Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure
Introduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Gastroenterology Insights |
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| Online Access: | https://www.mdpi.com/2036-7422/14/1/7 |
| _version_ | 1797611625973284864 |
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| author | Albert Stuart Reece Gary Kenneth Hulse |
| author_facet | Albert Stuart Reece Gary Kenneth Hulse |
| author_sort | Albert Stuart Reece |
| collection | DOAJ |
| description | Introduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centre for Drugs and Drug Addiction. Income data were taken from the World Bank. Results: When countries with increasing rates of daily cannabis use were compared with those which were not, the overall rate of gastrointestinal CA’s (GCA’s) was higher in the former group (<i>p</i> = 0.0032). The five anomalies which were related to the metrics of cannabis exposure on bivariate analysis were bile duct atresia, Hirschsprungs, digestive disorders, annular pancreas and anorectal stenosis or atresia. The following sequence of GCA’s was significantly linked with cannabis metrics at inverse-probability-weighted-panel modelling, as indicated: esophageal stenosis or atresia, bile duct atresia, small intestinal stenosis or atresia, anorectal stenosis or atresia, Hirschsprungs disease: <i>p</i> = 1.83 × 10<sup>−5</sup>, 0.0046, 3.55 × 10<sup>−12</sup>, 7.35 × 10<sup>−6</sup> and 2.00 × 10<sup>−12</sup>, respectively. When this GCA series was considered in geospatial modelling, the GCA’s were significantly cannabis-related from <i>p</i> = 0.0003, N.S., 0.0086, 6.652 × 10<sup>−5</sup>, 0.0002, 71.4% of 35 E-value estimates and 54.3% minimum E-values (mEVv’s) > 9 (high zone) and 100% and 97.1% > 1.25 (causality threshold). The order of cannabis sensitivity by median mEVv was Hirschsprungs > esophageal atresia > small intestinal atresia > anorectal atresia > bile duct atresia. Conclusions: Seven of eight GCA’s were related to cannabis exposure and fulfilled the quantitative criteria for epidemiologically causal relationships. Penetration of cannabinoids into the community should be carefully scrutinized and controlled to protect against exponential and multigenerational genotoxicity ensuing from multiple cannabinoids. |
| first_indexed | 2024-03-11T06:31:22Z |
| format | Article |
| id | doaj.art-be564946f16740a582345342177b9943 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-03-11T06:31:22Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
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| series | Gastroenterology Insights |
| spelling | doaj.art-be564946f16740a582345342177b99432023-11-17T11:14:03ZengMDPI AGGastroenterology Insights2036-74142036-74222023-02-011416410910.3390/gastroent14010007Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance ExposureAlbert Stuart Reece0Gary Kenneth Hulse1Division of Psychiatry, University of Western Australia, Crawley, WA 6009, AustraliaDivision of Psychiatry, University of Western Australia, Crawley, WA 6009, AustraliaIntroduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centre for Drugs and Drug Addiction. Income data were taken from the World Bank. Results: When countries with increasing rates of daily cannabis use were compared with those which were not, the overall rate of gastrointestinal CA’s (GCA’s) was higher in the former group (<i>p</i> = 0.0032). The five anomalies which were related to the metrics of cannabis exposure on bivariate analysis were bile duct atresia, Hirschsprungs, digestive disorders, annular pancreas and anorectal stenosis or atresia. The following sequence of GCA’s was significantly linked with cannabis metrics at inverse-probability-weighted-panel modelling, as indicated: esophageal stenosis or atresia, bile duct atresia, small intestinal stenosis or atresia, anorectal stenosis or atresia, Hirschsprungs disease: <i>p</i> = 1.83 × 10<sup>−5</sup>, 0.0046, 3.55 × 10<sup>−12</sup>, 7.35 × 10<sup>−6</sup> and 2.00 × 10<sup>−12</sup>, respectively. When this GCA series was considered in geospatial modelling, the GCA’s were significantly cannabis-related from <i>p</i> = 0.0003, N.S., 0.0086, 6.652 × 10<sup>−5</sup>, 0.0002, 71.4% of 35 E-value estimates and 54.3% minimum E-values (mEVv’s) > 9 (high zone) and 100% and 97.1% > 1.25 (causality threshold). The order of cannabis sensitivity by median mEVv was Hirschsprungs > esophageal atresia > small intestinal atresia > anorectal atresia > bile duct atresia. Conclusions: Seven of eight GCA’s were related to cannabis exposure and fulfilled the quantitative criteria for epidemiologically causal relationships. Penetration of cannabinoids into the community should be carefully scrutinized and controlled to protect against exponential and multigenerational genotoxicity ensuing from multiple cannabinoids.https://www.mdpi.com/2036-7422/14/1/7tobaccoalcoholcannabiscannabinoidcancercancerogenesis |
| spellingShingle | Albert Stuart Reece Gary Kenneth Hulse Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure Gastroenterology Insights tobacco alcohol cannabis cannabinoid cancer cancerogenesis |
| title | Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure |
| title_full | Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure |
| title_fullStr | Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure |
| title_full_unstemmed | Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure |
| title_short | Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure |
| title_sort | congenital gastrointestinal anomalies in europe 2010 2019 a geo spatiotemporal and causal inferential study of epidemiological patterns in relationship to cannabis and substance exposure |
| topic | tobacco alcohol cannabis cannabinoid cancer cancerogenesis |
| url | https://www.mdpi.com/2036-7422/14/1/7 |
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