Occupational exposure to PCDDs, PCDFs, and PCBs of metallurgical workers in some industrial plants of the Brescia area, northern Italy

Human biomonitoring of PCDDs, PCDFs, and PCBs in women living in a Northern Italy industrial area

In Brescia , a highly industrialized city in the Lombardy Region (Northern Italy) classified as a SIN (Contaminated Site of National Interest), a human biomonitoring study was carried out on breast milk of two groups of women residing in areas with presumably different levels of exposure to polychlorodibenzo-p-dioxins, polychlorodibenzofurans, and polychlorobiphenyls. This study was aimed at evaluating the possible difference between women living in Brescia and women living far from it but in the same Region. Between 2016 and 2018, 82 women were enrolled (41 "exposed" subjects and 41 "not exposed"), breast milk samples were collected, and a specific questionnaire was administered to the donors. Data obtained were processed by robust regression and Principal Component Factor Analysis. The differences in concentration between the two groups were significant for all the classes of analytes (except for PCDDs). The concentration increase rates from the not exposed to the exposed group resulted highly significant: some PCB congeners showed increase rates more than 1000 ng/g lb per one-unit change of the independent variable. Among the variables significantly associated with the observed concentrations, age showed the greatest influence, while BMI showed a counteracting effect. Consumption of vegetable oil and fruit resulted to possibly influence the chemicals body burden. For the not exposed group, the levels appear to be in line with the decreasing trend (2001-2018) observed for these contaminants in Italy.

Determinants of exposure to polychlorinated biphenyls in the Italian population in the last decades

Polychlorinated biphenyls (PCBs) are industrial products extensively used in the past. Because of their widespread presence and toxic effects, the international community adopted control measures to reduce their release into the environment. Currently, PCB concentrations are decreasing, but humans are still exposed. In this paper, we reported the results of a study concerning PCB concentrations in human serum samples collected in Italy over two decades. The aim of the study was to investigate the trend of major determinants of PCB human exposure, several decades after the end of their production. PCB concentrations ranged over three orders of magnitude (from 0.4 to 958 ng/g lipid), with a median value of 85 ng/g lipid. We identified age, sampling year, body mass index, sex, and living near hot spots or being occupationally exposed as relevant factors in determining body burden. Our results can give indications to refine regulatory policies on PCBs in Italy, with particular attention to the disposal of residue PCB-containing products. To improve control measures can further decrease the exposure of citizens to PCBs, limit health implications, and improve citizens' perception about chemical risk management.

Time trends of PCDDs, PCDFs, DL-PCBs, and NDL-PCBs in Italian women from biomonitoring studies

A number of biomonitoring investigations were carried out in Italy between 2000 and 2018 by the Unit of Human Exposure to Environmental Chemicals of the Italian National Institute of Health (Rome). The investigations were characterized by different features (case-control or cross-sectional studies, participants from impacted or no impacted areas, etc), but despite the differences, it was possible to study the time trends of Σ₇(PCDDs), Σ₁₀(PCDFs), Σ₁₂(DL-PCBs), and Σ₆(NDL-PCBs) (analytical and TEQ cumulative concentrations, as appropriate). All the chemicals considered showed clear rates of a time-dependent concentration decrease, data having previously been adjusted for the sampled Region and subject age. Σ₇(PCDDs) exhibited the fastest decrease with an average rate of -4.44 pg/g-fat year^-1 (2009-2018), whereas Σ₆(NDL-PCBs) was characterized by the slowest decrease with a rate of -0.771 ng/g-fat year^-1 (2000-2018). A clear distinction between the decreasing rates of Σ₇(PCDDs) and Σ₁₀(PCDFs) was observed, as the latter decreased at half the rate of the Σ7(PCDDs). The slower rate of the Σ₁₀(PCDFs) decline may be due to an ongoing source of PCDFs in the environment beyond those traditionally considered for this group of contaminants such as the production of PCDFs due to PCBs thermal conversion from matrices contaminated with PCBs. Production of PCDFs due to thermal conversion of matrices contaminated with PCBs could be an ongoing source which may be of concern because recent data have highlighted the diffusion of PCBs in the European environment. The decreasing rates of PCDDs + PCDFs, DL-PCBs, and PCDDs + PCDFs + DL-PCBs - original analytical data converted to "dioxin equivalents" - were respectively estimated as (pgTEQ/g-fat year^-1) -2.08, -2.06, and -2.10, values exhibiting good compatibility between one another.

Time and spatial trends of operated cryptorchidism in France and environmental hypotheses: a nationwide study from 2002 to 2014

STUDY QUESTION

Is there an evolution in the risk of operated cryptorchidism in France and does local geographical environment appear as an important trigger for this defect?

SUMMARY ANSWER

We observed an increase of the risk of operated cryptorchidism in boys under the age of 7 years during the period 2002-2014 and a strong spatial heterogeneity, with the detection of spatial clusters suggesting environmental factors.

WHAT IS KNOWN ALREADY

Epidemiologic data on cryptorchidism are scarce and its etiology is poorly understood. As part of the testicular dysgenesis syndrome, cryptorchidism is suspected to be a male genital developmental disorder caused by endocrine disruptor chemical (EDC) exposure during the prenatal period.

STUDY DESIGN, SIZE, DURATION

This was a retrospective and descriptive study using data from the French national hospital discharge database, in the 2002-2014 study period. We built an indicator to reflect incident cases of operated cryptorchidism in boys under the age of 7 years in metropolitan France, with an algorithm using specific codes for diseases (ICD-10 codes) and surgical acts (CCAM codes).

PARTICIPANTS/MATERIALS, SETTING, METHODS

The study population was composed of 89 382 new cases of operated cases of cryptorchidism in boys under the age of 7 years. We estimated the temporal evolution of the incidence rate. We fitted a spatial disease-mapping model to describe the risk of cryptorchidism at the postcode scale. We used Kulldorff's spatial scan statistic and Tango's flexibly shaped spatial scan statistic to identify spatial clusters.

MAIN RESULTS AND THE ROLE OF CHANCE

The estimated increase in the incidence of operated cryptorchidism from 2002 to 2014 was equal to 36.4% (30.8%; 42.1%). Cryptorchidism displayed spatial heterogeneity and 24 clusters (P < 0.0001) were detected. The main cluster was localized in a former coal mining and metallurgic area in northern France, currently an industrial area. The cluster analysis suggests the role of shared socio-economic and environmental factors that may be geographically determined and intertwined. The industrial activities identified in the clusters are potentially the source of persistent environmental pollution by metals, dioxins and polychlorinated biphenyls.

LIMITATIONS, REASONS FOR CAUTION

The indicator we used reflects operated cases of cryptorchidism, with an under-evaluation of the health problem. We cannot exclude a possible role of the evolution and local differences in surgical practices in the observed trends. Our inclusion of boys under 7 years of age minimized the biases related to differences in practices according to age. Regarding the environmental hypothesis, this is an exploratory study and should be considered as a hypothesis-generating process for future research studies.

WIDER IMPLICATIONS OF THE FINDINGS

To our knowledge, this is the first descriptive study to address nationwide trends of operated cryptorchidism with detection of spatial clusters, with a very large sample allowing great statistical power. Our results generate plausible environmental hypotheses, which need to be further tested.

STUDY FUNDING/COMPETING INTEREST(S)

This study was entirely funded by Santé publique France, the French National Public Health Agency. All authors declare they have no actual or potential competing financial interest.

TRIAL REGISTRATION NUMBER

N/A.

Adolescents exposed to the World Trade Center collapse have elevated serum dioxin and furan concentrations more than 12years later

BACKGROUND

The collapse of the World Trade Center (WTC) on September 11, 2001 released a dust cloud containing numerous environmental contaminants, including polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans (PCDD/Fs). PCDD/Fs are toxic and are associated with numerous adverse health outcomes including cancer, diabetes, and impaired reproductive and immunologic function. Prior studies have found adults exposed to the WTC disaster to have elevated levels of PCDD/Fs. This is the first study to assess PCDD/F levels in WTC-exposed children.

METHODS

This analysis includes 110 participants, a subset of the 2014-2016 WTC Adolescent Health Study, a group of both exposed youths who lived, attended school, or were present in lower Manhattan on 9/11 recruited from the WTC Health Registry (WTCHR) and unexposed youths frequency matched on age, sex, race, ethnicity, and income. Our sample was selected to maximize the contrast in their exposure to dust from the WTC collapse. Questionnaire data, including items about chronic home dust and acute dust cloud exposure, anthropometric measures, and biologic specimens were collected during a clinic visit. Serum PCDD/F concentrations were measured according to a standardized procedure at the New York State Department of Health Organic Analytical Laboratory. We used multivariable linear regression to assess differences in PCCD/Fs between WTCHR and non-WTCHR participants. We also compared mean and median PCDD/F and toxic equivalency (TEQ) concentrations in our cohort to 2003-4 National Health and Nutrition Examination Survey (NHANES) levels for youths age 12-19.

RESULTS

Median PCDD/F levels were statistically significantly higher among WTCHR participants compared to non-WTCHR participants for 16 out of 17 congeners. Mean and median TEQ concentrations in WTCHR participants were >7 times those in non-WTCHR participants (72.5 vs. 10.1 and 25. 3 vs. 3.39pg/g lipid, respectively). Among WTCHR participants, median concentrations of several PCDD/Fs were higher than the NHANES 95th percentiles. After controlling for dust cloud exposure, home dust exposure was significantly associated with higher PCDD/F level.

CONCLUSIONS

Adolescents in lower Manhattan on the day of the WTC attack and exposed to particulate contamination from the WTC collapse had significantly elevated PCDD/F levels >12years later compared to a matched comparison group, driven by chronic home dust exposure rather than acute dust cloud exposure. PCDD/F and TEQ levels substantially exceeded those in similar-aged NHANES participants. Future studies are warranted to explore associations of PCDD/Fs with health and developmental outcomes among individuals exposed to the WTC disaster as children.

Occupational exposure to PCDDs, PCDFs, and DL-PCBs in metallurgical plants of the Brescia (Lombardy Region, northern Italy) area

The concentration values of polychlorodibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and dioxin-like polychlorobiphenyls (DL-PCBs) in blood serum samples (pools) of metallurgical workers in the area of the city of Brescia (northern Italy) were statistically processed. As to workers' exposure characteristics, pools were divided into 34 professionally exposed (PE) and 11 non-professionally exposed (NPE). A further subdivision of PE pools was according to workplaces in which ferrous (N = 24) and non-ferrous (N = 10) materials were handled. To evaluate the aforesaid differences we applied the age-adjusted Generalized Linear Models. We identified significant (P ≤ 0.05) exposure models of the classification groups. The first subdivision was confirmed by the concentrations of 1,2,3,4,6,7,8-H₇CDF, DL-PCB 105, and DL-PCB 189; the second was confirmed by the concentrations of PCDF TEQ₉₇, PCDD + PCDF + DL-PCB (TEQ_TOT) TEQ₉₇, 2,3,4,7,8-P₅CDF, 1,2,3,6,7,8-H₆CDD, 1,2,3,4,6,7,8-H₇CDD, and PCB 189. Based on the literature, all mentioned congeners have been found in stack gas and fly ash samples of metallurgical plants: therefore, these indicators indicate the exposure to such work environments. Specifically, the concentrations measured in the workers' blood serum appear to depend on the type of material processed during work.

Substantial decline of polychlorinated biphenyls serum levels 10years after public health interventions in a population living near a contaminated site in Northern Italy

INTRODUCTION

Polychlorinated biphenyls (PCBs) are persistent pollutants classified among endocrine disruptors and human carcinogens. In an urban area in Northern Italy (Brescia), a chemical factory producing PCBs from 1938 to 1984 caused soil and food pollution. Since the discovering of the environmental pollution in the area in 2001, various public health interventions have been implemented to avoid human contamination.

METHODS

Two independent surveys were carried out in 2003 and 2013 using the same study design and methods. A random sample of the adult general population living in four areas of the town with different soil contamination level was enrolled in both surveys. Investigation included serum levels of 24 PCB congeners and of other common clinical-chemical parameters and questions about residential and occupational history as well as current and past diet and consumption of locally produced food. 537 subjects were tested in the 2003 and 488 in the 2013 survey.

RESULTS

Total PCB serum levels showed a strong correlation with age (Spearman r=0.71 in 2003 and r=0.80 in 2013), but not with gender. Consumers of food produced in the most polluted area had higher total PCB serum levels (median 15.6 and 4.7ng/ml in 2003 and 2013, respectively) than non-consumers (4.1 and 2.3ng/ml) and consumers of food produced in non-polluted areas (6.5 and 1.9ng/ml), with increasing trend of PCB serum levels with cumulative local food intake. PCB serum levels from 2003 to 2013 survey declined by around half in all age groups, especially among the youngest people. The total PCB reduction was found to be due to a combination of a birth cohort effect (-41% every 10years) and survey period effect (-18% in 2013 versus 2003), with medium chlorinated CB congeners showing the most relevant reduction (-30%) between the two surveys. High chlorinated CBs were more strongly associated with birth cohort (-46% every 10years): in the 2013 survey they represented 58% of total PCBs in 60-79years old while they were 37% among the under 40s with a median value 20 times higher in the oldest than in the youngest (3.1 versus 0.16ng/ml).

CONCLUSIONS

PCBs serum levels declined from the 2003 to 2013 survey though they are still high in the elderly mainly because of past intake of locally produced contaminated food. Present findings suggest that PCBs food chain contamination and human absorption have been interrupted successfully in the area since discovery of the pollution in 2001.

Case-study and risk management of dioxins and PCBs bovine milk contaminations in a high industrialized area in Northern Italy

Milk supplied to a dairy plant in Brescia City (Northern Italy) was found to be contaminated by dioxin like PCBs at levels above the European (EU) action limit (2 pg WHO-TEQ/g fat). As a consequence, 14 dairy farms were sampled individually, in order to identify and possibly eliminate the source of contamination. All the farms were located in Brescia or just nearby, an area that is characterized by a strong industrialization. Four out of the 14 farms showed contamination levels above the legal maximum limit set by European Commission at 5.5 pg WHO-TEQ/g fat for the sum of dioxins and DL-PCBs. Concentrations of 8.16, 6.83, 5.71 and 5.65 pg WHO-TEQ/g fat were detected. In the three most polluted farms, cow ration was substituted with feed coming from uncontaminated areas and the time needed to reduce milk pollution was evaluated. In all the three farms, contamination levels dropped below the EU legal limit after only 1 month from the removal of the pollution source. In each sampled farm, DL-PCBs were the major contributors to the total WHO-TEQ level, with percentages up to 87% in the most contaminated one. PCB 126 WHO-TEQ value explained by itself large part of this contamination, and its decrease was fundamental for the reduction of milk contamination levels. This study provides an example of an on-field successful emergency intervention that succeeded in decontamination of dairy cows, allowing a fast restart of their production activity.

Formation and potential mechanisms of polychlorinated dibenzo-p-dioxins and dibenzofurans on fly ash from a secondary copper smelting process

Secondary copper smelting (SeCu) is widely considered to be an important source of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs and PCDFs; PCDD/Fs). Laboratory experiments were performed using SeCu fly ash as a matrix for thermochemical reactions to investigate the effects of fly ash on the formation of PCDD/Fs and the potential mechanisms. Thermochemical reactions on SeCu fly ash over a temperature range of 250-450 °C and reaction times of 10-120 min caused the PCDD/F concentrations in the fly ash to increase significantly. The PCDD/F concentrations formed in the thermal reactions were about 99-139 times higher than the PCDD/F concentrations in the original fly ash, clearly indicating that fly ash promoted the formation of PCDD/Fs. The PCDFs dominated the PCDDs, and the PCDF/PCDD concentration ratio was about 30-40. Octachlorodibenzofuran (OCDF), octachlorodibenzo-p-dioxin, and the heptachlorodibenzofurans were the most dominant homologs that were formed. A comparison of the PCDD/F patterns produced in the thermochemical reactions and the patterns in the original fly ash suggested that the chlorination of less chlorinated PCDFs might be an important pathway in the formation of higher chlorinated furans. The results of this study indicated that SeCu fly ash has a high PCDD/F formation potential. It is crucial to have the fly ash filter at low temperature and that fly ash in the cooling system should be minimized.

Priority persistent contaminants in people dwelling in critical areas of Campania Region, Italy (SEBIOREC biomonitoring study)

To investigate if protracted living in degraded environments of the Caserta and Naples provinces (Campania Region, Italy) had an impact on exposure of local people, highly toxic persistent contaminants were measured in blood, blood serum, and human milk of a large number of healthy donors. Sampling was carried out from 2008 to 2009. Blood was collected from over 850 20-64-year old donors; by pooling, 84 blood and 84 serum samples were obtained. Milk was donated by 52 mothers: specimens were pooled into six samples. Polychlorodibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs, dioxin-like (DL) and non-dioxin-like (Σ6PCBs)), arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) were measured in serum (organic biomarkers) and blood (metals); these chemicals and polybromobiphenyl ethers (Σ9PBDEs) were analyzed in milk. PCDD+PCDF, DL-PCB, TEQTOT, and Σ6PCB concentration ranges (medians) in serum were 6.26-23.1 (12.4), 3.42-31.7 (11.5), 10.0-52.8 (23.9) pgTEQ97/g fat, and 55.5-647 (219) ng/g fat, respectively, while in milk concentration ranges were 5.99-8.77, 4.02-6.15, 10.0-14.2 pgTEQ97/g fat, and 48.7-74.2 ng/g fat. Likewise, As, Cd, Hg, and Pb findings in blood spanned 2.34-13.4 (5.83), 0.180-0.930 (0.475), 1.09-7.60 (2.60), 10.2-55.9 (28.8) μg/L, respectively; only Pb could be measured in milk (2.78-5.99 μg/L). Σ9PBDE levels in milk samples were 0.965-6.05 ng/g fat. Biomarkers' concentrations were found to be compatible with their current values in European countries and in Italy, and consistent with an exposure primarily determined by consumption of commercial food from the large distribution system. Based on relatively higher biomarker values within the hematic biomonitoring database, the following municipalities were flagged as possibly deserving attention for health-oriented interventions: Brusciano and Caivano (As), Giugliano (Hg), Pianura (PCDDs+PCDFs), and Qualiano-Villaricca (As, Hg). The analysis of samples' qualitative variability indicated that biomarker composition was sensitive at municipality level, a feature that can potentially drive interventions for future local risk assessment and/or management measures.

Serum levels of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in a population living in the Naples area, southern Italy

The objective of this study was to estimate the levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (DL-PCBs and NDL-PCBs) in blood serum obtained from non-occupationally exposed volunteers living in the Naples area (Campania Region, southern Italy). The samples were taken from two geographical zones: one was an urban area of Naples and its surroundings and the other was located in an area deemed to be at high environmental risk. Total mean concentrations of these persistent pollutants proved to be in the range 1.43-17.38 pg WHO-TEQ1998 g(-1) lipid for PCDD/Fs, and 0.98-25.45 pg WHO-TEQ1998 g(-1) lipid for DL-PCBs. NDL-PCBs were in the range 316.57-482.90 ng g(-1) lipid. No significant differences were observed between women and men, nor between donors living in the two different areas. The mean levels of PCDD/Fs and PCBs in the population living in the Naples area were lower than those observed in some studies of populations living in exposed areas (near incineration plants or industrial sites) and urban or rural areas.

Polychlorinated dibenzodioxins, dibenzofurans, and biphenyls in fresh water fish from Campania Region, southern Italy

Twenty-eight fish muscle specimens from the main water bodies of the Campania Region were analyzed in our laboratory. On average, results showed a low contamination by PCDDs+PCDFs and a relatively more important presence of DL-PCBs. All specimens were compliant with EU regulatory maximum levels. Cumulative PCDD+PCDF+DL-PCB concentrations (TEQ(TOT)) were comprised in the range 0.223-11.4 pgWHO(97)-TEQ g(-1) fresh weight (fw). DL-PCB contribution to TEQ(TOT) was on average greater than 86% (range, 50.2-97.1%). The cumulative concentrations of 30 non-dioxin-like PCB congeners (Σ(30)(NDL-PCBs)) and of the six indicators (Σ(6)(NDL-PCBs)) were respectively in the ranges 3.30-515 and 1.30-195 ng g(-1) fw. The hybrid clustering approach adopted to analyze the sample-specific congener profiles indentified the main analytical patterns present in the database and, in particular, two main diverse exposure macro-areas that seem to exist north and south of the city of Naples. The distribution of PCDD and PCDF congeners among different species showed significant variations from chub (Leuciscus cephalus), characterized by a higher proportion of low-chlorinated congeners (e.g. 2,3,7,8-T(4)CDD), to eel (Anguilla anguilla), whose contamination consisted mainly of highly chlorinated congeners (e.g. O(8)CDD). To have a more complete perspective in relation to the contaminants present in the environment, the study suggestion is to use benthic as well as pelagic species to obtain an integrated characterization of fish tissue contamination.