Stephen Rothenberg

• PhD
• (Retired) at Instituto Nacional de Salud Pública

This study aimed to estimate the carcinogenic and non-carcinogenic risk as well as the attributable cases due to exposure to organochlorine pesticides (OCPs): hexachlorobenzene (HCB), dichlorophenyltrichloroethane (DDT), hexachlorocyclohexane (HCH), heptachlor, and chlordane. From serum concentrations of pesticides of interest in a sample of 908 wo...

Background Breast cancer (BC) is not a single disease, but a set of molecular subtypes that could differ within their risk factors, which may include several metals. Our objective was to evaluate the association between BC molecular subtypes and metal mixtures, and to identify their main metal contributors within the mixture.Methods The present rep...

This study aims to assess breast cancer (BC) association with metals and whether polymorphisms in CYP1A1, CYP1B1, GSTM1 and GSTT1 act as confounders or as modifiers of those relationships. We performed a secondary analysis of 499 histologically confirmed BC cases and the same number of age-matched population controls. We measured urinary concentrat...

Exposure to inorganic arsenic (iAs) damages health in many ways. The main routes of human exposure are consumption of contaminated water and diet, but evidence regarding the dietary contribution of iAs is limited. The objective of this work was to determine the foods and beverages that contribute to urinary total arsenic levels (TAs). This is a sec...

Humans are environmentally exposed to many metals throughout their lives. Simultaneous exposure to several metals could result in synergistic or antagonistic toxicological effects among them; however, the information on exposure to mixtures of metals and breast cancer (BC) is scarce. The objective of this report was to compare metals considered hum...

Breast cancer (BC) is the leading cancer worldwide among women. “Prudent” dietary patterns have been consistently and negatively associated with the risk of BC. However, prospective studies have shown a positive association between “Western” dietary patterns and the risk of BC, but only among postmenopausal women. In this regard, evidence from Lati...

Environmental exposure to some metals and metalloids has been linked to several health risks, including cancer, and in Mexico it has been poorly studied. Our objective was to describe the urinary concentrations of potentially toxic metal(loids) in a sample of Northern Mexican women, according to selected characteristics. From 998 women living in No...

Cadmium (Cd), a carcinogenic metal also related to reproductive and cardiovascular diseases, is contained in tobacco and elevated concentrations of it in humans have been consistently associated with first-hand tobacco smoke; however, there is scarce and inconclusive evidence of the relationship between Cd and secondhand smoke (SHS) exposure. Our a...

Background Exposure to air pollution is the main risk factor for morbidity and mortality in the world. Exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) is associated with cardiovascular and respiratory conditions, as well as with lung cancer, and there is evidence to suggest that it is also associated with type II diabetes...

Cadmium (Cd) is an endocrine disruptor. Selenium (Se) is an essential element that counteracts Cd effects. The interaction between these elements on breast cancer (BC) risk was evaluated in two retrospective studies with inconclusive results. BC survival varies by molecular subtype and its risk factors may also differ. To date, no information is av...

Background Recent studies have reported that air pollution exposure may have neurotoxic properties. Objective To examine longitudinal associations between prenatal particles less than 2.5 μm in diameter (PM2.5) exposure and neurodevelopment during the first two years of children's life. Methods Analysis was conducted in PROGRESS, a longitudinal b...

Exposure to PM2.5 has been associated with the prevalence of obesity. In the Greater Mexico City Area (GMCA), both are ranked among the highest in the world. Our aim was to analyze this association in children, adolescents, and adults in the GMCA. We used data from the 2006 and 2012 Mexican National Surveys of Health and Nutrition (ENSANUT). Partic...

PurposeTo evaluate breast cancer (BC) molecular subtypes association with reproductive characteristics and an index of cumulative exposure to endogenous estrogens (EEI) in Mexican women.Methods We performed a study of incident cases and population controls in northern Mexico. We included BC cases with tumor molecular classification in their medical...

Prenatal folate and vitamin B 12 status have been linked to child neuropsychological development, but less is known about maternal genetic influences on this association. We conducted an exploratory longitudinal study of 181 mother–child pairs to assess whether maternal MTHFR 677C>T genotype modifies the association between maternal plasma folate a...

Background: Paraoxonase 1 (PON1) is important in the development of atherosclerosis, and it has become the subject of intensive research. Our aim was to evaluate the association of serum PON1 activity and polymorphisms with cardiovascular disease (CVD) using four different substrates. Materials and methods: Activity of PON1-related to arylestera...

Paraoxonase 1 (PON1) is an A-esterase calcium-dependent enzyme that is associated with high-density lipoprotein (HDL) and capable of hydrolyzing a wide variety of substrates, including organophosphate (OP) pesticides. The PON1 phenotype can be modulated by multiple internal and external factors, thereby affecting the catalytic capacity of the enzym...

Background Child neurodevelopment has been positively linked to maternal intake of polyunsaturated fatty acids (PUFAs) during pregnancy; however, it is unknown if that relationship persists among populations exposed to environmental neurotoxicants. Objective The aim of this work was to assess whether maternal dietary intake of PUFAs during pregnan...

Background Bronchiolitis is a common respiratory disorder in children. Although there are specific ICD-9-CM diagnosis codes for bronchiolitis, the illness is often coded using broader diagnosis codes. This creates the potential for subject misclassification if researchers rely on specific diagnosis codes when assembling retrospective cohorts. Here...

Despite the removal of lead from gasoline in 1997, elevated blood lead levels (BLLs) > 5 µg/dL are still detectable in children living in Mexico City. The use of lead-glazed ceramics may explain these persistent exposure levels. Mexico lacks a national surveillance program for BLL, but temporal trends can be derived from epidemiological studies. Wi...

Background Bronchiolitis sometimes triggers the development of subsequent recurrent wheezing. Treatment with either acetaminophen or ibuprofen during the initial episode may affect the occurrence of subsequent wheezing. Materials and methods We did a retrospective study comparing the effect of prescribing acetaminophen, ibuprofen, or neither for a...

Range of possible coefficients for each drug using various sensitivity analyses. (PDF)

Objective We hypothesized (1) that gastrointestinal (GI) and renal adverse events (AE) would occur more often in infants first prescribed ibuprofen before rather than after six months of age and (2) that ibuprofen would be associated with more adverse effects than acetaminophen in infants younger than six months. Methods We created two partly over...

Objective: To evaluate whether child dietary intake of folate and vitamin B12, is associated with mental and psychomotor development in Mexican children, respectively, at 24 and 30 months of age. Materials and methods: Information about neurodevelopment and dietary intake of folate and vitamin B12 at 24 and 30 months of age among 229 children be...

Letter from the food and drug administration refusing over-the-counter labelling for ibuprofen for children younger than six months of age. (PDF)

Background and purpose: Acute exposure to particulate matter with aerodynamic diameter <2.5 μm (PM2.5) is associated with acute cardiovascular and cerebrovascular mortality. The aim of this study was to evaluate these associations with specific causes of cardiovascular and cerebrovascular mortality in Mexico City. Methods: We obtained daily mort...

Background: Unhealthy environments and food advertisements are major determinants of childhood obesity. Recent regulation has banned unhealthy foods from schools in Mexico. However, currently there is no regulation limiting exposure to food marketing around schools. Thus, our objective was to analyze the characteristics of food advertising practic...

Background: Maternal 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) serum levels during pregnancy have been negatively linked to child neurodevelopment in contrast to intake of omega-3 and -6 (ω-3 and ω-6) fatty acids. Objectives: To assess whether maternal dietary intake of ω-3 and ω-6 during pregnancy modifies the association between expos...

Inorganic arsenic (iAs) exposure increases risk of several diseases, including cancer. Some nutrients such as flavonoids enhance glutathione activity, which in turn play a key role in iAs elimination. Our objective was to explore whether dietary non-soy flavonoids are associated with iAs metabolism. We hypothesized that the intake of flavonoids bel...

Background and aim: Dengue Fever (DF) is a human vector-borne disease and a major public health problem worldwide. In Mexico, DF and Dengue Hemorrhagic Fever (DHF) cases have increased in recent years. The aim of this study was to identify variations in the spatial distribution of DF and DHF cases over time using space-time statistical analysis an...

Psychomotricity plays a very important role in children's development, especially for learning involving reading-writing and mathematical calculations. Evaluate motor development in children 3 years old and its relationship with their cognitive abilities at the age of 5 years. Based on a cohort study, we analyzed the information about motor perform...

Objective: To assess links between the social variables and longer-term El Niño-Southern Oscillation (ENSO) related weather conditions as they relate to the week-to-week changes in dengue incidence at a regional level. Materials and methods: We collected data from 10 municipalities of the Olmeca region in México, over a 10 year period (January 199...

Introduction: The childhood obesity epidemic is a global concern. There is limited evidence in Mexico linking the local food environment to obesity. The purpose of this study is to describe the links between the local food environment around elementary schools and schoolchildren's BMI in two Mexican cities. Methods: Cross-sectional surveys were...

Background and objectives: Central apnea complicates, and may be the presenting complaint in, bronchiolitis. Our objective was to prospectively derive candidate clinical decision rules (CDRs) to identify infants in the emergency department (ED) who are at risk for central apnea. Methods: We conducted a prospective observational study over 8 year...

We read with interest the current guidelines on the management of bronchiolitis.1 Here we raise our concern with the recommendation that bronchodilators not be used. The guideline authors imply that our randomized controlled trial in 703 children with bronchiolitis supports their assertion that “clinical scores may vary from between observers”.1,2...

Background: Prenatal exposure to p,p'-DDE is associated with impairments in motor development during the first year of life, with no related repercussions on mental or motor development at 12-30 months and with impairments in cognitive areas, but not in perceptual and motor areas at preschool age. However, its association with particular psychomot...

Background: Limited data suggest that lead (Pb), cadmium (Cd), and uranium (U) may disrupt vitamin D metabolism and inhibit production of 1,25-dihydroxyvitamin D [1,25(OH)2D], the active vitamin D metabolite, from 25-hydroxyvitamin D [25(OH)D] in the kidney. Objectives: We evaluated the association between blood lead (BPb) and urine arsenic (As)...

The objective of this study was to predict chloroform formation resulting from the process of disinfecting water, particularly trihalomethane which is most frequently produced. A statistical model was used which included repeated measurements of water parameters used for monitoring water quality at 51 sites covering the municipal water system of Mo...

Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also be...

High blood lead (BPb) levels in children and elevated soil and dust arsenic, cadmium, and lead were previously found in Torreón, northern Mexico, host to the world's fourth largest lead-zinc metal smelter. The objectives of this study were to determine spatial distributions of adolescents with higher BPb and creatinine-corrected urine total arsenic...

Objective: To evaluate the association between prenatal exposure to molybdenum (Mo) and infant neurodevelopment during the first 30 months of life. Methods: We selected a random sample of 147 children who participated in a prospective cohort study in four municipalities in the State of Morelos, Mexico. The children were the products of uncomplic...

Cleaning products are associated with many health and environmental problems. Contamination of water resources by cleaning products is more likely to occur with septic tanks as sewage treatment systems especially in karstic terrains. We explored women's ideas about water sources and the risk cleaning products pose to health and sewage in Mérida, a...

Purpose We aimed to evaluate the association between changes in airborne particulate matter concentration (PM) with changes in cases of mortality, acute respiratory infections (ARI) and asthma over 2004–2008 in an industrialized and polluted region in central Mexico. Methods A generalized linear model with a Poisson distribution and a negative b...

Aldo-keto reductases (AKRs) metabolize a wide range of substrates, including polycyclic aromatic hydrocarbons (PAHs), generating metabolites (o-quinones) and reactive oxygen species (ROS), which are capable of initiating and promoting carcinogenesis. Exposure to PAHs, their metabolites, and ROS further increase AKRs isoform expression that may ampl...

Background: The results of previous studies suggest that prenatal exposure to bis[p-chlorophenyl]-1,1,1-trichloroethane (DDT) and to its main metabolite, 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene (DDE), impairs psychomotor development during the first year of life. However, information about the persistence of this association at later ages is l...

Objective: To evaluate the association of heart rate variability with job strain in first year resident physicians. Methods: We performed the study at the "Manuel Gea González" General Hospital in Mexico City. 54 resident doctors were studied over a period of 24 hr in their first year of specialization. Two questionnaires were administered: the...

AKR1A1 or aldehyde reductase is a member of the aldo-keto reductases superfamily that is evolutionarily conserved among species. AKR1A1 is one of the five AKRs (AKR1A1 and 1C1-1C4) implicated in the metabolic benzo(a)pyrene (BaP) activation to reactive BaP 7,8-dione. BaP is a polycyclic aromatic hydrocarbon (PAH) widely distributed in aquatic ecosy...

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants presenting a public health risk, particularly to children, a vulnerable population. PAHs have genotoxic and carcinogenic properties, which depend on their metabolism. Many enzymes involved in PAH metabolism, including CYP1A1, CYP1B1, GSTM and GSTT are polymorphic, which may modulate...

Central apnoea occurs in infants and if not detected leads to death. Central apnoea is a prostaglandin E(2) (PGE2) mediated effect that is susceptible to pharmacologic manipulation in animal models. Paracetamol and ibuprofen are centrally and peripherally acting PGE2 inhibitors, respectively. To determine if infants who had received paracetamol or...

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Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants presenting a public health risk, particularly to children, a vulnerable population. PAHs have genotoxic and carcinogenic properties, which depend on their metabolism. Many enzymes involved in PAH metabolism, including CYP1A1, CYP1B1, GSTM and GSTT are polymorphic, which may modulate...

To identify factors associated with culture-proven serious bacterial infection (SBI) and positive emergency department septic screening (EDSS) tests in children with bronchiolitis and to identify factors associated with the performance of EDSS. We reviewed an existing study database of patients with bronchiolitis. We defined a positive EDSS as urin...

To know the variability of the creatinine-adjusted inorganic mercury (HgUCr) levels in women aged >or=12 years to evaluate the impact of residing at a site contaminated by mercury in soil. A cross-sectional epidemiologic study was conducted, in which 122 women participated, in whom, HgUCr was determined. Simultaneously, a questionnaire was applied...

Although there is evidence from animal studies of impaired reproductive function by exposure to organophosphates (OP), the effects on birth weight have not been sufficiently evaluated in epidemiological studies. Paraoxonase (PON1) detoxifies organophosphates by cleavage of active oxons. Some PON1 gene polymorphisms could reduce the enzyme activity...

Merida city in Yucatan, Mexico, has received rural-to-urban migration for decades, with most immigrants settling in the city's southern neighborhoods. Exposure of immigrants to new environmental and sociocultural conditions can generate biological responses, including changes in physical growth pattern at early age. We performed a study to identify...

OBJECTIVE: The goal of this study was to assess linkages between microclimate and longer-term ENSO-related weather forcing on the week-to-week changes in dengue prevalence in Matamoros, Tamaulipas, Mexico, over a recent decade of dengue observations. MATERIAL AND METHODS: An auto-regressive model to evaluate the role of climatic factors (sea-surfac...

Previous reviews have shown increases in blood pressure and hypertension associated with increases in lead levels in blood. We performed a meta-analysis of the association of bone lead levels with systolic blood pressure, diastolic blood pressure, and hypertension using published data. We searched Medline, Embase, and Toxline for epidemiologic stud...

The goal of this study was to assess linkages between microclimate and longer-term ENSO-related weather forcing on the week-to-week changes in dengue prevalence in Matamoros, Tamaulipas, Mexico, over a recent decade of dengue observations. An auto-regressive model to evaluate the role of climatic factors (sea-surface temperature) and weather (maxim...

To compare the effect of nebulized racemic epinephrine to nebulized racemic albuterol on successful discharge from the emergency department (ED). Children up to their 18th month of life presenting to two teaching hospital EDs with a clinical diagnosis of bronchiolitis who were ill enough to warrant treatment but did not need immediate intubation we...

We evaluated the impact of weather variables and climatic indicators associated with the incidence of dengue in two municipalities of the state of Veracruz, Mexico, from 1995 to 2003. A retrospective ecological study was conducted, using time-series analysis in which we compiled the weekly reported cases of dengue and the weather and climatic param...

Background: Although cholera kills thousands each year globally, locally acquired cases are rare in the United States and are most often associated with Gulf Coast seafood. Toxigenic Vibrio cholerae O1, the agent of cholera, is endemic in the brackish waters of southern Louisiana. In the year following Hurricane Katrina, six cholera cases were repo...

Reported autochthonous dengue fever transmission in the United States has been limited to 5 south Texas border counties since 1980. We conducted a cross-sectional serosurvey in Brownsville, Texas, and Matamoros, Tamaulipas, Mexico (n = 600), in 2004 to assess dengue seroprevalence. Recent dengue infection was detected in 2% (95% confidence interval...

This systematic review evaluates the evidence on the association between lead exposure and cardiovascular end points in human populations. METHODS: We reviewed all observational studies from database searches and citations regarding lead and cardiovascular end points. RESULTS: A positive association of lead exposure with blood pressure has been ide...