Polychlorinated biphenyl congeners as markers of toxic equivalents of polychlorinated biphenyls, dibenzo-p-dioxins and dibenzofurans in breast milk

Are temporal trends of some persistent organochlorine and organobromine compounds in Swedish breast milk slowing down?

We investigated body burdens of persistent organic pollutants (POPs) in Swedish first-time mothers by measurements in breast milk, and followed up the temporal trends between 1996 and 2017. POPs were analysed in individual samples (n = 539) from participants from Uppsala county, Sweden. This made it possible to adjust temporal trends for age of the mother, pre-pregnancy BMI, weight gain during pregnancy, weight loss after delivery, and education, the main determinants for POP body burdens, apart from sampling year. We also compared observed body burdens with the body burdens determined to be safe from a health perspective in the risk assessment of dioxin-like polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), published by the European Food Safety Authority (EFSA). Declining temporal trends in breast milk of on average -4 to 14% per year were observed 1996-2017 for PCBs, PCDD/Fs, chlorinated pesticides, and brominated flame retardants, except for the polybrominated diphenyl ethers (PBDEs) BDE-153 and BDE-209. The toxic equivalents (TEQs) for PCDD declined faster than PCDF TEQs, -6.6% compared to -3.5% per year. For CB-169, CB-180, PCDDs, PCDFs, Total TEQ, and hexachlorobenzene (HCB), a change point year (CP) was observed around 2008-2009 and after that, the decline in levels has slowed down. If breast milk levels follows the exponential declining trend of total TEQ estimated for the entire period (-5.7% per year), 97.5% of first time mothers from the Uppsala area will have body burdens below the estimated safe level in year 2022. If instead it follows the estimated % decline after the CP in 2008 (-1.6% per year), it will take until 2045 before 97.5% is below the estimated safe level. It is important to proceed with the monitoring of POPs in breast milk from Swedish mothers in order to further observe if the levels are stabilizing or continue to decline.

Internal exposure levels of typical POPs and their associations with childhood asthma in Shanghai, China

Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) are common persistent organic pollutants (POPs) that may be associated with childhood asthma. The concentrations of PBDEs, PCBs and OCPs were analyzed in pooled serum samples from both asthmatic and non-asthmatic children. The differences in the internal exposure levels between the case and control groups were tested (p value <0.0012). The associations between the internal exposure concentrations of the POPs and childhood asthma were estimated based on the odds ratios (ORs) calculated using logistic regression models. There were significant differences in three PBDEs, 26 PCBs and seven OCPs between the two groups, with significantly higher levels in the cases. The multiple logistic regression models demonstrated that the internal exposure concentrations of a number of the POPs (23 PCBs, p,p'-DDE and α-HCH) were positively associated with childhood asthma. Some synergistic effects were observed when the children were co-exposed to the chemicals. BDE-209 was positively associated with asthma aggravation. This study indicates the potential relationships between the internal exposure concentrations of particular POPs and the development of childhood asthma.

Spatial and temporal trends of the Stockholm Convention POPs in mothers' milk -- a global review

Persistent organic pollutants (POPs) have been of environmental and health concern for more than half a century and have their own intergovernmental regulation through the Stockholm Convention, from 2001. One major concern is the nursing child's exposure to POPs, a concern that has led to a very large number of scientific studies on POPs in mothers' milk. The present review is a report on the assessment on worldwide spatial distributions of POPs and of their temporal trends. The data presented herein is a compilation based on scientific publications between 1995 and 2011. It is evident that the concentrations in mothers' milk depend on the use of pesticides and industrial chemicals defined as POPs. Polychlorinated biphenyls (PCBs) and "dioxins" are higher in the more industrialized areas, Europe and Northern America, whereas pesticides are higher in Africa and Asia and polybrominated diphenyl ethers (PBDEs) are reported in higher concentrations in the USA. POPs are consequently distributed to women in all parts of the world and are thus delivered to the nursing child. The review points out several major problems in the reporting of data, which are crucial to enable high quality comparisons. Even though the data set is large, the comparability is hampered by differences in reporting. In conclusion, much more detailed instructions are needed for reporting POPs in mothers' milk. Temporal trend data for POPs in mothers' milk is scarce and is of interest when studying longer time series. The only two countries with long temporal trend studies are Japan and Sweden. In most cases, the trends show decreasing concentrations of POPs in mothers' milk. However, hexabromocyclododecane is showing increasing temporal concentration trends in both Japan and Sweden.

Levels of PCDDs, PCDFs, and dioxin-like PCBs in human milk among Hong Kong mothers

Dioxins are a family of persistent organic pollutants (POPs) listed under the Stockholm Convention, and include PCDDs, PCDFs, and dioxin-like PCBs. These toxic chemicals are carcinogenic, widely dispersed, and have long half-lives. They have contaminated the food web and, being fat-soluble, accumulate in adipose tissues and milk in the human body. To assess human exposure, we collected breast milk samples from 137 first-time mothers recruited from around Hong Kong. Samples were analysed by HRGC-HRMS in four pools, according to the subject's age and length of residency. Exposure was related to age, duration of stay, and possibly diet. Generally, older mothers, and mothers with a longer stay in Hong Kong, had higher levels of dioxins in their milk. This pattern was clearest for the PCBs, although deviations were observed for some of the PCDD/Fs. Mean concentrations, measured per gram of lipid weight in terms of WHO toxic equivalents (WHO-TEQs), were 7.48 pg/g for PCDD/Fs and 3.79 pg/g for PCBs, giving a total of 11.27 pg/g for PCDD/Fs and PCBs combined. Compared to an earlier Hong Kong study we conducted in 2002, the mean WHO-TEQ values in our latest findings were about 9% lower overall for PCDD/Fs and 19% lower for PCBs, with the mean total WHO-TEQ for PCDD/Fs and PCBs being around 13% lower in this study. This indicates a general declining trend in the levels of POPs in Hong Kong. However, our levels were still high when compared to those in some other Asian-Pacific countries. More stringent policies on reducing and eliminating POPs should help to lower these. Continued surveillance for POPs in human milk, as well as in common foodstuffs, will provide us with important information on human exposures that will be necessary for tracking our progress, and making future health risk assessments.

Occurrence of halogenated contaminants in inland and coastal fish from Ghana: levels, dietary exposure assessment and human health implications

Fish consumption is known to have several health benefits for humans. However, the accumulation of toxic contaminants, such as PCBs, PBDEs and HBCDs in fish could pose health hazards. These contaminants were measured in tilapia fish species collected from Ghana. Mean levels were PCBs (62 ng/g lw), PBDEs (7.3 ng/g lw) and HBCDs (1.2 ng/g lw) and the predominance of CB-153, CB-138, CB-180, BDE-47 and α-HBCD is in concordance with scientific literature. The congener profiles of PBDEs and PCBs in the fish suggest that sources of Penta- and Deca-BDE technical mixtures as well as technical PCB mixture (Clophen A60) exist in Ghana, while textile operations and associated release of untreated wastewater are likely to be significant sources of HBCDs. Comparison of the results with some reported studies showed moderate contamination in Ghana although Ghana is a developing country in Africa. Concentrations of PCBs measured in all the specimens in this study were below the food safety guidelines issued by the Food and Drug Administration, USA and the European Commission. The calculated hazard index levels of the target contaminants were below the threshold value of one, indicating that the levels of the target contaminants do not seem to constitute a health risk via fish consumption, with regard to PCBs, PBDEs and HBCDs, based on the limited number of samples that was accounted for in this study. However, due to the continuous discharge of untreated effluents, follow up studies are warranted as the consumption of fish is the primary route of human exposure to PCBs. This maiden report on the status of PBDEs and HBCDs in fish from Ghana will contribute to the knowledge about environmental contamination by POPs in a less industrialized region of the world so far sparsely covered in the literature.

Prenatal exposure to polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) may influence birth weight among infants in a Swedish cohort with background exposure: a cross-sectional study

BACKGROUND

Prenatal exposure to persistent organic pollutants, e.g. polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) has been suggested to negatively affect birth weight although epidemiological evidence is still inconclusive. We investigated if prenatal exposure to PCBs and PBDEs is related to birth weight in a Swedish population with background exposure.

METHODS

Breast milk was sampled during the third week after delivery from first-time mothers in Uppsala county, Sweden 1996-2010 (POPUP cohort) (N = 413). Samples were analysed for di-ortho PCBs (CB-138, 153, 180) and tetra- to hexa- brominated PBDEs (BDE-47, 99, 100, 153). Simple and multiple linear regression models were used to investigate associations between lipid-adjusted, ln-transformed PCB and PBDE concentrations, and birth weight. Covariates included in the multivariate regression model were PCB and PBDE exposure, maternal age, pre-pregnancy BMI, weight gain during pregnancy, education, smoking, gender of the infant and gestational length. The effect of including fish consumption was also investigated.

RESULTS

In the multivariate model, prenatal exposure to di-ortho PCBs was significantly associated with increased birth weight (β = 137; p = 0.02). The result did not change when gestational length was added to the model. An inverse association between PBDE(4) (sum of BDE-47, -99, -100 and -153) and birth weight was observed in the multivariate model including gestational length (β = -106; p = 0.04). Maternal pre-pregnancy BMI and weight gain during pregnancy were important confounders of the association between di-ortho PCBs and birth weight. The associations were not alleviated after adjustment for fish consumption, a major source of PCB and PBDE exposure. The observed associations were stronger for boys than for girls.

CONCLUSIONS

Our results indicate that prenatal exposure to di-ortho PCBs and PBDE(4) may influence birth weight in different directions, i.e. PCB exposure was associated with higher birth weight and PBDE exposure with lower birth weight. Maternal pre-pregnancy BMI and weight gain during pregnancy were important confounders that may hide positive association between di-ortho PCB exposure and birth weight if they are not included in the statistical model. We speculate that even small PCB- and PBDE-induced shifts in the distribution of birth weight may influence future public health in populations with background exposure.

Human exposure to PCBs, PBDEs and HBCDs in Ghana: Temporal variation, sources of exposure and estimation of daily intakes by infants

Human exposure to polychlorinated biphenyls (PCBs) and brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) was evaluated in Ghana using breast milk samples collected in 2004 and 2009. Mean levels and ranges of PBDEs (4.5; 0.86-18 ng/g lw) and PCBs (62; 15-160 ng/g lw) observed in the present study were unexpectedly high, in spite of the fact that Ghana is a non-industrialized country when compared with many of the Asian and European countries. Significant increases were found in the concentrations of PCBs and PBDEs over the years, while no significant increase was observed for HBCDs. Estimated hazard quotient (HQ) showed that all the mothers had HQ values exceeding the threshold of 1 for PCBs, indicating potential health risk for their children. PCBs in dirty oils and obsolete equipment should be of concern as potential sources in Ghana, and e-waste recycling with little or no experience in safe handling could be a threat to this sub-region noted for unregulated disposal of e-waste. The results may point towards an increase in trends in human milk in Ghana, especially in the larger cities but further analysis would be required to confirm this upward trend in levels. This is the first study to report BFRs in human breast milk from Africa, and undoubtedly from Ghana.

PCDD/Fs and dioxin-like PCBs in human milk and estimation of infants' daily intake: a review

This paper reviews the recent scientific literature on PCDDs, PCDFs and dioxin-like PCBs in human milk. All the papers reporting levels of these contaminants in human breast milk published from January 2000 to January 2009 and available on the www.sciencedirect.com web site were identified and included. The aim was (1) to study levels of PCDDs, PCDFs and PCBs in human milk in mothers from different geographical areas and assess infant exposure to these contaminants; (2) to study the effect of variables such as the mother's age, number of deliveries, dietary and smoking habits and her own nutrition in infancy, and the environment, on levels of the contaminants in breast milk; (3) to study time patterns, and (4) to identify data gaps.

Regional differences in levels of chlorinated and brominated pollutants in mother's milk from primiparous women in Sweden

Early life exposure to halogenated persistent organic pollutants, such as polychlorinated biphenyls (PCBs), the DDT metabolite p,p'-dichlorodiphenyldichloroethane (p,p'-DDE), polybrominated diphenylethers (PBDEs), and hexabromocyclododecane (HBCD), may affect human health. We determined if there are regional differences in mother's milk levels of these compounds in Sweden. In year 2000-2004, milk was sampled from 204 randomly recruited primiparas from four regions of Sweden. Levels of the compounds were measured by gas chromatography with dual electron-capture detectors. Women were recruited at delivery in three hospitals located in urban areas in southern and central Sweden (Lund, Gothenburg and Uppsala), and in one hospital located in a more rural area in northern Sweden (Lycksele). Information about dietary habits and medical/life-style factors were collected by questionnaires. Among PCB congeners, CB 153, CB 138 and CB 180 showed the highest median concentrations (18-48 ng/g mother's milk lipid), whereas more than 50% of the women had CB 52, CB 101, CB 114, and CB 157 levels below the LOQ (0.3-1.5 ng/g lipid). Median p,p'-DDE levels were in the range of 46-78 ng/g lipid. BDE 47 showed the highest median concentrations (1-2 ng/g lipid) among the brominated compounds, whereas more than 50% of the women had levels of BDE 28, BDE 66, BDE 138, BDE 154, and HBCD below the LOQ (0.05-0.10 ng/g lipid). Regional differences in median organohalogen compound concentrations were small, less than 2-fold. Lycksele women generally had the lowest levels of Σmono-and Σdi-ortho PCBs, mainly due to a lower average age. In contrast, these women had higher tetra- to penta-brominated PBDE levels, but no diet or life-style factor could explain this finding. Wide ranges of PBDEs and HBCD levels (up to 200-fold) were found, especially in the Lycksele area. The highest levels of PBDE were in the range of average levels found in mother's milk from North America, suggesting that food may not be the only source of exposure to PBDEs among some individuals.

The effect of waste combustion on the occurrence of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) in breast milk in Italy

Levels of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were measured in the breast milk of mothers living in Giugliano (Campania, Italy), an area at increased risk of PCDD and PCDF exposure caused by recent and serious open-air waste-combustion accidents. Polychlorinated biphenyls (PCBs) in milk samples were also studied. Breast milk was also monitored in two cities in northern Italy, Milan and Piacenza, which were selected as controls. Other variables, such as diet and age of the mothers, were also studied. PCDD/F and PCB levels and congener profiles in breast-milk samples were similar in all these cities, though total PCDD/F and DL-PCB TEQs in samples from Giugliano were significantly lower than those in Milan and Piacenza (8.65 pg WHO-TEQ in Giugliano vs. 11.0 and 9.94 pg WHO-TEQ in Milan and Piacenza respectively). Thus no direct correlations were found between PCDD/F and PCB levels in breast milk and the suspected increased exposure through open-air waste combustion in Giugliano. Diet did not seem to affect PCDD/F and PCB levels, whereas a significant correlation was observed between the mother's age and an increased concentration of PCDDs/Fs and PCBs in milk. Comparison of these findings with those of previous surveys in Italy in 2000-2001 showed a marked reduction of PCDD/F (about 60%) and DL-PCB (about 20%) levels in breast milk occurring over the last 10 years. This might well be a result of well functioning legislation, for example European Directives on of the reduction of the emission limits of PCDDs/Fs and PCBs from waste incineration set by EU Directive 2000/76/EC implemented in 2000, or Commission Regulations such as (EC) No. 466/2001 and 1881/2006 setting maximum levels for certain contaminants in foodstuffs.

POP levels in breast milk and maternal serum and thyroid hormone levels in mother-child pairs from Uppsala, Sweden

In experimental studies, it has frequently been observed that the homeostasis of thyroid hormones (THs) is affected by exposure to persistent organic pollutants (POPs), such as dioxins and PCBs. In man, similar effects have been indicated in several epidemiological studies. In order to investigate the possible effect on THs at low background exposures found among the Swedish population the following study was performed. Primiparous women (n=395) in the Uppsala region were recruited between 1996 and 1999. Of these, 325 mothers agreed to donate a serum sample in late pregnancy and breast milk was obtained from 211 women 3 weeks after delivery. Babies were sampled for blood at 3 weeks (n=150) and 3 months (n=115) after birth. In connection to the sampling, questions on personal characteristics were asked. Levels of low (tri- to penta-) chlorinated PCB, di-ortho PCB, p,p'-DDE, (mono-ortho) PCB TEQ and PCDD/DF TEQ were monitored in breast milk and in mother's blood (not PCDD/DF). The results showed that the measured TH levels (thyroid-stimulating hormone - TSH, total tri-iodothyronine - TT3, free thyroxine - FT4) in mothers and children were within the reference range. Some significant associations were seen between POP exposures and TH levels in mother or child after simple regression analysis. Following adjustment for important confounding factors, the significant associations mostly disappeared. However, significantly decreasing TT3 levels with increasing prenatal low-chlorinated PCB exposure were still seen in 3 week old children, and on TT3 in mothers exposed to PCDD/DF. In conclusion, the study clearly shows the importance of adjustment for important confounding factors in the analysis of possible associations between POP exposure and hormonal effects. The remaining associations are weak in both children and mothers and the clinical consequences of these alterations are uncertain. When comparing studies that investigate associations between TH levels and POP levels during the perinatal stage, no obvious between-study concordance was seen regarding the critical dose for hormonal effects to occur.

Persistent organochlorine and organobromine compounds in mother's milk from Sweden 1996-2006: compound-specific temporal trends

High body burdens of persistent halogenated organic pollutants (POPs) among pregnant and nursing women are of concern because of exposure of the growing foetus and breast-feeding infant. We examined the temporal trends of polychlorinated biphenyls (PCBs), dibenzo-p-dioxin (PCDDs) and dibenzofurans (PCDFs), polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCD) in milk samples from Swedish women. POPs were analysed in individual mother's milk samples from randomly recruited primiparas (N=335) who lived in Uppsala County and delivered between 1996 and 2006. Results were adjusted for life-style factors that are associated with POP body burdens. PCB levels declined 3.9-8.6% per year. The levels of PCDDs decreased faster (6-9% per year) than the levels of PCDFs (3-6% per year). Temporal trends of PBDEs did not follow any consistent pattern. Concentrations of BDE-47 and BDE-99 decreased, while the concentrations of BDE-153 increased. No change in BDE-100 concentrations was observed. In most samples, concentrations of HBCD were below the quantification limit (<0.20 ng/g lipid). Generally, adjustment of the temporal trends of PCBs and PCDD/Fs for personal characteristics of the mothers (age, body mass index (BMI), weight changes during and after pregnancy) resulted in faster declining rates, with age having the greatest influence. The age of the participating mothers increased during the study period, and since the POP levels increased with increasing age, this counteracted the decreasing temporal trends in the unadjusted model. It is consequently important to include personal characteristics in the analysis of temporal trends of POPs. Compound-specific temporal trends are probably caused by differences in sources of exposure, as well as by differences in persistence between compounds.

Immune cell counts and risks of respiratory infections among infants exposed pre- and postnatally to organochlorine compounds: a prospective study

BACKGROUND

Early-life chemical exposure may influence immune system development, subsequently affecting child health. We investigated immunomodulatory potentials of polychlorinated biphenyls (PCBs) and p,p'-DDE in infants.

METHODS

Prenatal exposure to PCBs and p,p'-DDE was estimated from maternal serum concentrations during pregnancy. Postnatal exposure was calculated from concentrations of the compounds in mother's milk, total number of nursing days, and percentage of full nursing each week during the 3 month nursing period. Number and types of infections among infants were registered by the mothers (N = 190). White blood cell counts (N = 86) and lymphocyte subsets (N = 52) were analyzed in a subgroup of infants at 3 months of age.

RESULTS

Infants with the highest prenatal exposure to PCB congeners CB-28, CB-52 and CB-101 had an increased risk of respiratory infection during the study period. In contrast, the infection odds ratios (ORs) were highest among infants with the lowest prenatal mono-ortho PCB (CB-105, CB-118, CB-156, CB-167) and di-ortho PCB (CB-138, CB-153, CB-180) exposure, and postnatal mono- and di-ortho PCB, and p,p'-DDE exposure. Similar results were found for pre- and postnatal CB-153 exposure, a good marker for total PCB exposure. Altogether, a negative relationship was indicated between infections and total organochlorine compound exposure during the whole pre- and postnatal period. Prenatal exposure to CB-28, CB-52 and CB-101 was positively associated with numbers of lymphocytes and monocytes in infants 3 months after delivery. Prenatal exposure to p,p'-DDE was negatively associated with the percentage of eosinophils. No significant associations were found between PCB and p,p'-DDE exposure and numbers/percentages of lymphocyte subsets, after adjustment for potential confounders.

CONCLUSION

This hypothesis generating study suggests that background exposure to PCBs and p,p'-DDE early in life modulate immune system development. Strong correlations between mono- and di-ortho PCBs, and p,p'-DDE exposures make it difficult to identify the most important contributor to the suggested immunomodulation, and to separate effects due to pre- and postnatal exposure. The suggested PCB and p,p'-DDE modulation of infection risks may have consequences for the health development during childhood, since respiratory infections early in life may be risk factors for asthma and middle ear infections.

Population physiologically based pharmacokinetic modeling for the human lactational transfer of PCB-153 with consideration of worldwide human biomonitoring results

BACKGROUND

One of the most serious human health concerns related to environmental contamination with polychlorinated biphenyls (PCBs) is the presence of these chemicals in breast milk.

OBJECTIVES

We developed a physiologically based pharmacokinetic model of PCB-153 in women, and predict its transfer via lactation to infants. The model is the first human, population-scale lactational model for PCB-153. Data in the literature provided estimates for model development and for performance assessment.

METHODS

We used physiologic parameters from a cohort in Taiwan and reference values given in the literature to estimate partition coefficients based on chemical structure and the lipid content in various body tissues. Using exposure data from Japan, we predicted acquired body burden of PCB-153 at an average childbearing age of 25 years and compared predictions to measurements from studies in multiple countries. We attempted one example of reverse dosimetry modeling using our PBPK model for possible exposure scenarios in Canadian Inuits, the population with the highest breast milk PCB-153 level in the world.

RESULTS

Forward-model predictions agree well with human biomonitoring measurements, as represented by summary statistics and uncertainty estimates.

CONCLUSION

The model successfully describes the range of possible PCB-153 dispositions in maternal milk, suggesting a promising option for back-estimating doses for various populations.

Distribution of polychlorinated biphenyls and organochlorine pesticides in human breast milk from various locations in Tunisia: levels of contamination, influencing factors, and infant risk assessment

The concentrations of dichlorodiphenytrichloroethane and its metabolites (DDTs), hexachlorobenzene (HCB), hexachlorocyclohexane isomers (HCHs), dieldrin, and 20 polychlorinated biphenyls (PCBs) were determined in 237 human breast milk samples collected from 12 locations in Tunisia. Gas chromatography with electron capture detector (GC-ECD) was used to identify and quantify residue levels on a lipid basis of organochlorine compounds (OCs). The predominant OCs in human breast milk were PCBs, p,p'-DDE, p,p'-DDT, HCHs, and HCB. Concentrations of DDTs in human breast milk from rural areas were significantly higher than those from urban locations (p<0.05). With regard to PCBs, we observed the predominance of mid-chlorinated congeners due to the presence of PCBs with high K(ow) such as PCB 153, 138, and 180. Positive correlations were found between concentrations of OCs in human breast milk and age of mothers and number of parities, suggesting the influence of such factors on OC burdens in lactating mothers. The comparison of daily intakes of PCBs, DDTs, HCHs, and HCB to infants through human breast milk with guidelines proposed by WHO and Health Canada shows that some individuals accumulated OCs in breast milk close to or higher than these guidelines.

Reproductive toxicity of seafood contaminants: prospective comparisons of Swedish east and west coast fishermen's families

Cohorts comprising fishermen's families on the east coast of Sweden have been found to have a high consumption of contaminated fish as well as high body burdens of persistent organochlorine pollutants (POPs). Their west coast correspondents are socio-economically similar, but with considerably lower POP exposure since the fish caught on the west coast is far less contaminated. The rationale for this was that the cohorts residing on the east coast of Sweden have been found to have a high consumption of contaminated fish as well as high body burdens of POPs, whereas their west coast correspondents are socio-economically similar, but with considerably lower POP exposure since the fish caught on the west coast is far less contaminated. Among the reproductive outcomes investigated are included both male and female parameters, as well as couple fertility and effects on the fetus. A range of exposure measures, including both questionnaire assessments of fish consumption and biomarkers, have been used. The most consistent findings of the studies are those related to the fetus, where a decreased birth weight was found across all measures of exposure, which is in agreement with studies from other populations. Some markers for male reproduction function, i.e. sperm motility, sperm chromatin integrity, and Y:X chromosome ratio, were associated with POP exposure, whereas others, such as sperm concentration and semen volume, were not. With respect to couple fertility and female reproductive parameters, no support was given for associations with POP exposure. Although some associations may have been affected by beneficial effects of essential nutrients in seafood, the overall findings are meaningful in the context of reproductive toxicity and support the usefulness of the epidemiological design.

Monitoring concentrations of persistent organic pollutants in the general population: the international experience

Assessing the adverse effects on human health of persistent organic pollutants (POPs) and the impact of policies aiming to reduce human exposure to POPs warrants monitoring body concentrations of POPs in representative samples of subjects. While numerous ad hoc studies are being conducted to understand POPs effects, only a few countries are conducting nationwide surveillance programs of human concentrations of POPs, and even less countries do so in representative samples of the general population. We tried to identify all studies worldwide that analyzed the distribution of concentrations of POPs in a representative sample of the general population, and we synthesized the studies' main characteristics, as design, population, and chemicals analyzed. The most comprehensive studies are the National Reports on Human Exposure to Environmental Chemicals (USA), the German Environmental Survey, and the Arctic Monitoring and Assessment Programme. Population-wide studies exist as well in New Zealand, Australia, Japan, Flanders (Belgium) and the Canary Islands (Spain). Most such studies are linked with health surveys, which is a highly-relevant additional strength. Only the German and Flemish studies analyzed POPs by educational level, while studies in the USA offer results by ethnic group. The full distribution of POPs concentrations is unknown in many countries. Knowledge gaps include also the interplay of age, gender, period and cohort effects on the prevalence of exposures observed by cross-sectional surveys. Local and global efforts to minimize POPs contamination, like the Stockholm convention, warrant nationwide monitoring of concentrations of POPs in representative samples of the general population. Results of this review show how such studies may be developed and used.

The influence of lipid and lifestyle factors upon correlations between highly prevalent organochlorine compounds in patients with exocrine pancreatic cancer

We aimed to analyse the influence of cholesterol and triglycerides, and of tobacco, coffee and alcohol consumption upon correlations between serum concentrations of organochlorine compounds (OCs) in patients with exocrine pancreatic cancer (EPC). Incident cases of EPC diagnosed in eastern Spain were prospectively identified (N=144). OCs were analysed by high-resolution gas chromatography with electron-capture detection. A strong correlation was observed between hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH) (Spearman's rho=0.758). beta-HCH showed rho>0.4 with p,p'-DDT, p,p'-DDE, PCB138 and PCB153 (all p<0.001). Some correlations among compounds were slightly affected by tobacco, coffee or alcohol consumption. We observed a striking diversity of correlation patterns by strata of cholesterol and triglycerides. Most correlations were higher in the lowest category of triglycerides than in the lowest category of cholesterol. Most coefficients above 0.7 were seen in the lowest category of triglycerides (e.g., OC pairs p,p'-DDT and HCB, p,p'-DDT and beta-HCH, p,p'-DDE and beta-HCH, or HCB and beta-HCH). Correlations among OCs may be stronger when concentrations of triglycerides are low than when they are high. This is compatible with a dilution in the early phases of cancer and with a concentration effect as triglycerides become lower in the advanced phases of the disease.

Recent global trends and physiologic origins of dioxins and furans in human milk

Restrictions on releases of polychlorinated dibenzo-dioxins and polychlorinated dibenzofurans (PCDDs/Fs) to the environment from industrial practices have resulted in an attendant decrease in levels of these compounds in the environment. Continued environmental monitoring and biomonitoring of PCDDs/Fs ensure that exposures do not increase unexpectedly or unnoticed. Perhaps the most highly exposed part of the population, however, is the breastfed infant and a periodic assessment of levels of dioxins and furans in human milk provides exposure information for infants. A previous international review of levels of PCDDs/Fs in human milk based on data from the 1970's to the mid-1990's showed a decline in many countries for which data were available. In this paper, recent (1998-2005) global data on PCDDs/Fs in human milk are described. A comparison of these recent data to pre-1998 data suggests a continuing decline in global levels of PCDDs/Fs in human milk. In addition, this paper explores research on physiological origins of these compounds in human milk (e.g., adipose tissue mobilization, recent dietary exposures). The question of whether the presence of PCDDs/Fs in milk is from the lifetime accumulation of PCDDs/Fs in adipose tissue or current diet (or, as is more likely, a complex combination of both) remains unanswered. Whether diet during lactation has a greater influence on milk levels PCDDs/Fs levels than previously suspected, and whether infant exposures to PCDDs/Fs via breastfeeding could be reduced by changes in diet during lactation, are important--and currently unexplored--lines of inquiry.

PCBs and PCDD/FS in fish and fish products and their impact on the human body burden in Belgium

The concentrations of marker PCBs (28, 52, 101, 118, 138, 153, 180) in fish have been assessed with GC-MS: an average concentration of 540 ng-PCB g(-1) fat (5.02 ng-PCB g(-1) wet weight) was observed. The average concentration of PCDD/Fs, assessed with the CALUX bioassay, amounted to 64 pg-CALUX-TEQ g(-1) fat (0.58 pg-CALUX-TEQ g(-1) wet weight) and that of PCDD/Fs + dioxin-like PCBs amounted to 131 pg-CALUX-TEQ g(-1) fat (1.18 pg-CALUX-TEQ g(-1) wet weight). Results of the PCB congeners analyses show that PCB-153 is the most abundant congener in almost all samples, with also main contributions of the 138- and 180-congeners. For some species such as the sand sole and lemon sole, a fairly constant PCB content, independent of the fat percentage, was observed. For a second group of species such as whelks, cod, and whiting, a positive correlation was observed between their PCB concentration (ng g(-1) fat) and their % of fat. The relationship between marker PCBs and PCDD/Fs concentrations, when plotted on a log scale, fits a straight line (correlation coefficient r = 0.83). With our results on fish and literature data for other food products, intake of marker PCBs and PCDD/Fs could be calculated for the adult population in Belgium (19-60 years old). The Total Daily Intake (TDI) of marker PCBs (ng-PCB day(-1)) ranges between 1690 and 2210. The TDI of PCDD/Fs (pg-CALUX day(-1)) ranges between 80.5 and 122, that of PCDD/Fs + dioxin-like PCBs amounts to 151. When PCDD/Fs in fish are assessed with GC-HRMS, the TDI can be lower. The relative importance of fish regarding marker PCB intake amounts to 15-19%, while regarding PCDD/Fs intake it amounts to 34-51%. Using TDI, the body burden evolution of marker PCBs and PCDD/Fs, with age has been calculated.

Dioxin concentrations in sediments of the Baltic Sea--a survey of existing data

Recent survey results for polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs, dioxins) in Baltic Sea sediments from Finland, Sweden and Denmark were merged with previously published Baltic Sea data. Regional distribution of concentration levels, differences in congener patterns, and temporal changes in sediment profiles were examined. One of the main objectives was to study if any major point sources for different PCDD/F congeners could be identified on a regional scale, based on sediment records. The survey confirmed the impact of chlorophenol production derived highly chlorinated PCDF-congeners on the total toxicity in sediments in the Gulf of Finland near the Kymijoki river estuary. Signatures of other point sources or combined point sources pertinent to specific industry branches or particular production processes (such as pulp bleaching, vinyl chloride production, thermal processes) may be discerned. However, the findings did not support any of the known point sources significantly influencing those congeners that are most abundant in Baltic herring and salmon. Instead, regional distributions in the Baltic Sea indicate that atmospheric deposition may act as a major source for those congeners and especially for 2,3,4,7,8-PeCDF. There were clear indications of declines in levels in sediment in some areas, but generally the levels of highly chlorinated PCDD/Fs on the northern coast of the Gulf of Finland were still high when compared with other areas of the Baltic Sea. Major areas with data gaps cover the south-eastern and eastern coastal regions of the Baltic Proper and the southern Gulf of Finland.

A comparison of PCDD/PCDFs exposure in infants via formula milk or breast milk feeding

Food is the major source for polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) accumulation in human body. In infant period, breast milk and formula milk are the major food sources. Congener-specific analyses of 17 PCDD/PCDFs were performed on 10 brands of formula milk samples which were milk-based and 37 breast milk samples collected from women living in southern Taiwan. The levels of 17 PCDD/PCDFs in 10 formula milk samples ranged from 0.468 to 0.962 pg WHO-TEQ/g lipid, with a mean value of 0.713+/-0.163 pg WHO-TEQ/g lipid. For the 37 breast milk samples, their PCDD/PCDF levels were 14.7+/-9.36 pg WHO-TEQ/g lipid, with a range between 4.21 and 52.8 pg WHO-TEQ/g lipid. At 12th month of age for infants, average daily intakes (ADI) of PCDD/PCDFs were 2.1 pg WHO-TEQ/kg/day for the formula-feeding infants, and 13 pg WHO-TEQ/kg/day for the breast-feeding infants. The present data may provide useful information for risk-benefit evaluation of formula- and breast-feeding.

Ontogenetic development, sexual differentiation, and effects of Aroclor 1254 exposure on expression of the arylhydrocarbon receptor and of the arylhydrocarbon receptor nuclear translocator in the rat hypothalamus

Interaction of polychlorinated biphenyls (PCBs) with the aryl hydrocarbon receptor (AhR)/nuclear translocator (ARNT) system might interfere with the mechanisms controlling the sexual differentiation of the developing hypothalamus. The aim of this study was to evaluate the presence of AhR/ARNT in brain cells and the developmental profile of their expression in the hypothalamus of male and female rats during the perinatal period. Brain accumulation of the main PCB congeners after prenatal exposure to Aroclor 1254 and its influence on hypothalamic expression of AhR/ARNT was also assessed. The results show that: (a) AhR and ARNT are expressed both in neurons and in glia; (b) AhR expression progressively increases in the developing hypothalamus particularly in males, while ARNT is relatively constant in both sexes; (c) the prenatal administration of Aroclor to dams produces a differential accumulation of PCBs, depending on the chlorine atom number, and stimulates AhR expression only in the male hypothalamus. In conclusion, the developing male hypothalamus might be more sensitive to disrupting potential of PCBs.

Exposures among pregnant women near the World Trade Center site on 11 September 2001

We have characterized environmental exposures among 187 women who were pregnant, were at or near the World Trade Center (WTC) on or soon after 11 September 2001, and are enrolled in a prospective cohort study of health effects. Exposures were assessed by estimating time spent in five zones around the WTC and by developing an exposure index (EI) based on plume reconstruction modeling. The daily reconstructed dust levels were correlated with levels of particulate matter < or = 2.5 microm in aerodynamic diameter (PM2.5; r = 0.68) or PM10 (r = 0.73-0.93) reported from 26 September through 8 October 2001 at four of six sites near the WTC whose data we examined. Biomarkers were measured in a subset. Most (71%) of these women were located within eight blocks of the WTC at 0900 hr on 11 September, and 12 women were in one of the two WTC towers. Daily EIs were determined to be highest immediately after 11 September and became much lower but remained highly variable over the next 4 weeks. The weekly summary EI was associated strongly with women's perception of air quality from week 2 to week 4 after the collapse (p < 0.0001). The highest levels of polycyclic aromatic hydrocarbon-deoxyribonucleic acid (PAH-DNA) adducts were seen among women whose blood was collected sooner after 11 September, but levels showed no significant associations with EI or other potential WTC exposure sources. Lead and cobalt in urine were weakly correlated with sigmaEI, but not among samples collected closest to 11 September. Plasma OC levels were low. The median polychlorinated biphenyl level (sum of congeners 118, 138, 153, 180) was 84 ng/g lipid and had a nonsignificant positive association with sigmaEI (p > 0.05). 1,2,3,4,6,7,8-Heptachlorodibenzodioxin levels (median, 30 pg/g lipid) were similar to levels reported in WTC-exposed firefighters but were not associated with EI. This report indicates intense bystander exposure after the WTC collapse and provides information about nonoccupational exposures among a vulnerable population of pregnant women.

Polychlorinated biphenyls in serum and time to pregnancy

Polychlorinated biphenyls (PCBs) may affect the female reproductive system in both animals and humans. In Sweden, a main exposure source to PCBs is consumption of fatty fish from the Baltic Sea. From 165 female consumers of such fish (fishermen's sisters), information on time to pregnancy (TTP) and miscarriages was collected, blood was drawn, and serum was analyzed for 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153), a biomarker for total PCB exposure. TTP and miscarriage data, as well as plasma CB-153 concentrations, for 121 fishermen's wives were available from previous studies. Thus, information on 286 women was available for investigation of whether a high exposure to PCB affects fertility negatively by increasing the TTP. The concentrations of CB-153 at the time of conception were estimated and trichotomized into low, medium, and high exposure groups. When we analyzed the joint data set of fishermen's wives and fishermen's sisters, a decrease rather than an increase in TTP was indicated for women in the medium (fecundability ratio 1.27 [95% confidence interval 0.89-1.82]) and high (fecundability ratio 1.42 [0.99-2.03]) exposure groups compared to those in the low exposure group. Similar results were found when we stratified on the original data set (fishermen's wives and fishermen's sisters) or childhood exposure. Women with miscarriages had lower estimated past CB-153 concentrations than women with live births. Our data provide no evidence of a hazardous effect associated with CB-153 concentration in the exposure range assessed. The exposure levels found in the fishermen's families, although high compared to that in the general Swedish population, may not be high enough to negatively affect fertility.

Dioxin-like components in human breast milk collected from Hong Kong and Guangzhou

The H4IIE rat hepatoma cell line was employed as a cell model to screen 7-ethoxyresorufin O-deethylase (EROD)-TCDD equivalents (EROD-TEQ) of human breast milk samples collected from Hong Kong and Guangzhou, China. The screening methods employed a 96-well plate spectrofluorometer-EROD assay. For cell-line validation, our results demonstrated a dose-dependent increase in the Ah receptor-mediated response (i.e., CYP1A1 mRNA and EROD) of the cells upon exposure to a number of known Ah receptor agonists, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), 2,3,7,8-tetrachlorodibenzothiophene, benzo[a]pyrene, and beta-naphthaflavone. TCDD induced CYP1A1 mRNA and EROD was in a close positive correlation (r=0.98). For the screening of dioxin-like compounds, breast milk samples collected during lactation weeks 3-5 were used. One hundred (from Hong Kong) and 48 (from Guangzhou) breast milk samples were assayed, of which 65% and 68% of the samples, respectively, showed detectable dioxin-like activities using the H4IIE cell EROD screening method. For sixty-five samples from Hong Kong the mean EROD-TEQ values ranged from 58.1 to 96.5 pg/g of milk fat for those aged 21-36 years while 32 samples from Guangzhou had mean values of 98.8-202.1 pg/g of milk fat. In comparisons of the EROD-TEQ values for different age groups from both cities, there were no significant differences (P<0.05). However, the mean and median EROD-TEQ values of the Guangzhou population were in general higher than those of the Hong Kong population. The results of the present study indicate that it is feasible to use the H4IIE cell-line as a model for screening dioxin-like compounds in human breast milk. In addition, the method is rapid and cost-effective, particularly for a routine and high-throughput sample screening analysis, compared to the costly and time-intensive chemical analytical techniques.

Level of polychlorinated dibenzo-p-dioxins, dibenzofurans and biphenyls (PCDD/Fs, PCBs) in human milk and the input to infant body burden

This study determined PCDD/F and PCB levels in human milk, examined factors associated with levels of contamination, and assessed the infant body burden from breast-feeding. The congeners of PCDD/Fs, dioxin-like PCBs, and indicator PCBs were analyzed by HRGC/HRMS for 36 human milk samples from healthy women, aged 20-35 years, from December 2000 to November 2001 in central Taiwan. Mean levels of WHO-TEQs in human milk were 10.5 (95% CI=8.8-12.2) and 14.5 (95% CI=12.5-16.5) pg-TEQ/g lipid for those <29 and > or =29 years old, respectively. PCB 138 concentration significantly predicted total WHO-TEQs with r2=0.84 (p <0.001). Milk level of dioxin-TEQ was 9.63 pg-TEQ/g lipid (95% CI=7.0-13.2) in those with a yearly income $29,000 compared to 6.3 pg-TEQ/g lipid (95% CI=5.2-7.6) for those whose yearly income was $18,000 per year. Women who reported being Buddhist (64.3 ng/glipid) had significantly higher indicator PCB concentrations than did those who reported being Taoist (35.3 ng/g lipid). The monthly dioxin intake of exclusively breastfed infants decreased with increasing duration of lactation. The cumulative dose of exclusively breastfed infants (76.5 ng TEQ, 95% CI=69.7-83.3) was significantly greater compared to that of formula-fed infants (CI=16.4-17.0) at one year and to that of infants at birth (3.90 ng TEQ, 95% CI=3.6-4.2). Our findings suggest that breast-feeding should be strongly encouraged for infants in Taiwan.

Altered menstrual cycles in women with a high dietary intake of persistent organochlorine compounds

Dietary exposure to persistent organochlorine compounds (POCs) has been found to affect the menstrual cycle in both animals and humans. In Sweden, the major exposure route for POCs is the consumption of fatty fish from the Baltic Sea. Thus, women who eat relatively large amounts of this fish constitute a suitable study group when investigating a possible association between dietary exposure to POC and menstrual cycle disruption. Questionnaires were sent to the exposed women, as well as to a socioeconomically similar cohort of controls, and information was collected on their menstrual cycles. Since the exposed women tended to smoke more than the controls, all results were adjusted for smoking habits. A cohort comparison found that the exposed women on average had 0.46 (95% confidence interval: 0.03, 0.89) days shorter menstrual cycles than controls. However, within the exposed cohort no effects were found of the proxy variables early life exposure and high consumption of Baltic Sea fatty fish. The results give some support to previous results from studies on women with similar exposure, but are not conclusive with respect to whether there is a causal association between POC exposure and menstrual cycle disruption.