Persistent organic pollutants (POPs) in human milk: a biomonitoring study in rural areas of Flanders (Belgium)

Exploring novel insights into the molecular mechanisms underlying Bisphenol A-induced toxicity: A persistent threat to human health

Bisphenol A (BPA) is a ubiquitous industrial chemical used in the production of polycarbonate plastics and epoxy resins, found in numerous consumer products. Despite its widespread use, its potential adverse health effects have raised significant concerns. This review explores the molecular mechanisms and evidence-based literature underlying BPA-induced toxicities and its implications for human health. BPA is an endocrine-disrupting chemical (EDC) which exhibits carcinogenic properties by influencing various receptors, such as ER, AhR, PPARs, LXRs, and RARs. It induces oxidative stress and contributes to cellular dysfunction, inflammation, and DNA damage, ultimately leading to various toxicities including but not limited to reproductive, cardiotoxicity, neurotoxicity, and endocrine toxicity. Moreover, BPA can modify DNA methylation patterns, histone modifications, and non-coding RNA expression, leading to epigenetic changes and contribute to carcinogenesis. Overall, understanding molecular mechanisms of BPA-induced toxicity is crucial for developing effective strategies and policies to mitigate its adverse effects on human health.

Persistent Organic Pollutants in Austrian Human Breast Milk Collected between 2013 and 2016

Breast milk holds an immense nutritional value as it contains health-promoting substances in a unique, optimal form. Additionally, breast milk's significance extends to health and environmental protection, as it serves as an indicator of both maternal and infant exposure. In this study, breast milk samples collected in 2013 and in 2014-2016 from mothers in Vienna (Austria) were analysed for polybrominated diphenyl ethers (PBDE) and per- and polyfluoroalkyl substances (PFAS), as well as further substances which have been listed under the Stockholm Convention on Persistent Organic Pollutants (POPs) due to their persistent, bioaccumulative and toxic properties. The total concentration of the PBDE congeners in the samples (n = 18, sampled 2013) ranged from 0.055 to 52 ng/g lipid, and from 0.002 to 2.5 ng/g breast milk. In the pooled sample, the sum of PBDEs was detected at a level of 4.4 ng/g lipid. Based on the 2014-2016 study population, certain PFAS were detected in all samples (n = 40). Exposure to the sum of four specific PFAS including perfluorooctanesulphonate (PFOS), perfluorooctanoic acid (PFOA), perfluoro-n-nonanoic acid (PFNA) and perfluoro-1-hexanesulfonate (PFHxS) ranged between 0.014 and 0.12 ng/L breast milk. In the pooled sample, PFOS and PFOA were found in concentrations of 0.025 ng/g and of 0.045 ng/g, respectively. In addition, the first generation of POPs, mainly organochlorine compounds, was measured in a pooled sample of breast milk from participants sampled in 2014-2016 as part of the WHO/UNEP breast milk monitoring program and compared to the POPs measured in pooled samples collected in 1987/1988 and 1992/1993, respectively. Therefore, this paper demonstrates the effectiveness of the Stockholm Convention on POPs by comparing the Austrian results from the WHO/UNEP global breast milk study from 1987 to 2016. However, the data also show that, despite these reductions, health-relevant levels are still being reached, particularly in terms of children's health when the presence of the new generation of POPs, such as PBDEs and PFAS, in human breast milk is taken into account.

Update of the risk assessment of polybrominated diphenyl ethers (PBDEs) in food

The European Commission asked EFSA to update its 2011 risk assessment on polybrominated diphenyl ethers (PBDEs) in food, focusing on 10 congeners: BDE-28, -47, -49, -99, -100, -138, -153, -154, -183 and ‑209. The CONTAM Panel concluded that the neurodevelopmental effects on behaviour and reproductive/developmental effects are the critical effects in rodent studies. For four congeners (BDE-47, -99, -153, -209) the Panel derived Reference Points, i.e. benchmark doses and corresponding lower 95% confidence limits (BMDLs), for endpoint-specific benchmark responses. Since repeated exposure to PBDEs results in accumulation of these chemicals in the body, the Panel estimated the body burden at the BMDL in rodents, and the chronic intake that would lead to the same body burden in humans. For the remaining six congeners no studies were available to identify Reference Points. The Panel concluded that there is scientific basis for inclusion of all 10 congeners in a common assessment group and performed a combined risk assessment. The Panel concluded that the combined margin of exposure (MOET) approach was the most appropriate risk metric and applied a tiered approach to the risk characterisation. Over 84,000 analytical results for the 10 congeners in food were used to estimate the exposure across dietary surveys and age groups of the European population. The most important contributors to the chronic dietary Lower Bound exposure to PBDEs were meat and meat products and fish and seafood. Taking into account the uncertainties affecting the assessment, the Panel concluded that it is likely that current dietary exposure to PBDEs in the European population raises a health concern.

Has Regulatory Action Reduced Human Exposure to Flame Retardants?

Flame retardant (FR) exposure has been linked to several environmental and human health effects. Because of this, the production and use of several FRs are regulated globally. We reviewed the available records of polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDDs) in human breast milk from literature to evaluate the efficacy of regulation to reduce the exposure of FRs to humans. Two-hundred and seven studies were used for analyses to determine the spatial and temporal trends of FR exposure. North America consistently had the highest concentrations of PBDEs, while Asia and Oceania dominated HBCDD exposure. BDE-49 and -99 indicated decreasing temporal trends in most regions. BDE-153, with a longer half-life than the aforementioned isomers, typically exhibited a plateau in breast milk levels. No conclusive trend could be established for HBCDD, and insufficient information was available to determine a temporal trend for BDE-209. Breakpoint analyses indicated a significant decrease in BDE-47 and -99 in Europe around the time that regulation has been implemented, suggesting a positive effect of regulation on FR exposure. However, very few studies have been conducted globally (specifically in North America) after 2013, during the time when the most recent regulations have been implemented. This meta-analysis provides insight into global trends in human exposure to PBDEs and HBCDD, but the remaining uncertainty highlights the need for ongoing evaluation and monitoring, even after a compound group is regulated.

Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) in human breast milk from Colombia: A probabilistic risk assessment approach

Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs) are ubiquitous environmental contaminants. They were produced in relatively large volumes in the last century and are now subject to long-term monitoring and regulated under the United Nations Stockholm Convention (SC) on persistent organic pollutants (POPs). Though restricted, human exposure is still a concern and in some regions of the globe the information on the health risk is limited. Sixty breast milk samples from nursing mothers were collected between 2014 and 2015, residing in Bogota, Cartagena, and Medellin, which are industrialized cities in Colombia. This is the first comprehensive study to determine the concentrations in breast milk of PBDEs (n = 7), PCBs (n = 29), and OCPs (n = 28) in Colombia. The detection frequency of POPs, including BDE-47, CB-138, CB-153, CB-156, and CB-180, as well as several OCPs such as chloroneb, aldrins, HCHs, DDTs, and heptachlor, was found to be 100% in all samples tested. The mean concentrations of the analyzed legacy POPs were ∑3DDTs (423 ng/g lw) > chloroneb (50.1 ng/g lw) > ∑2permetrins (17.5 ng/g lw) > ∑2aldrins (16.7 ng/g lw) > 29 PCBs (15.04 ng/g lw) > ∑2chlordanes (CHLs) (11.2 ng/g lw) ≈ ∑3endosulfans (11.1 ng/g lw) > ∑2heptachlors (2.43 ng/g lw) > 7PBDEs (2.1 ng/g lw) > ∑4HCHs (0.58 ng/g lw). The results of this study suggest that the concentrations of DDTs were present in breast milk samples from Colombia at levels comparable to those found in previous studies conducted in other countries such as Brazil, Uruguay, Chile, and various Asian countries. The concentrations of PBDE and PCB congeners, as well as many pesticides, were found to be significantly correlated with each other. This suggests that these substances may have similar sources of exposure. The strength of the pair correlation among concentrations of POPs was assessed using Spearman's correlation coefficients, which varied from r = 0.62 for the association between BDE-47 and CB-153, to a high correlation of 0.99 for the correlation between γ-Chlordane and heptachlor. This suggests that these POPs may share similar sources, such as diet. An exposure assessment model obtained by Monte Carlo simulation showed that infants were exposed to low concentrations of POPs with exception of p,p'-DDE and Aldrin, in which 25th, 50th and 95th percentiles were greater than the threshold reference values of non-carcinogenic effects suggested by US-EPA regulations while the 90th percentile of pg TEQ/Kg-bw/day for dl-PCBs was above of the tolerable daily intake (TDI) proposed by the World Health Organization (WHO). Therefore, the health risk of infants exposed to OCPs and dl-PCBs should be exanimated continually through biomonitoring programs in the Colombian population.

Impact of exposure to per- and polyfluoroalkyl substances on fecal microbiota composition in mother-infant dyads

There is growing evidence suggesting that chemical exposure alters gut microbiota composition. However, not much is known about the impact of per- and polyfluoroalkyl substances (PFAS) on the gut microbial community. Here, in a mother-infant study, we set out to identify the gut bacterial species that associate with chemical exposure before (maternal) and after (maternal, infant) birth. Paired serum and stool samples were collected from mother-infant dyads (n = 30) in a longitudinal setting. PFAS were quantified in maternal serum to examine their associations with the microbial compositions (determined by shotgun metagenomic sequencing) in mothers and infants. High maternal exposure to PFAS was consistently associated with increased abundance of Methanobrevibacter smithii in maternal stool. Among individual PFAS compounds, PFOS and PFHpS showed the strongest association with M. smithii. However, maternal total PFAS exposure associated only weakly with the infant microbiome. Our findings suggest that PFAS exposure affects the composition of the adult gut microbiome.

Investigation of polychlorinated biphenyls in breast milk from two regions in Bulgaria

Human breast milk is an optimally balanced infant food and a suitable tool for assessing the burden of humans with lipophilic persistent organic pollutants. The aim of this study was to investigate the accumulation profile of polychlorinated biphenyls in breast milk of women living in Bulgaria and to assess the health risk to infants. Breast milk samples were obtained from 72 healthy primiparae and multiparae mothers, living in two regions in northeastern Bulgaria - Varna region and Dobrich region, in the period October 2019-July 2021. Important information for the study, such as age, body mass, smoking and dietary habits, was collected through a questionnaire. Fifteen congeners of PCBs, including six indicator congeners, were determined by capillary gas chromatography system with mass spectrometry detection. The lipid content of the tested samples was in the range from 0.5% to 6.7%, with average value 3.25%. The six indicator PCBs in human milk samples formed up to 89% of the total PCBs levels. The most abundant congener was PCB 153, followed by PCB 138 and PCB 180. Five of the 15 PCB congeners (77, 126, 128, 156, 169) were not detected in any of the milk samples. The arithmetic mean PCB levels in milk samples from Varna (32.7 ng/g lw) were found higher than PCB levels in breast milk of mothers from Dobrich (22.5 ng/g lw). The highest PCB levels were found in milk samples from primiparae mothers in 36-40 age group (for both regions). Infant exposure to PCBs present in human milk was estimated using toxic equivalents (TEQ). The health risk to infants was assessed and was compared to the tolerable daily intake (TDI). Positive correlation was found between the arithmetic mean PCBs levels and two important factors - the age and body mass index of the primiparae group. The mean values of the analyzed PCB congeners in breast milk samples from multiparae were lower than in those from primiparae mothers. The regional differences in PCB concentrations were small, suggesting similar exposures in the studied regions. The levels of PCBs in breast milk were found lower than levels from studies in other European countries. Statistical data does not show any association between PCB levels in milk and dietary habits. The results showed that infants are not at risk of any adverse effects caused by PCBs through breast milk.

Assessment of endocrine disrupting chemicals in breast milk: Association with dietary habits and duration of lactation

The present study was aimed to assess infant safety associated with the presence of persistent organochlorine pesticides (OCPs) in breast milk, a possible route of transfer of endocrine-disrupting chemicals to newborns in North India. Colostrum and breast milk samples (n = 130) were collected at different stages of lactation. Pesticides analysis was performed using gas chromatography mass spectrometry (GC-MS). We observed that of all the samples analysed, OCPs concentration was higher in breast milk than in colostrum, suggesting pesticides contamination increases over lactation period. As far as OCPs are concerned, dieldrin [1196.64 ± 673.75 ng/g lipid weight (lw)], and β-HCH [1107.78 ± 1301.72 ng/g lw], were the predominant OCPs, followed by aldrin [977.09 ± 707.69 ng/g lw], α-HCH [948.04 ± 476.65 ng/g lw] and 1,1'-(2,2-Dichloroethene-1,1-diyl)bis(4-chlorobenzene) (p,p'DDE) [790.11 ± 399.35 ng/g lw]. The association between OCPs levels and women dietary habits were also explored, and all the OCPs were grouped and compared to each other by consumption level of fish, meat, sea foods, eggs, and dairy products. We found that women consuming non vegetarian food, like fish and meat, were exposed 3.5 times more to OCPs than women consuming vegetarian food. In addition, we also observed that factors like mother's age was positively (<0.005 - <0.001) correlated while gestational age and infant birth weight were negatively (<0.005) associated with the levels of OCPs in colostrum and breast milk, respectively. Unfortunately, neither any standards nor guidelines are available for the use of pesticides, therefore, it is suggested that careless use of OCPs should be checked and suitable remedial measures be taken to decrease human contamination. Moreover, further studies are warranted to elucidate relationship between pesticide residues in breast milk and the maternal and child health.

Assessment of risks, implications, and opportunities of waterborne neurotoxic pesticides

Pesticides are a well-known family of chemicals that have contaminated water systems globally. Four common subfamilies of pesticides include organochlorines, organophosphates, pyrethroids, and carbamate insecticides which have been shown to adversely affect the human nervous system. Studies have shown a link between pesticide exposure and decreased viability, proliferation, migration, and differentiation of murine neural stem cells. Besides human exposure directly through water systems, additional factors such as pesticide bioaccumulation, biomagnification and potential synergism due to co-exposure to other environmental contaminants must be considered. A possible avenue to investigate the molecular mechanisms and biomolecules impacted by the various classes of pesticides includes the field of -omics. Discovery of the precise molecular mechanisms behind pesticide-mediated neurodegenerative disorders may facilitate development of targeted therapeutics. Likewise, discovery of pesticide biodegradation pathways may enable novel approaches for water system bioremediation using genetically engineered microorganisms. In this mini-review, we discuss recently established harmful impacts of various categories of pesticides on the nervous system and the application of -omics field for discovery, validation, and mitigation of pesticide neurotoxicity.

Per- and polyfluoroalkyl substances (PFAS) in breast milk and infant formula: A global issue

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are transferred from mother to infants through breastfeeding, a time when children may be particularly vulnerable to PFAS-mediated adverse health effects. Infants can also be exposed to PFAS from infant formula consumption. Our recent literature-based scoping of breast milk levels reported that four PFAS often exceeded the United States Agency for Toxic Substances and Disease Registry (ATSDR) children's drinking water screening levels in both the general population and highly impacted communities in the U.S. and Canada. This work presents a comparison of global breast milk and infant formula PFAS measurements with the only reported health-based drinking water screening values specific to children.

METHODS

We focused on four PFAS for which ATSDR has developed children's drinking water screening values: PFOA (perfluorooctanoic acid), PFOS (perfluorooctanesulfonic acid), PFHxS (perfluorohexanesulfonic acid), and PFNA (perfluorononanoic acid). Published literature on PFAS levels in breast milk and infant formula were identified via PubMed searches. Data were compared to children's drinking water screening values.

DISCUSSION

Breast milk concentrations of PFOA and PFOS often exceed children's drinking water screening values, regardless of geographic location. The limited information on infant formula suggests its use does not necessarily result in lower PFAS exposures, especially for formulas reconstituted with drinking water containing PFAS. Unfortunately, individuals generally cannot know whether their infant's exposures exceed children's drinking water screening values. Thus, it is essential that pregnant and lactating women and others, especially those having lived in PFAS-contaminated communities, have data required to make informed decisions on infant nutrition. An international monitoring effort and access to affordable testing are needed for breast milk, drinking water and infant formula to fully understand infant PFAS exposures. Currently, our understanding of demonstrable methods for reducing exposures to emerging PFAS is limited, making this research and the communications surrounding it even more important.

Persistent Organic Pollutants in Human Milk: Exposure Levels and Determinants among Lactating Mothers in Lebanon

ABSTRACT

Exposure of newborns to persistent organic pollutants (POPs) is a public health concern. The objective of this study was to assess the prevalence of POPs in human milk collected from lactating mothers in Lebanon and to investigate the sociodemographic, nutritional, and other lifestyle determinants. Fifty-four breast milk samples were collected as per World Health Organization guidelines. A survey was used to assess the anthropometric and demographic characteristics of participants. Dietary habits were evaluated based on a semiquantitative food frequency questionnaire. Organochlorine pesticides and polychlorinated biphenyls were measured in milk samples with liquid-liquid extraction and gas chromatography. Among the screened POPs, dichlorodiphenyldichloroethylene (DDE) was the only POP detected in breast milk samples and was found in only 17.9% of the samples, with a mean (SD) of 11.6 (5.0) μg/L and a range of 5.7 to 21.4 μg/L. Prepregnancy body mass index and age were positively associated with DDE contamination in breast milk. Women who consumed cereals at least two times per week had detectable DDE contamination in their breast milk. Consumption of potatoes and beans at least once per week was also associated with DDE contamination. Our study is the first to assess the presence of POPs in breast milk in Lebanon. The benefits of breastfeeding compensate for the low prevalence of DDE in the breast milk. Our findings highlight the high need to implement monitoring policies, good agricultural practices, and education programs for breastfeeding mothers.

HIGHLIGHTS

Global footprints of organochlorine pesticides: a pan-global survey

Organochlorine pesticides (OCPs) are ubiquitous environmental contaminants widely used all over the world. These chlorinated hydrocarbons are toxic and often cause detrimental health effects because of their long shelf life and bioaccumulation in the adipose tissues of primates. OCP exposure to humans occurs through skin, inhalation and contaminated foods including milk and dairy products, whereas developing fetus and neonates are exposed through placental transfer and lactation, respectively. In 1960s, OCPs were banned in most developed countries, but because they are cheap and easily available, they are still widely used in most third world countries. The overuse or misuse of OCPs has been rising continuously which pose threats to environmental and human health. This review reports the comparative occurrence of OCPs in human and bovine milk samples around the globe and portrays the negative impacts encountered through the long history of OCP use.

Effects of Organochlorine Pesticide Residues in Maternal Body on Infants

There are many organochlorine pollutants in the environment, which can be directly or indirectly exposed to by mothers, and as estrogen endocrine disruptors can cause damage to the lactation capacity of the mammary gland. In addition, because breast milk contains a lot of nutrients, it is the most important food source for new-born babies. If mothers are exposed to organochlorine pesticides (OCPs), the lipophilic organochlorine contaminants can accumulate in breast milk fat and be passed to the infant through breast milk. Therefore, it is necessary to investigate organochlorine contaminants in human milk to estimate the health risks of these contaminants to breastfed infants. In addition, toxic substances in the mother can also be passed to the fetus through the placenta, which is also something we need to pay attention to. This article introduces several types of OCPs, such as dichlorodiphenyltrichloroethane (DDT), methoxychlor (MXC), hexachlorocyclohexane (HCH), endosulfan, chlordane, heptachlorand and hexachlorobenzene (HCB), mainly expounds their effects on women's lactation ability and infant health, and provides reference for maternal and infant health. In addition, some measures and methods for the control of organochlorine pollutants are also described here.

Concentrations of perfluoroalkyl substances in donor breast milk in Southern Spain and their potential determinants

BACKGROUND

Breast milk is considered to offer the best nutrition to infants; however, it may be a source of exposure to environmental chemicals such as perfluoroalkyl compounds (PFAS) for breastfeeding infants. PFAS are a complex group of synthetic chemicals whose high stability has led to their ubiquitous contamination of the environment.

OBJECTIVE

To assess the concentrations and profiles of PFAS in breast milk from donors to a human milk bank and explore factors potentially related to this exposure.

METHODS

Pooled milk samples were collected from 82 donors to the Human Milk Bank of the Virgen de las Nieves University Hospital (Granada, Spain). Ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) was applied to determine milk concentrations of 11 PFAS, including long-chain and short-chain compounds. A questionnaire was used to collect information on donors' socio-demographic characteristics, lifestyle, diet, and use of personal care products (PCPs). Factors related to individual and total PFAS concentrations were evaluated by multivariate regression analysis.

RESULTS

PFAS were detected in 24-100% of breast milk samples. PFHpA was detected in 100% of samples, followed by PFOA (84%), PFNA (71%), PFHxA (66%), and PFTrDA (62%). Perfluorooctane sulfonate (PFOS) was detected in only 34% of donors. The median concentrations ranged from <0.66 ng/dL (perfluorohexane sulfonic acid [PFHxS]) to 19.39 ng/L (PFHpA). The median of the sum of PFAS concentrations was 87.67 ng/L and was higher for short-chain than long-chain PFAS. Factors most frequently associated with increased PFAS concentrations included intake of creatin animal food items and use of PCPs such as skin care and makeup products.

CONCLUSIONS

Several PFAS, including short-chain compounds, are detected in pooled donor milk samples. Breast milk may be an important pathway for the PFAS exposure of breastfed infants, including preterm infants in NICUs. Despite the reduced sample size, these data suggest that various lifestyle factors influence PFAS concentrations, highlighting the use of PCPs.

Update of the risk assessment of hexabromocyclododecanes (HBCDDs) in food

The European Commission asked EFSA to update its 2011 risk assessment on hexabromocyclododecanes (HBCDDs) in food. HBCDDs, predominantly mixtures of the stereoisomers α-, β- and γ-HBCDD, were widely used additive flame retardants. Concern has been raised because of the occurrence of HBCDDs in the environment, food and in humans. Main targets for toxicity are neurodevelopment, the liver, thyroid hormone homeostasis and the reproductive and immune systems. The CONTAM Panel concluded that the neurodevelopmental effects on behaviour in mice can be considered the critical effects. Based on effects on spontaneous behaviour in mice, the Panel identified a lowest observed adverse effect level (LOAEL) of 0.9 mg/kg body weight (bw) as the Reference Point, corresponding to a body burden of 0.75 mg/kg bw. The chronic intake that would lead to the same body burden in humans was calculated to be 2.35 μg/kg bw per day. The derivation of a health-based guidance value (HBGV) was not considered appropriate. Instead, the margin of exposure (MOE) approach was applied to assess possible health concerns. Over 6,000 analytical results for HBCDDs in food were used to estimate the exposure across dietary surveys and age groups of the European population. The most important contributors to the chronic dietary LB exposure to HBCDDs were fish meat, eggs, livestock meat and poultry. The CONTAM Panel concluded that the resulting MOE values support the conclusion that current dietary exposure to HBCDDs across European countries does not raise a health concern. An exception is breastfed infants with high milk consumption, for which the lowest MOE values may raise a health concern.

Levels and profiles of persistent organic pollutants in breast milk in China and their potential health risks to breastfed infants: A review

Although some persistent organic pollutants (POPs) were prohibited or limited in use several decades ago, they are still frequently detected in the human body. The purpose of this study was to understand the levels and profiles of POPs in breast milk in China and assess their potential health risks among breastfed infants under six months of age. A literature review focused on China was performed for studies published from 2001 to 2020. The POP levels in breast milk along with other important variables were extracted, and then the average individual POP levels in breast milk were estimated. This review summarises the distribution of traditional and new POPs, including polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), legacy brominated flame retardants (BFRs), perfluorinated compounds (PFCs), and chlorinated paraffins (CPs) and reported notably high levels of short-chain chlorinated paraffins and 1,1-dichloro-2,2-bis (p-chlorophenyl) ethylene (p,p'-DDE) in breast milk. Although the levels of traditional POPs generally declined over time, especially p,p'-DDE and beta-hexachlorocyclohexane (β-HCH), women living in coastal areas, urban areas, and southern China still have a high body burden of certain POPs. In the present study, the estimated daily intake (EDI) of POPs through breastfeeding was used to evaluate the health risk for infants by comparing with acceptable levels. The findings suggested that infants born in coastal areas most likely suffered potential health risk from exposure to DDT, and the health risk of hexachlorobenzene (HCB) in infants in most nationwide regions remains a concern. More importantly, the EDI of PCBs for infants exceeds the safe limit on a national scale. Continuous surveillance of PCBs in breast milk is critical to evaluate the potential health effects on humans.

Endocrine-Disrupting Organochlorine Pesticides in Human Breast Milk: Changes during Lactation

The aim of the present study was to assess infant safety associated with the occurrence of endocrine-disrupting organochlorine pesticides (OCP) in breast milk. Moreover, the association between pregnant mothers' dietary habits and these compounds levels in breast milk was investigated. Breast milk was collected at various stages of lactation. The samples were analyzed by the GC-MS method. The OCP concentrations ranged from < limit of detection (LOD) to 6.81 ng/g lipids. The highest OCP concentrations in breast milk occurred primarily within the first month of lactation, and decreased over the lactation period. It was found that the maternal consumption of certain food products-in particular pork, beef, poultry, eggs, and dairy products-could have affected the content of 1,1'-(2,2,2-Trichloroethane-1,1-diyl)bis(4-chlorobenzene), called DDT and its metabolites in the breast milk. The levels of beta-endosulfan were positively correlated with fish and poultry consumption. The redundancy analysis indicated that the diets of the pregnant women had an important impact on pesticide residues in the breast milk. There is a potential possibility of lowering the content of organochlorine compounds in breast milk by adhering to nutritional recommendations, e.g., avoiding the excessive consumption of fish and other raw food materials of unknown origin.

Exposure characteristics for congeners, isomers, and enantiomers of perfluoroalkyl substances in mothers and infants

Per- and polyfluoroalkyl substances (PFASs) are ubiquitous in the environment, making it inevitable for humans to be exposed to these pollutants. The exposure begins while in utero and continues in infancy, during the potentially most sensitive early stages of life. This review summarizes the current knowledge on pre- and neo-natal exposures based on more than 200 articles published from 2000 to date. All relevant biological matrices used in the cited studies were included, such as maternal blood, umbilical cord blood, breast milk, placenta, amniotic fluid, fetal organs, newborns' dried blood spots, and infant serum. We show that such exposures are geographically global with significant discrepancies among countries and continents, and that while the levels of major legacy PFASs (PFOS and PFOA) have declined since 2000, those of others may have not. We also show that levels of PFOS and PFOA exceed those of some major environmental toxins, such as p,p'-DDE, BDE-47, PCB-153, PBB-153, and OH-PBDEs in maternal blood. Given that the behavior and potential effects have an origin in molecular structure, biomonitoring and research at the levels of isomers and enantiomers are critically important. Through critical analysis of these works, we summarize the major achievements, consensus, and the deficiencies of existing research. To our knowledge, this is the first review on the overall internal exposure status of mothers and infants to PFASs during pregnancy and lactation.

Prenatal exposure to perfluoroalkyl substances modulates neonatal serum phospholipids, increasing risk of type 1 diabetes

In the last decade, increasing incidence of type 1 diabetes (T1D) stabilized in Finland, a phenomenon that coincides with tighter regulation of perfluoroalkyl substances (PFAS). Here, we quantified PFAS to examine their effects, during pregnancy, on lipid and immune-related markers of T1D risk in children. In a mother-infant cohort (264 dyads), high PFAS exposure during pregnancy associated with decreased cord serum phospholipids and progression to T1D-associated islet autoantibodies in the offspring. This PFAS-lipid association appears exacerbated by increased human leukocyte antigen-conferred risk of T1D in infants. Exposure to a single PFAS compound or a mixture of organic pollutants in non-obese diabetic mice resulted in a lipid profile characterized by a similar decrease in phospholipids, a marked increase of lithocholic acid, and accelerated insulitis. Our findings suggest that PFAS exposure during pregnancy contributes to risk and pathogenesis of T1D in offspring.

Biomonitoring of PFOA, PFOS and PFNA in human milk from Czech Republic, time trends and estimation of infant's daily intake

BACKGROUND

Perfluoralkylated substances (PFASs) are persistent and bioaccumulative environmental contaminants. They are included on the list of emergent compounds monitored in the frame of HBM4EU project.

OBJECTIVES

To analyze PFASs levels in human milk samples collected in the period 2006 through 2017, to follow their time trends, to assess the PFASs exposure in breastfed infants, to calculate the daily intake of PFASs and to compare it with the tolerable daily/weekly) intakes and to quantify risk from exposure using the hazard quotient and hazard index approach.

MATERIAL AND METHODS

A broad spectrum of PFASs were analyzed by means of UHPLC-MS/MS in primipara human milk samples collected in four consecutive time periods 2006, 2010/11, 2014, and 2017; N = 46, 183, 164 and 232, respectively. Mothers living in urban and suburban residences were recruited after their delivery at maternity hospitals, and milk samples were taken within 2 and 8 weeks after delivery. The questionnaire was focused on possible sources of exposure, dietary habits and lifestyle.

RESULTS

Only perfluorooctane sulfonate (PFOS) and perfluorooctanoid acid PFOA (in 2017, also perfluorononanoic acid (PFNA)) were quantified in more than 90% of analyzed human milk samples. In all sampling periods, the levels of PFOA were higher than those of PFOS (p < 0.05). A significant downward temporal trend (p < 0.001) was observed for both PFOA and PFOS levels. The median concentrations in sampling years 2006, 2010/11, 2014, and 2017 were 0.075, 0.059, 0.035, and 0.023 ng/mL for PFOA and 0.045, 0.031, 0.029, and 0.020 ng/mL for PFOS, respectively. In 2017, PFNA was also quantified in 99% of samples with the median concentration of 0.007 ng/mL. The levels of PFASs correlated with maternal sea fish consumption. No maternal age-related relationship was observed. Using the tolerably daily intake (TDI) values for PFOS and PFOA set by the European Food Safety Authority (EFSA) in 2008, the calculated daily intakes from breastfeeding were clearly below these limits. Using the new, more conservative EFSA Provisional Tolerably Weekly Intake (PTWI) values set in 2018, we demonstrated a considerable exceedance of PTWI, with a hazard index above 1.

CONCLUSION

Significant time-related decreasing trends in the PFOS and PFOA levels in human milk were observed. Nevertheless, the body burden of infants from breastfeeding might pose an enhanced health risk to infants when the current PTWI values are applied. These findings strongly support the present EU efforts to phase out PFOA, its salts and PFOA related compounds. Since PFOS exposure there has still been widely detected despite PFOS usage reduction measures, the major exposure routes should be further monitored and, if possible, eliminated.

Potential Mechanisms of Bisphenol A (BPA) Contributing to Human Disease

Bisphenol A (BPA) is an organic synthetic compound serving as a monomer to produce polycarbonate plastic, widely used in the packaging for food and drinks, medical devices, thermal paper, and dental materials. BPA can contaminate food, beverage, air, and soil. It accumulates in several human tissues and organs and is potentially harmful to human health through different molecular mechanisms. Due to its hormone-like properties, BPA may bind to estrogen receptors, thereby affecting both body weight and tumorigenesis. BPA may also affect metabolism and cancer progression, by interacting with GPR30, and may impair male reproductive function, by binding to androgen receptors. Several transcription factors, including PPARγ, C/EBP, Nrf2, HOX, and HAND2, are involved in BPA action on fat and liver homeostasis, the cardiovascular system, and cancer. Finally, epigenetic changes, such as DNA methylation, histones modification, and changes in microRNAs expression contribute to BPA pathological effects. This review aims to provide an extensive and comprehensive analysis of the most recent evidence about the potential mechanisms by which BPA affects human health.

Human milk contamination by nine organochlorine pesticide residues (OCPs)

Organochlorine pesticides (OCPs) are widely used around the world as insecticides, herbicides, fungicides, nematicides, and rodenticides. Despite banned in Brazil, the usage remains occurring in many countries. The persistence and extreme mobility of OCPs contribute to the contamination of the environment and the human body. The OCPs bioaccumulation in adipose tissue triggers the excretion into human milk during breastfeeding. Hence, the present study determined eighteen OCPs residues in the breast milk of mothers from the Western Region of Bahia State, Brazil. Nine different residue species were found, including beta-Hexachlorocyclohexane (9.24 ± 0.00 ng g^-1 fat), delta- Hexachlorocyclohexane (22.15 ± 10.48 ng g^-1 fat), Heptachlor (58.08 ± 74.13 ng g^-1 fat), Aldrin (142.65 ± 50.65 ng g^-1 fat), Dieldrin (774.62 ± 472.68 ng g^-1 fat), Endosulfan I (408.44 ± 245.51 ng g^-1 fat), Dichloro-diphenyl-dichloro-ethylene (29.17 ± 22.42 ng g^-1 fat), Dichloro-diphenyl-trichloro-ethane (28.87 ± 0.00 ng g^-1 fat) and Methoxychlor (1699.67 ± 797.43 ng g^-1 fat). The Methoxychlor presence in all samples may reveal a recent exposure, while Dieldrin and Endosulfan I analyses can point to distant past exposure.

Concentrations of perfluoroalkyl substances in human milk from Ireland: Implications for adult and nursing infant exposure

Concentrations of 10 perfluoroalkyl substances (PFASs) were measured in 16 pools of human milk from Ireland. Only four PFASs were detected (PFOA, PFNA, PFHxS and PFOS), with concentrations dominated by PFOA which was detected in all samples at a median of 0.10 ng/mL. Concentrations and the relative abundance of PFASs in human milk from Ireland are within the range reported for other countries. Estimated exposures for nursing infants to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) do not suggest a health concern. A one compartment pharmacokinetic model was used to predict the intakes of PFOS and PFOA required to support the observed concentrations in human milk. This suggests current adult exposure in Ireland to PFOS is below the provisional tolerable weekly intake (TWI) proposed by EFSA. In contrast, the model predicts that the maximum concentration detected in human milk in this study, implies a level of adult exposure that would exceed EFSA's provisional TWI for PFOA. As exposure of the Irish population to PFASs via drinking water, indoor air and dust is well-characterised, current understanding suggests that the major contributor to overall exposure of the Irish population is via the diet and/or less well-studied pathways like dermal uptake from PFAS-containing fabrics and cosmetics.

On the Behavior of Perfluorinated Persistent Organic Pollutants (POPs) at Environmentally Relevant Aqueous Interfaces: An Interplay of Hydrophobicity and Hydrogen Bonding

The behavior of perfluorinated persistent organic pollutants (POPs), especially perfluoroalkyl carboxylic and sulfonic acids, at aqueous interfaces is crucial for their transport and speciation in the environment and subsequent immunotoxicity. Here, we investigate the surface prevalence and interfacial interaction of a prototype perfluorinated-POP, perfluoroheptanoic acid (PFHA), with environmentally relevant amphiphiles of varying hydrophobicity and head groups (C_nH_2n+1-X; n: 8 vs 16; -X: -OH vs -COOH) using interface-selective vibrational sum frequency generation (VSFG) spectroscopy. SFG intensity spectra in the CH- and OH-stretch regions reveal that PFHA prevails at aqueous interfaces that contain amphiphiles of intermediate chain length such as 1-octanol (n = 8) and heptanoic acid (n = 6). PFHA partially expels as well as increases the alkyl chain order of octanol on the water surface. Whereas heptanoic acid, though less hydrophobic than octanol, is retained at the water surface through hydrogen-bonding with the PFHA head group (^(PFHA)COO^-···HOOC^{(heptanoic-acid)}). Long chain amphiphiles (n = 16) such as hexadecanol and palmitic acid expel PFHA from the water surface regardless of the difference in their head groups. Interestingly, the dangling OH (3710 cm^-1) which is diminished at the hydrogenated-amphiphile-water interface is preserved at the perfluorinated-POP-water interface.

Rat liver epigenome programing by perinatal exposure to 2,2',4'4'-tetrabromodiphenyl ether

Perinatal exposures to polybrominated diphenyl ethers permanently reprogram liver metabolism and induce a nonalcoholic fatty liver disease-like phenotype and insulin resistance in rodents. Aim: To test if these changes are associated with altered liver epigenome. Materials & methods: Expression of small RNA and changes in DNA methylation in livers of adult rats were analyzed following perinatal exposure to 2,2',4,4'-tetrabromodiphenyl ether, the polybrominated diphenyl ether congener most prevalent in human tissues. Results: We identified 33 differentially methylated DNA regions and 15 differentially expressed miRNAs. These changes were enriched for terms related to lipid and carbohydrate metabolism, insulin signaling, Type-2 diabetes and nonalcoholic fatty liver disease. Conclusion: Changes in the liver epigenome are a likely candidate mechanism of long-term maintenance of an aberrant metabolic phenotype.

Polybrominated diphenyl ethers in mothers' breast milk and associated health risk to nursing infants in Uganda

The aim of this study was to investigate levels of polybrominated diphenyl ethers (PBDEs) in breast milk samples from healthy primiparous mothers who had lived in Kampala capital city (urban area) and Nakaseke district (a rural area) for the last five years. Fifty samples were collected between March and June 2018 and were extracted by dispersive solid-phase extraction (SPE). Clean-up was performed on an SPE column and analysis was done using gas chromatography-mass spectrometry. Total (∑) PBDEs (BDE 28, 47, 49, 66, 77, 99, 100,138,153, 154, 183 and 209) ranged from 0.59 to 8.11 ng/g lipid weight (lw). The levels of PBDEs in samples from Kampala capital city were significantly higher than those from Nakaseke (p < 0.01, Mann-Whitney U test). The most dominant congeners were BDE-209 and -47 (contributed 37.1% and 20.2%, respectively to ∑PBDEs), suggesting recent exposure of mothers to deca-and penta-BDE formulations. Fish and egg consumption, plastics/e-waste recycling and paint fumes were associated with higher levels of BDE-47, -153 and -99, respectively, implying that diet and occupation were possible sources of the pollutants. Estimated dietary intakes (ng kg^-1 body weight day^-1) for BDE-47, -99 and -153 were below the US EPA reference doses for neurodevelopmental toxicity, suggesting minimal health risks to nursing infants who feed on the milk. Generally, the risk quotients for BDE-47, -99 and -153 were <1 in majority (96%) samples, indicating that the breast milk of mothers in Uganda was fit for human consumption.

Polybrominated diphenyl ethers and novel brominated flame retardants in human milk from the general population in Beijing, China: Occurrence, temporal trends, nursing infants' exposure and risk assessment

The levels of eight polybrominated diphenyl ether (PBDE) congeners, and six novel brominated flame retardants (NBFRs) were determined in human milk collected from Beijing, China in 2014. The tested 111 samples were collected from 37 mothers, and each donor provided one milk sample per month for 3 months after childbirth. Levels of ∑PBDEs (total tri- to deca-BDEs) were in the range of 0.288 to 22.2 ng g^-1 lw (lipid weight). BDE-209, with a median level of 2.2 ng g^-1 lw, was the predominant congener. Decabromodiphenyl ethane (DBDPE), as an NBFR and a substitute for deca-BDE, was found to be the most abundant BFR in all tested human milk (median:5.96 ng g^-1 lw). This result might suggest that the predominantly consumed BFRs in China have changed from PBDEs to PBDE substitutes. Additionally, a comparison to our previous studies conducted in 2005 and 2011 revealed that levels of tri- to hepta-BDEs showed significant reduction from 2005 to 2014, whereas levels of BDE-209 showed no significant variation from 2011 to 2014. Temporal trends of BFR levels over the three months of lactation were also investigated, and no significant changes were found in concentration with time over the three months lactation. For nursing infants up to 6 months old, the median lower bound of daily BFR intakes via human milk ingestion ranged from zero for 2,3-dibromopropyl-2,4,6-tribromophenyl ether (DPTE) and 1,2-bis(2,4,6-tribromophenoxy)-ethane (BTBPE) to 18.7 ng kg^-1 bodyweight day^-1 for DBDPE. Although the daily dietary BFR intake for nursing infants was found to be much higher than that for adults, the risk assessment evaluated by the margin of exposure (MOE) approach revealed that dietary BFR intake for nursing infants was unlikely to pose significant health risks.

Determinants of persistent organic pollutant (POP) concentrations in human breast milk of a cross-sectional sample of primiparous mothers in Belgium

BACKGROUND

Bio-accumulation of persistent organic pollutants (POPs) in the environment and in the food chain can lead to high pollutant concentrations in human fat-containing tissues and breast milk.

OBJECTIVES

We aimed to identify the maternal characteristics that determined POP concentrations in breast milk of primiparous mothers in Belgium.

METHODS

Breast milk samples were obtained from a cross-sectional sample of 206 primiparous mothers in 2014. POP concentrations in breast milk samples were determined by GC-ECNI-MS and GC-EI-MS/MS depending on the analytes' sensitivity. Associations between POP concentrations in breast milk and potential determinants were investigated using two-way contingency tables and multivariable generalized linear models.

RESULTS

Fifteen of the 23 screened POPs were detected in the breast milk samples. Four organochlorine compounds (p,p'-DDT, p,p'-DDE, HCB and β-HCH) and two brominated flame retardant congeners (BDE-47, BDE-153) were detected at concentrations above the limit of quantification in >50% of the breast milk samples. Maternal age and BMI were usually associated with higher POP concentrations. Rural residency and consumption of home-produced eggs, fatty fish and fish oil supplements were associated with higher concentrations of DDT and DDE. Consumption of fatty fish and being breastfed during childhood were associated with higher concentrations of HCB and β-HCH. Fish oil supplements and home-produced eggs were associated with higher concentrations of BDEs, but for BDE congeners exposure routes other than diet require further investigation.

CONCLUSIONS

Dietary and non-dietary determinants predict individual POP concentrations in breast milk.

The human body burden of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in residents' human milk from Guangdong Province, China

Human milk samples were collected from 179 mothers in 2017 and 2018 in six counties of Guangdong province, China. Concentrations of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) were determined to evaluate the human body burden of dioxin-like compounds on the general population of South China. Samples were analyzed using high-resolution gas chromatography/high-resolution mass spectrometry in six pools, according to the subjects' resident county. The mean ∑PCDD/Fs and ∑DL-PCBs concentrations in human milk samples were 323.10 pg g-1 lipid and 2166.58 pg g-1 lipid, respectively, and the corresponding WHO toxicity equivalent (TEQ) values calculated with Toxic Equivalent Factors (TEFs) established by the WHO in 2005 (TEFWHO 2005) were 6.96 and 2.13 pg g-1 lipid. The concentrations of samples collected in Guangzhou, the capital city of Guangdong Province, were higher than those taken in the other five investigation regions. The levels of PCDD/Fs and DL-PCBs in human milk and the estimated daily intake doses of breast-fed infants were still high when compared with some non-exposure areas in mainland China. TEQ levels of PCDD/Fs and DL-PCBs in the present study have been compared to data obtained from a reported national study conducted in 2011. The mean TEQ (calculated with TEFWHO 2005) of ∑(DL-PCBs + PCDD/Fs) (8.4-9.0 pg g-1 lipid in 2011 vs. 9.09 pg g-1 lipid in 2018) seemed to be relatively stable during the period 2011-2018. These findings and continuing the surveillance of PCDD/Fs and DL-PCBs in human milk will be helpful in furthering our understanding of human exposure to dioxin-like compounds in the general population.

Levels of polychlorinated biphenyls in human milk samples in European countries

Polychlorinated biphenyls (PCBs) are persistent pollutants, harmful to human health, which enter the human body mainly through food and bind to body fat. For these reasons their use in most countries is prohibited. Human milk has an advantage over other types of human samples in measuring human exposure to PCBs, as it is obtained with non-invasive sampling methods. In Europe, including Croatia, PCB levels have been monitored for many years. This review summarises PCB trends in human milk across Europe. The trend is generally downward, with higher levels prevailing in urban areas near industrial plants. The highest PCB levels were reported in the Czech Republic and Slovakia.

Persistent Organic Pollutants Residues in Human Breast Milk from Bathinda and Ludhiana Districts of Punjab, India

In the present study, persistent organic pollutants (POPs), including six congeners of polychlorinated biphenyls (PCBs) and organochlorine pesticides, were estimated in human breast milk samples collected from two districts of Punjab (India). The mean concentrations of POP residues were recorded higher in Bathinda district (PCBs: 33.7; DDTs: 519.2; HCHs: 46.6 ng g^-1 lipid wt.) than Ludhiana (PCBs: 24.2; DDTs; 415.3; HCHs; 35.5 ng g^-1 lipid wt.). Levels of PCBs and DDTs were observed higher in primiparas, whereas HCHs residues were seen more in multiparas. Risk analysis to POPs exposure through breast milk reflected that the daily intake for some infants was close to or above the tolerable daily intake limit for detrimental effects, which may raise a health concern. Comparative evaluation of present data indicated that DDT and HCHs residue levels in human breast milk from Punjab, India were among the lowest values reported for developing countries. The first-order kinetic reaction at a steady-state condition used to estimate the half-life of DDT and HCH suggested that DDT levels have declined from 18,211 to 490 ng g^-1 lipid wt. with a half-life (Tdec_1/2) of 3.25 years over a span of 15 years. Similarly, HCH levels have decreased from 8609 to 46.6 ng g^-1 in this duration with Tdec_1/2 of 2.25 years. Because some infants are still at risk, continuous monitoring of POPs in human milk is needed for surveillance and interpretation of time trends and for linkage to strict enforcement of agricultural regulations.

A short review on human exposure to and tissue distribution of per- and polyfluoroalkyl substances (PFASs)

PFASs are widely distributed in natural and living environment and can enter human bodies via different routes. Many studies have reported that PFASs may be associated with human diseases, such as urine acid and thyroid diseases. In this study, we reviewed PFAS levels in human bodies reported in past seven years, including blood, urine, milk, and tissues (hair and nails). Most studies focused on human blood. Blood type, spatiality, human age, and gender were found to have a strong relationship with PFAS levels in blood samples. The PFAS distribution in urine samples was reported to be associated with the chain length of PFASs and human gender. Urinary excretion was found to be an important pathway of PFAS elimination. PFAS levels in human milk might be affected by various factors, such as mothers' age, dietary habit, parity of mothers and the interval of interpregnancy. Data in hair and nails remain very limited, but these matrices offer a non-invasive approach to evaluate human exposure to PFASs.

Inter-individual, inter-city, and temporal trends of per- and polyfluoroalkyl substances in human milk from Swedish mothers between 1972 and 2016

Inter-individual, inter-city, and temporal trends of 19 per- and polyfluoroalkyl substances (PFASs) were investigated in human milk collected in Stockholm (1972-2016) and Gothenburg (2007-2015), Sweden. The concentrations of perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA), perfluoroundecanoate (PFUnDA), and perfluorotridecanoate (PFTrDA) in human milk from Stockholm increased significantly over the entire monitoring periods, whereas branched (Br) and linear (L) isomers of perfluorooctane sulfonamide (FOSA) decreased. In human milk from Gothenburg, significant downward trends were detected for perfluorododecanoate (PFDoDA), PFHxS and Br-perfluorooctane sulfonate (Br-PFOS) over the last decade. This declining trend was also observed for perfluorohexanoate (PFHxA), PFHxS, perfluorooctanoate (PFOA) and Br-PFOS in Stockholm over the same time period. No significant differences were observed in concentrations or relative PFAS profiles between Stockholm and Gothenburg. However, a comparison of the PFAS profile in Stockholm milk revealed distinct profiles for the time periods 1972-1996, 2000-2012, and 2013-2016, reflecting a shift in exposure over time. The lower bound estimated daily intake (EDI) for ∑PFAS concentrations in infants ranged from 7.1-40 ng per kg body weight per day (ng/kg bw/d) in Stockholm and from 5.2-25 ng/kg bw/d in Gothenburg over the studied time period, consistent with other European countries. Overall these data indicate that exposure to some legacy PFASs via breastmilk is declining, presumably as a result of regulation and phase-out initiatives. However, increasing concentrations for other PFASs and a shift in the overall PFAS profile in recent years may pose an ongoing health risk to infants.

Hexabromocyclododecanes in breast milk from residents in Shenzhen, China: Implications for infant exposure

Hexabromocyclododecanes (HBCDs) are widely used as flame retardants for various products and have become ubiquitous pollutants in environmental media. However, little is known about HBCD exposure for humans, especially in China. This study aimed to investigate the levels and profiles of hexabromocyclododecanes (HBCDs) in human breast milk and to estimate the daily HBCD intake for infants in Shenzhen, China. Levels of the HBCD diastereoisomers α-, β-, and γ-HBCD in 180 breast milk samples collected from primiparas in Shenzhen were measured. The concentrations of α-, β-, and γ-HBCD (ΣHBCDs) ranged within 0.103-15.1ng/g lipid and had a median of 1.82ng/g lipid. ΣHBCDs levels in milk in the present study are comparable to those in milk from other countries and regions but are markedly higher than those for most populations in other regions of China. Among the diastereoisomers, α-HBCD was predominant, accounting for 97.6% of the concentration of ΣHBCDs. The estimated daily intake of ΣHBCDs via breast milk for infants in Shenzhen ranged from 0.481 to 100ng/kgbw/day with a median of 8.40ng/kgbw/day, however, which was unlikely to raises a health concern based on the margin of exposure (MOE) approach. The duration of residence was found to have a significant positive correlation with the HBCD levels in the human breast milk (p<0.05). To our knowledge, this is the first report on HBCD levels in breast milk from Shenzhen residents.

Legacy and emerging brominated flame retardants in China: A review on food and human milk contamination, human dietary exposure and risk assessment

Brominated flame retardants (BFRs) are a large group of widely used chemicals, which have been produced and used since 1970s. As a consequence of substantial and long-term usage, BFRs have been found to be ubiquitous in humans, wildlife, and abiotic matrices around the world. Although several reports have reviewed BFRs contamination in general, none have focused specifically on foods and human milk, and the corresponding dietary exposure. Foods (including human milk) have long been recognized as a major pathway of BFRs intake for non-occupationally exposed persons. This review summarizes most available BFRs data in foods and human milk from China in recent years, and emphasizes several specific aspects, i.e., contamination levels of legacy and emerging BFRs, dietary exposure assessment and related health concerns, comparison between various BFRs, and temporal changes in BFRs contamination.

Transcriptomic Analysis of Gonadal Adipose Tissue in Male Mice Exposed Perinatally to 2,2',4,4'-Tetrabromodiphenyl Ether (BDE-47)

For the majority of lipophilic compounds, adipose tissue is traditionally considered as a storage depot and only rarely as a target organ. Meanwhile, abnormalities in adipose tissue physiology induced by chemical exposure may contribute to the current epidemic of obesity and metabolic diseases. Polybrominated diphenyl ethers (PBDEs) are a group of lipophilic flame retardants found in the majority of human samples in North America. Their ability to alter the physiology of adipose tissue is unknown. We exposed pregnant mice to 0.2 mg/kg body weight/day of BDE-47 perinatally. Transcriptomic changes in gonadal adipose tissue were analyzed in male offspring using the RNA-seq approach with subsequent bioinformatic analysis. The expression of genes of coagulation and complement cascade, de novo lipogenesis, and xenobiotic metabolism was altered in response to BDE-47 exposure. The affected molecular network included the following hubs: PPARα, HNF1A, and HNF4. These findings suggest that adipose tissue should be considered a target tissue for BDE-47, in addition to its role as a storage depot. This study also builds a background for a targeted search of sensitive phenotypic endpoints of BDE-47 exposure, including lipid profile parameters and coagulation factors in circulation. Additional studies are needed to investigate the role of PBDEs as an obesogen.

A national survey of tetrabromobisphenol-A, hexabromocyclododecane and decabrominated diphenyl ether in human milk from China: Occurrence and exposure assessment

A national survey of three currently used brominated flame retardants (BFRs), tetrabromobisphenol A (TBBPA), hexabromocyclododecane (HBCD) and decabrominated diphenyl ether (BDE-209) in human milk was conducted in 2011. Human milk from 16 provinces of China were collected, pooled and measured. The estimated daily intake (EDI) via human milk ingestion for nursing infant and the related health risks were evaluated. The median levels of TBBPA, HBCD and BDE-209 were 1.21, 6.83 and 0.556ng/g lipid weight (lw), respectively. Levels of BDE-209 were lower than those of TBBPA, indicating that the production and application of deca-BDE in China has been below that of TBBPA after the restriction of PBDEs. Moreover, contamination levels of TBBPA and HBCD in this survey were higher than those observed in last national survey conducted in 2007, indicating an increase of TBBPA and HBCD in the environment from 2007 to 2011. The mean estimated daily intakes (EDIs) of TBBPA, HBCD and BDE-209 via human milk for 1-6months old infant were 39.2, 51.7 and 3.65ng/kgbw/day, respectively. For risk assessment, margin of exposure (MOE) was calculated by comparing the BMDL₁₀ (benchmark dose lower confidence limit for a benchmark response of 10%) to the EDI of each BFR. Large MOEs indicates that the estimated dietary exposure to these three BFRs for nursing infant is unlikely to raise significant health concerns. Compared with some currently used novel BFRs which also measured in this survey, higher contamination levels were found in some non-PBDE BFRs, indicating that the consumption pattern of BFRs has shifted from PBDEs to non-PBDE BFRs in China.

Polybrominated diphenyl ethers and indicator polychlorinated biphenyls in human milk from China under the Stockholm Convention

Seven congeners of polybrominated diphenyl ethers (PBDEs) (BDE-28, BDE-47, BDE-99, BDE-100, BDE-153,BDE-154 and BDE-183) and six indicator polychlorinated biphenyls (PCBs) (PCB-28, PCB-52, PCB-101, PCB-138, PCB-153 and PCB-180) were measured in 32 regional pooled human milk samples originating from 1760 volunteering primiparous mothers to evaluate the current human body burden of general population and the temporal trend in China. Individual human milk samples were collected following a WHO-designed procedure. This work is one of parts of the evaluation of effectiveness of Stockholm Convention performance. The concentration of ∑₇PBDEs ranged from 0.3 ng g^-1 lipid to 4.0 ng g^-1 lipid with a mean of 1.5 ng g^-1 lipid. The concentration of ∑₆PCBs ranged from 2.3 ng g^-1 lipid to 19.0 ng g^-1 lipid with a mean of 6.6 ng g^-1 lipid. By comparing with background determination in 2007, there was no significance for ∑₇PBDEs. However, BDE-47, BDE-99, and BDE-100 significantly decreased with an average of 45%, 48%, and 46%, respectively, from 2007 to 2011, and an increase of BDE-183 was founded in most regions. For ∑₆PCBs, there was a significant decline with an average reduction of 41% from 2007 to 2011. These results indicate the effectiveness of reduction and elimination of POPs in China. Future national human milk biomonitoring is worthy to be done to further evaluate the time trend and effectiveness of the Convention performance.

Legacy and alternative halogenated flame retardants in human milk in Europe: Implications for children's health

In this study, 10 polybrominated diphenyl ethers (PBDEs) and 19 alternative halogenated flame retardants (AFRs) were determined in >450 human milk samples across three European countries, representing northern, western and eastern Europe. This study provides first insights into the occurrence of selected AFRs in mother milk samples and compares them among three European countries. Sums of median concentrations of the most frequently detected PBDEs were 2.16, 0.88 and 0.45ngg^-1 lipid weight (lw) in Norway, the Netherlands and Slovakia, respectively. The sum of the concentrations of AFRs ranged from 0.14 to 0.25ngg^-1lw in all countries, which was 2 to 15 times less compared to Σ₇PBDEs. The Penta-BDE replacement, bis(2-ethylhexyl) tetrabromophthalate, BEH-TEBP, was present at the greatest concentrations of any of the AFRs and in some samples exceeded concentrations of BDE 47 and BDE 153. Four AFRs including bromobenzenes (hexabromobenzene, pentabromobenzene, pentabromotoluene) and another Penta-BDE replacement (2-ethylhexyl-2,3,4,5-tetrabromobenzoate, EH-TBB) were detected in >42% of all human milk samples. Because of the potential developmental neurotoxicity of the halogenated flame retardants, infant dietary intakes via breastfeeding were estimated; in four cases the intakes of BDE 47 exceeded the reference dose indicating that the present concentrations may pose a risk for children.

Simultaneous liquid chromatography-tandem mass spectrometry analysis of brominated flame retardants (tetrabromobisphenol A and hexabromocyclododecane diastereoisomers) in French breast milk

TBBPA and HBCDs are the two classes of flame retardants that are still allowed for use by the European Commission. In May 2013, HBCDs were listed as Persistent Organic Pollutants under the Stockholm Convention, and they were banned with an exemption on EPS/XPS for cavity wall insulation. This study describes the development and optimisation of a rapid LC-ESI-MS/MS method using isotopic dilution quantification including a simplified extraction step using a mixture of solvents and sulphuric acid hydrolysis followed by the one-shot analysis of TBBPA and each of the α-, β- and γ-HBCD diastereoisomers. The limits of detection and quantification (LOD and LOQ) were 0.5 and 2.5 ng g^-1 (lipid weight, lw) for TBBPA and HBCD diastereoisomers, respectively. The method was applied to analyse 106 samples of individual mature breast milk. TBBPA was quantified in 42% of these samples within a range of <LOQ to 15.1 ng g^-1 lw. HBCD diastereoisomers were quantified in 8%, 3% and 3% of the collected samples for α-, β- and γ-HBCDs, respectively. The α-form was predominant in each quantifiable breast milk sample. The rapid newly developed LC-MS/MS method appears to be suitable for simultaneously analysing and quantifying TBBPA and HBCDs (three isomers) in human breast milk with the aim of establishing BFR multi-contamination profiles of breast milk samples.

Perinatal exposure to low dose 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) alters sperm DNA methylation in adult rats

Polybrominated diphenyl ethers (PBDEs) are a group of ubiquitous reproductive toxins. Given that spermatogenesis requires extensive epigenetic changes, we hypothesize that PBDEs impact sperm DNA methylation. Pregnant Wistar rats were exposed perinatally to 0.2mg/kg 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) and caudal epididymal sperm were collected from offspring on postnatal days (PNDs) 65 and 120. Libraries were prepared from sperm DNA and sequenced with an average of 18.0 million unique reads per sample. Differential methylated regions (DMRs) were identified via MethPipe package. BDE-47 exposure increased DNA methylation of epididymal sperm on PND 65 in genes, promoters and intergenic regions; however, on PND120 methylation decreased in these genomic elements. We identified 21 and 9 exposure-related DMRs in sperm collected on PND65 and PND120, respectively. Two DMRs overlapped between the two time-points. This is the first study to demonstrate that environmentally-relevant perinatal exposure to PBDE results in long-lasting changes in sperm DNA methylation.

Dioxins/furans and PCBs in Canadian human milk: 2008-2011

Human milk was collected between 2008 and 2011 as part of the Maternal - Infant Research on Environmental Chemicals (MIREC) study that was initiated to establish Canadian national estimates of maternal and infant exposure to a broad suite of environmental contaminants (e.g., persistent organic pollutants [POPs], trace elements, phthalates, etc.). Among the 1017 human milk samples collected, 298 were analysed for polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs). World Health Organization (WHO) toxic equivalency concentrations (WHO TEQ₂₀₀₅) for PCDD/F+dioxin-like (DL) PCB ranged from 2.2pg TEQ₂₀₀₅ g^-1 lipid to 27pg TEQ₂₀₀₅ g^-1 lipid. The relative contribution of PCDDs to the overall WHO TEQ₂₀₀₅ (PCDD/F+DL PCB) has decreased from earlier investigations into POP levels in Canadian human milk. Significantly higher PCB concentrations were observed in milk from women born in Europe relative to those born in Canada (p<0.001), in contrast to results for the PCDD/Fs (p=0.496). Age was found to significantly impact milk ∑PCB concentrations (p=0.018), with elevated concentrations observed in milk from women >30years relative to those <30years of age. While this trend was also observed for the PCDD/Fs, this relationship was impacted by parity. WHO TEQ₂₀₀₅ concentrations were significantly higher in milk from primiparous women (p=0.019) and those >30years relative to those <30years of age (p<0.001). No significant differences were associated with education level or pre-pregnancy body mass index. PCB and PCDD/F concentrations have continued to decline in Canadian human milk since the last sampling of human milk was performed.

Distribution of polybrominated diphenyl ethers in breast milk, cord blood and placentas: a systematic review

Polybrominated diphenyl ethers (PBDEs) have been extensively used as flame retardants in consumer products. PBDEs rapidly bioaccumulate in the environment, food, wild animals and humans. In this review, we investigated the harmful effects of PBDEs on humans, especially in early life, and summarised the levels of PBDEs in human biological samples (breast milk, cord blood and placentas). In addition, we described the spatiotemporal distribution of PBDEs in this review. PBDE levels in breast milk, cord blood and placentas were generally higher in North America than in other regions, such as Asia, Europe, Oceania and Africa. However, high levels of PBDEs in human biological samples were detected at e-waste recycling sites in South China, East China and South Korea. This finding suggests that newborns living in e-waste regions are exposed to high levels of PBDEs during prenatal and postnatal periods. The time trends of PBDE concentration differed according to the region. Few studies have investigated PBDE levels in humans from 1967 to 2000, but they increased rapidly after 2000. PBDE concentration peaked at approximately 2006 globally. Compared with other PBDE congeners, BDE-47, BDE-153 and BDE-209 were the major components, but the detection rate of BDE-209 was lower than those of others. Future studies should focus on determining the BDE-209 concentration, which requires the implementation of different analytical approaches. Additionally, the levels of PBDEs in human samples and the environment should be monitored, especially in e-waste recycling regions. Graphical abstract The figures described the spatial distribution of the lowest (Fig. a1) and highest concentration of ∑PBDE (Fig. a2) in different countries by 2006 and described the spatial distribution of the lowest (Fig. b1) and highest concentration of ∑PBDE (Fig. b2) in different countries from 2007 to 2015. All the figures indicated that the levels of PBDEs in North America were substantially higher than those in many regions of Europe, Asia, Oceania, or Africa. Comparing Fig. a1-b1 or Fig. a2-b2, increasing trends were observed in some countries, especially in some regions in China, Korea and Canada.

Developmental Exposure to 2,2',4,4'-Tetrabromodiphenyl Ether Induces Long-Lasting Changes in Liver Metabolism in Male Mice

Polybrominated diphenyl ethers (PBDEs) were used as flame-retardant additives in a wide range of polymers. The generations born when environmental concentrations of PBDEs reached their maximum account in the United States for one-fifth of the total population. We hypothesized that exposure to PBDEs during sensitive developmental windows might result in long-lasting changes in liver metabolism. The present study was based on experiments with CD-1 mice and human hepatocellular carcinoma cells (human hepatoma cell line, HepG2). Pregnant mice were exposed to 0.2 mg/kg 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) from gestation day 8 until postnatal day 21. The metabolic health-related outcomes were analyzed on postnatal day 21 and postnatal week 20 in male offspring. Several groups of metabolic genes, including ribosomal and mitochondrial genes, were significantly upregulated in the liver at both points. Genes regulated via mechanistic target of rapamycin (mTOR) pathway, the gatekeeper of metabolic homeostasis, were whether up- or downregulated at both measurement points. On postnatal day 21, but not week 20, both mTOR complexes in the liver were activated, as measured by phosphorylation of their targets. mTOR complexes were also activated by BDE-47 in HepG2 cells in vitro. The following changes were observed at week 20: a decreased number of polyploid hepatocytes, suppressed cytoplasmic S6K1, twofold greater blood insulin-like growth factor-1 and triglycerides, and 2.5-fold lower expression of fatty acid uptake membrane receptor CD36 in liver tissue. Thus, perinatal exposure to environmentally relevant doses of BDE-47 in laboratory mice results in long-lasting changes in liver physiology. Our evidence suggests involvement of the mTOR pathway in the observed metabolic programming of the liver.

Perspective on pre- and post-natal agro-food exposure to persistent organic pollutants and their effects on quality of life

BACKGROUND

Adipose tissue constitutes a continual source of internal exposure to organic pollutants (OPs). When fats mobilize during pregnancy and breastfeeding, OPs could affect foetal and neonatal development, respectively.

SCOPE AND APPROACH

The main aim of this review is to deal with pre- and post-natal external exposure to organic pollutants and their effects on health, proposing prevention measures to reduce their risk. The goal is the development of a biomonitoring framework program to estimate their impact on human health, and prevent exposure by recommending some changes in personal lifestyle habits.

KEY FINDINGS AND CONCLUSIONS

It has been shown that new studies should be developed taking into account their cumulative effect and the factors affecting their body burden. In conclusion, several programs should continuously be developed by different health agencies to have a better understanding of the effect of these substances and to develop a unified public policy.

Marine-Derived Biocatalysts: Importance, Accessing, and Application in Aromatic Pollutant Bioremediation

The aim of the present review is to highlight the potential use of marine biocatalysts (whole cells or enzymes) as an alternative bioprocess for the degradation of aromatic pollutants. Firstly, information about the characteristics of the still underexplored marine environment and the available scientific tools used to access novel marine-derived biocatalysts is provided. Marine-derived enzymes, such as dioxygenases and dehalogenases, and the involved catalytic mechanisms for the degradation of aromatic and halogenated compounds, are presented, with the purpose of underpinning their potential use in bioremediation. Emphasis is given on persistent organic pollutants (POPs) that are organic compounds with significant impact on health and environment due to their resistance in degradation. POPs bioaccumulate mainly in the fatty tissue of living organisms, therefore current efforts are mostly focused on the restriction of their use and production, since their removal is still unclear. A brief description of the guidelines and criteria that render a pollutant POP is given, as well as their potential biodegradation by marine microorganisms by surveying recent developments in this rather unexplored field.

Biomonitoring of persistent organic pollutants (POPs) in child populations living near contaminated sites in Mexico

The aim of this study was to conduct a POP biomonitoring programme for children in high-risk areas. We evaluated 247 serum samples from children between the ages of 6 and 12years old from two zones in Mexico: (1) indigenous zones, which included Cuatlamayan (CUA), Tocoy (TOC), and Santa Maria Picula (SAM); and (2) industrial zones, which included Tercera Chica (TC), Industrial San Luis (IND) and Rincon de San Jose (SJR); Mundo Nuevo (MN); and Alpuyeca (ALP). Our results showed that α-endosulfan was similar to CUA, TOC, SAM, TC and MN (178.6-306.9ng/g lipid). β-Endosulfan levels were higher in ALP (901.5ng/g lipid), followed by CUA (139.9ng/g lipid) and TOC, SAM, TC and MN, which had similar levels (55.4-64.5ng/g lipid). For endosulfan sulfate, the ALP community had the highest concentration levels (1096.4ng/g lipid), whereas CUA and TOC (212.3 and 289ng/g lipid, respectively) had concentrations similar to those found in SAM and TC (99.5 and 119.1ng/g lipid, respectively). DDE levels were found in malaria-endemic areas of SAM, CUA and TOC (1782.2, 1358.3 and 57.0ng/g lipid), followed by MN (35.1ng/g lipid). HCB concentration levels were found to be higher in MN and SJR (691.8 and 575.4ng/g lipid, respectively), followed by CUA and TC (363.9 and 269.1ng/g lipid, respectively), with levels similar to those found in TOC and SAM (191.8 and 181.9ng/g lipid, respectively). Finally, PCB 101 concentration levels were found to be the highest in ALP (1032.7ng/g lipid), followed by similar levels of SJR and IND (567.5 and 327.3ng/g lipid, respectively) and TC and MN, with 109.1 and 144.5ng/g lipid, respectively. The evidence provided by this exploratory study indicates that the evaluation of the health risks posed to children living in contaminated areas is a high priority health issue.

Developmental neurotoxicants in human milk: Comparison of levels and intakes in three European countries

Developmental neurotoxicants (DNTs), such as methylmercury (MeHg), polychlorinated biphenyls (PCBs) and selected organochlorine pesticides (OCPs), have gained increasing interest recently due to their possible relation to developmental disorders in children, which are increasing worldwide. We analyzed levels of 14 developmental neurotoxicants in human milk samples from Slovakia (n=37), the Netherlands (n=120) and Norway (n=388). Positive identification for most target analytes was >95% in all samples. In all three countries MeHg was measured for the first time in mother milk. The highest MeHg levels were observed in Norway (39pgg^-1 ww) with the highest fish consumption. Levels of indicator PCBs (iPCBs, sum of PCB 28, 52, 101, 138, 153 and 180), HCB and DDE+DDT were 2-4 times higher in Slovakia compared to the Netherlands or Norway. The levels of MeHg and organochlorine compounds were used for calculations of weekly or daily intakes (top-down approach) by means of pharmacokinetic modeling. The intakes ranged from 0.014 to 0.142μgkg_bw^-1week^-1 for MeHg and from 0.043 to 17.4ngkg_bw^-1day^-1 for organochlorine compounds in all three countries. Intakes of iPCBs exceeded a tolerable daily intake of 10ngkg_bw^-1day^-1 in 16% of the Slovak participants. The top-down estimates were compared with bottom-up intakes based on national dietary estimates and the results showed good consistency between both approaches, with the bottom-up intakes exceeding the top-down by a factor of maximum 3.8 for iPCBs in the Netherlands and 3.9 for HCB in Slovakia. This confirms that food consumption in all three countries represents the dominant pathway of exposure to these developmental neurotoxicants.