Salute San Raffaele in Milan, Italy, said the new study, which he was not involved in, “provides insight into the biological mechanisms potentially linking HPV to male reproductive health issues.” 

    Nevertheless, he said its findings should be “interpreted cautiously.”

    “Instead of conclusively proving a cause-effect relationship between HPV and male factor infertility, the study’s findings are more appropriately seen as generating hypotheses for further research,” Ventimiglia said.

    Can vaccination protect men’s fertility?

    Men’s HPV might also affect fertility in part by transmitting the virus into the woman’s reproductive tract; the virus might then harm the pregnancy at various stages, including before the fertilized egg implants in the womb. Couples receiving assisted reproductive technology have a greater chance of miscarriage if the man has HPV in his semen, researchers have found.

    Research indicates that providing the HPV vaccine to men who are having trouble conceiving and who have an active HPV infection might help them clear the virus faster and potentially improve their chances of conceiving.

    “Whatever other changes are thought to be associated with HPV, it should be noted that HPV infection is usually brief, as is the sperm lifespan,” said Dr. Marie-Hélène Mayrand, an epidemiologist and the chair of the obstetrics and gynecology department of University of Montreal. “This is reassuring that any effect, if found, would be brief and self-limited.” Mayrand was not involved in the new research.

    Rivero advises that men struggling with fertility receive testing for HPV and other sexually transmitted infections that could affect their fertility. If positive for HPV, additional testing may be needed to identify specific strains. 

    The test results, Rivero said, could help men identify a potential driver of their infertility. 

    HPV vaccination rates among adolescent boys and men have been rising over the last decade. Recent research suggested that the HPV vaccine was linked to a drastically lower rate of head and neck cancers in men and adolescent boys. 

    It’s not yet known if the vaccine could protect men’s fertility. 

    “When a critical mass of boys and girls are vaccinated, it is likely that the transmission of the HPV genotypes covered by the vaccines will decrease.” Rivero said. “But the broader impact on fertility remains uncertain.”

    Rivero said she hoped to see a larger study in the future that could lend more statistical heft to her findings. Her own lab plans to further study how simultaneous infections with HPV and other STIs might influence male fertility.

    This story first appeared on NBCNews.com. More from NBC News:

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    Benjamin Ryan | NBC News

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