Relative effects of educational level and occupational social class on body concentrations of persistent organic pollutants in a representative sample of the general population of Catalonia, Spain

Blood concentrations of metals, essential trace elements, rare earth elements and other chemicals in the general adult population of Barcelona: Distribution and associated sociodemographic factors

BACKGROUND

Very little information is available on the population distribution and on sociodemographic predictors of body concentrations of rare earth elements (REE) and other chemicals used in the manufacturing of high-tech devices.

OBJECTIVES

To analyze the distribution and associated sociodemographic factors of blood concentrations of chemical elements (including some metals, essential trace elements, rare earth elements and other minority elements) in a representative sample of the general population of Barcelona (Spain).

METHODS

A sample of participants in the Barcelona Health Survey of 2016 (N = 240) were interviewed face-to-face, gave blood, and underwent a physical exam. Concentrations of 50 chemical elements were analyzed by ICP-MS in whole blood samples.

RESULTS

All 50 chemicals studied, including 26 REE and minority elements, were detected. Lead, silver, arsenic, cadmium, mercury, antimony, strontium, thallium and six essential trace elements were detected in more than 70% of the population. The most frequently detected REE and minority elements were europium (62%), thulium (56%), gold (41%), indium (31%), ruthenium (24%), and tantalum (20%). Less affluent occupational social classes had higher percentages of detection of some REE. Median concentrations of silver, arsenic, cadmium and mercury were: 0.091, 3.01, 0.309, and 3.33 ng/mL, respectively. Women had lower median concentrations than men of lead (1.47 vs. 2.04 μg/dL, respectively), iron and zinc, and higher concentrations of copper and manganese. The influence of sociodemographic characteristics on chemical concentrations differed by sex.

CONCLUSIONS

While well-known contaminants as lead, mercury, cadmium, or arsenic were detected in the majority of the population, numerous individuals had also detectable concentrations of chemicals as europium, indium, thulium, or gold. Sociodemographic and physical characteristics (sex, age, social class, weight change) influenced concentrations of some chemicals.

Dechlorane Plus in environmental samples and human serum samples from new and old electronic waste dismantling areas in East China: Levels, composition profiles, and human exposure

The global presence of Dechlorane Plus (DP) in environmental and human samples highlights the need for further research into its ecological risks and health effects. This study determined DP concentrations in soil and air samples from an old electronic waste dismantling area (Fengjiang) and a new electronic waste dismantling area (Binhai) in Taizhou City, China. Both syn-DP and anti-DP isomers were found in all soil and air samples. The median concentrations of DP in soil and air were 90.5 ng/g and 48.4 pg/m3 in Fengjiang, and 6.69 ng/g and 28.8 pg/m3 in Binhai. DP were widespread in the local environment, and in general at moderate levels compared with reports from other electronic waste dismantling areas. The analysis of DP isomer profiles in different seasons and the calculation of related fugacity fraction showed that anti-DP perhaps easier than syn-DP to migrate from soil to air in summer. DP concentrations in serum of residents from Fengjiang (median 9.74 ng/g) were significantly higher than those from Huangyan (common control area, median 2.77 ng/g; p < 0.01), while the fanti value showed that Fengjiang was significantly lower than Huangyan (p < 0.05). This revealed that DP exposure levels in serum perhaps one of the crucial factors influencing fanti value. Moreover, DP concentrations in serum showed an increasing trend with increasing body mass index (BMI) or age. However, the relationship between DP and sex was not observed. The fanti values of serum samples were higher than those in soil and air samples, suggested that DP perhaps stereo-selectively absorbed into the body or stereo-selectively metabolised.

Live in same region, respond differently: Canine and human response to pollutants in placental accumulation

Polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), and polycyclic aromatic hydrocarbons (PAHs) are endocrine-disrupting chemicals (EDCs). Their presence in the environment is particularly concerning in cases of fetal exposure, which is the most vulnerable period of life for both human and animals who share the same environment. Placenta, as a sample collected using noninvasive methods to screen EDCs, is a good indicator for potential fetal exposure. Although recent studies indicate that companion animal may correspond to human exposure, species-specific anatomo-morphological and metabolic differences are controversial. In this study, placenta samples of 60 women and 25 dogs living and giving birth within the same region were evaluated for the presence of PCB, OCP, PBDE, and PAH residues; where, socio-demographic factors were also assessed to identify the possible sources. Gas chromatography-mass spectrometry method was validated for the matrix, and among 45 screened and targeted pollutants, only 18 were found in human placentas. While the most frequently detected pollutants were DDTs, followed by PAHs and PCBs in decreasing order, the pollutants with the highest concentrations were PAHs, followed by PCBs and DDTs. Only five of the target contaminants were detected in the dog placentas. These results indicate that; as dogs have different bioaccumulation capacities and higher excretion rates than humans, the life-long effects of exposure to endocrine compound and possible consequences related to adverse health outcomes are expected to vary and concentrations cannot be directly correlated.

Spatial distribution and source identification of persistent organic pollutants in the sediments of the Yeşilırmak River and coastal area in the Black Sea

Surface sediments from the Yeşilırmak River and the near coastal area in the Black Sea were collected using sediment traps to assess the spatial distributions of persistent organic pollutants and find their potential sources. Analyses were carried out to determine the concentrations of the persistent organic pollutants of seventeen polychlorinated dibenzo-p-dioxins and dibenzofurans, sixteen polycyclic aromatic hydrocarbons, seven polychlorinated biphenyls, and eight organochlorine pesticides using high-resolution gas chromatography-mass spectrometry and gas chromatography-tandem mass spectrometry systems. Analysis showed that the three main components of persistent organic pollutants (polychlorinated dibenzo-p-dioxins and dibenzofurans, polycyclic aromatic hydrocarbons, and organochlorine pesticides) primary sources are industrial activities. In addition, the widespread occurrence of persistent organic pollutants in the watershed surface sediments taken from the Yeşilırmak River basin showed that agricultural and urban areas are also diffuse persistent organic pollutants sources.

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.

Socio-economic inequalities in blood mercury (Hg) and serum polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik, Canada

OBJECTIVE

We examined the relationships between socio-economic characteristics and mercury (Hg) and polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik.

METHOD

We used biomonitoring data from 208 pregnant Inuit women recruited in the 14 villages of Nunavik between September 2011 and December 2013. Blood samples were collected to monitor levels of blood Hg and serum congener PCB-153 (surrogate of total PCB concentration). Ratio of omega 3/omega 6 polyunsaturated fatty acids, a validated biomarker of marine country food consumption, was also measured in red blood cell membranes to determine maternal dietary profile. Data on socio-economic characteristics (income and education), health-related lifestyles, and reproductive history were collected through questionnaires. Association between socio-economic characteristics and contaminant concentrations was assessed using linear regressions.

RESULTS

We observed a significant inverse relationship between education and Hg levels. Lower concentrations of Hg were observed among women who had completed high school compared to women who had not completed high school. However, no association was observed between level of education and concentration of PCBs.

CONCLUSION

Socio-economic disparities in maternal exposure to Hg exist in Nunavik. Further research is needed to determine whether environmental health inequalities also exist in other subgroups of the Nunavik population and in other Indigenous communities in Canada.

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.

Human biomonitoring from an environmental justice perspective: supporting study participation of women of Turkish and Moroccan descent

BACKGROUND

Environmental justice research shows how socially disadvantaged groups are more exposed and more vulnerable to environmental pollution. At the same time, these groups are less represented and, thus, less visible in biomedical studies. This socioeconomic participation bias is a form of environmental injustice within research practice itself.

METHODS

We designed, implemented and evaluated a targeted recruitment strategy to enhance the participation of socially disadvantaged pregnant women in a human biomonitoring study in Belgium. We focused on women of Turkish and Moroccan descent and developed a setup using personal buddies that enabled information transfer about study conditions in the pre-parturition period as well as support and follow-up with questionnaires in the post-parturition period.

RESULTS

We identified four barriers to the participation of women with a vulnerable social and ethnic background which were related to psychosocial and situational factors. Lack of trust in researchers and no perceived study benefits were important personal barriers; the complex study design and difficult self-administered questionnaires were equally significant barriers.

CONCLUSION

By investing in direct, person-to-person contact with trusted buddies and supported by practical advice about cultural and linguistic sensitivity, it was possible to increase study participation of socially disadvantaged people. Above all, this required openness and flexibility in the mind-set of researchers so that study design and procedures could be better grounded in the experiences and circumstances of underprivileged groups.

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.

Obesity, Persistent Organic Pollutants and Related Health Problems

The present review aims to delve into persistent organic pollutants (POPs) , as xenobiotics, in correlation to human health. POPs exhibit a group of common characteristics, including lipophilicity, persistence to decomposition and bioaccumulation in tissues. POPs have been thoroughly studied by former researchers, as they offer a particular interest in the elucidation of metabolic, endocrine and immune perturbation caused by their synergy with intracellular mechanisms. Herein particular focus is attributed to the relationship of POPs with obesity provocation. Obesity nowadays receives epidemic dimensions, as its prevalence elevates in an exponential degree. POPs-induced obesity rotates around interfering in metabolic and endocrinal procedures and interacting with peroxisome-proliferator and retinoic receptors. Moreover, polymorphisms in CYP gene families exert a negative result, as they incapacitate detoxification of POPs. Obesity could be deemed as a multidimensional condition, as various factors interact to lead to an obesogenic result. Therefore, concomitant disorders may occur, from mild to lethal, and get intensified due to POPs exposure. POPs exact function mechanisms remain rather enigmatic, thus further investigation should be prospectively performed, for a more lucid picture of this issue, and, consequently for the establishment of alternative solutions.

Number of Persistent Organic Pollutants Detected at High Concentrations in Blood Samples of the United States Population

Human exposure to environmental chemicals as persistent organic pollutants (POPs) is usually assessed considering each pollutant individually, with little attention to concentrations of mixtures in individuals or social groups. Yet, it may be relatively common for humans to have low and high concentrations of numerous POPs. The study objectives were to analyze the number of POPs detected per person at high concentrations in the U.S. population, and the associations between such type of indicators and socioeconomic factors as gender, race / ethnicity, education, and poverty level. From 91 POPs analyzed in serum samples of 4,739 individuals in three subsamples of the National Health and Nutrition Examination Survey (NHANES) 2003-2004 (the last period with valid updated individual data for the compounds considered in the present study), we computed the number of POPs whose serum concentrations were above selected cutoff points. POPs included were 13 organochlorine compounds (OCs), 10 polybrominated diphenyl ethers (PBDEs), the polybrominated biphenyl (PBB) 153, 38 polychlorinated biphenyls (PCBs), 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs), and 12 perfluorinated compounds (PFCs). Over 13% of participants had ≥10 of the 37 most detected POPs each at a concentration in the top decile (P90). Over 30% of subjects with total toxic equivalency (TEQ) ≥P75, had ≥10 of 24 POPs not included in TEQ calculations at concentrations ≥P90. Compared to non-Hispanic whites, the adjusted odds ratio of having ≥10 of the 37 POPs at P90 was 9.2 for non-Hispanic blacks and 0.18 for Mexican Americans. Poverty, body mass index, age, and gender were also independently associated with having ≥10 POPs in the top decile. More than one tenth of the US population may have ≥10 POPs each at concentrations in the top decile. Such pattern is nine times more frequent in Non-Hispanic blacks and four times less frequent in Mexican Americans than in non-Hispanic whites.

Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain

BACKGROUND

Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH.

OBJECTIVES

To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12).

METHODS

POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey.

RESULTS

Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-value<0.001). In crude models and in models adjusted for sex and BMI, the POPs-SRH association was often dose-dependent, and the likelihood of poor or regular SRH was 2 to 4-times higher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12.

CONCLUSIONS

Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders.

Climate change and environmental concentrations of POPs: A review

In recent years, the climate change impact on the concentrations of persistent organic pollutants (POPs) has become a topic of notable concern. Changes in environmental conditions such as the increase of the average temperature, or the UV-B radiation, are likely to influence the fate and behavior of POPs, ultimately affecting human exposure. The state of the art of the impact of climate change on environmental concentrations of POPs, as well as on human health risks, is here reviewed. Research gaps are also identified, while future studies are suggested. Climate change and POPs are a hot issue, for which wide attention should be paid not only by scientists, but also and mainly by policy makers. Most studies reported in the scientific literature are focused on legacy POPs, mainly polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and pesticides. However, the number of investigations aimed at estimating the impact of climate change on the environmental levels of polycyclic aromatic hydrocarbons (PAHs) is scarce, despite of the fact that exposure to PAHs and photodegradation byproducts may result in adverse health effects. Furthermore, no data on emerging POPs are currently available in the scientific literature. In consequence, an intensification of studies to identify and mitigate the indirect effects of the climate change on POP fate is needed to minimize the human health impact. Furthermore, being this a global problem, interactions between climate change and POPs must be addressed from an international perspective.

Human contamination by persistent toxic substances: the rationale to improve exposure assessment

We know quite a lot about the generalized human contamination by environmental chemical agents; this statement is fully compatible with the view that most countries lack the necessary monitoring systems. We also know quite a lot about the toxic effects of environmental pollutants; this statement is fully compatible with the proposal that we need both more research and more energetic policies to decrease human contamination by such pollutants. Unsurprisingly, we know too little about the (environmental and social) causes and the etiopathogenesis (mechanisms) of the most prevalent diseases, and we will continue to miss relevant causes and mechanisms if we neglect the toxic chemicals that commonly contaminate humans, worldwide. Basic, clinical end environmental-epidemiological research on human health should more often consider integrating biomarkers of internal dose of environmental chemical pollutants. When we act in more responsible, rational, and scientific ways; when we become less dismissive towards environmental hazards; and when we thus neglect less the generalized human contamination by environmental chemical agents and their toxic effects, we will expand mechanistic biologic knowledge, and we shall as well increase the effectiveness of interventions and policies that enable the primary prevention of human diseases which cause huge amounts of economic burden and human suffering.

[Vertical social mobility in Spain and ways to improve it. SESPAS report 2014]

In this article, we analyze the extent to which an individual's socioeconomic status is inherited and how equality of opportunity could be increased to improve social mobility. Poverty and deprivation can stop being dynastic-like if the social elevator works. In Spain, income inequality, measured by the Gini coefficient, rose from 0.31 in 2006 to 0.35 in 2012 (moving away from Scandinavia and Central Europe and more closely resembling income inequality in the UK or the United States), while the degree of intergenerational mobility is half-way between that in Italy and the United States. To change this situation and make the social elevator work, primary education should be improved and the health system should be steered toward primary healthcare. This will not be feasible without an improvement in politics and the institutional framework that determine these factors.

Persistent organic pollutants and obesity: are they potential mechanisms for breast cancer promotion?

Dietary ingestion of persistent organic pollutants (POPs) is correlated with the development of obesity. Obesity alters metabolism, induces an inflammatory tissue microenvironment, and is also linked to diabetes and breast cancer risk/promotion of the disease. However, no direct evidence exists with regard to the correlation among all three of these factors (POPs, obesity, and breast cancer). Herein, we present results from current correlative studies indicating a causal link between POP exposure through diet and their bioaccumulation in adipose tissue that promotes the development of obesity and ultimately influences breast cancer development and/or progression. Furthermore, as endocrine disruptors, POPs could interfere with hormonally responsive tissue functions causing dysregulation of hormone signaling and cell function. This review highlights the critical need for advanced in vitro and in vivo model systems to elucidate the complex relationship among obesity, POPs, and breast cancer, and, more importantly, to delineate their multifaceted molecular, cellular, and biochemical mechanisms. Comprehensive in vitro and in vivo studies directly testing the observed correlations as well as detailing their molecular mechanisms are vital to cancer research and, ultimately, public health.

Socioeconomic development as a determinant of the levels of organochlorine pesticides and PCBs in the inhabitants of Western and Central African countries

Several studies of environmental samples indicate that the levels of many persistent organic pollutants (POPs) are increasing in Africa, but few studies have been conducted in humans. Simultaneously, many African countries are experiencing a rapid economic growth and implementing information and communication technologies (ICT). These changes have generated high amounts of electronic waste (e-waste) that have not been adequately managed. We tested the hypothesis that the current levels of two main classes of POPs in Western and Central African countries are affected by the degree of socioeconomic development. We measured the levels of 36 POPs in the serum of recent immigrants (N=575) who came from 19 Sub-Saharan countries to the Canary Islands (Spain). We performed statistical analyses on their anthropometric and socioeconomic data. High median levels of POPs were found in the overall sample, with differences among the countries. Organochlorine pesticide (OCP) and polychlorinated biphenyl (PCB) levels increased with age. People from low-income countries had significantly higher OCP levels and much lower PCB levels than those from high-income countries. We found a significant association between the implementation of ICT and PCB contamination. Immigrants from the countries with a high volume of imports of second-hand electronic equipment had higher PCB levels. The economic development of Africa and the e-waste generation have directly affected the levels of POPs. The POP legacies of these African populations most likely are due to the inappropriate management of the POPs' residues.

Adjusting serum concentrations of organochlorine compounds by lipids and symptoms: a causal framework for the association with K-ras mutations in pancreatic cancer

In clinically aggressive diseases, patients experience pathophysiological changes that often alter concentrations of lipids and environmental lipophilic factors; such changes are related to disease signs and symptoms. The aim of the study was to compare the effects of correcting for total serum lipids (TSL) and other clinical factors on the odds of mutations in the K-ras oncogene by organochlorine compounds (OCs), in logistic models, in 103 patients with exocrine pancreatic cancer (EPC) using a causal directed acyclic graph (DAG) framework. Results and likelihood of bias were discussed in the light of possible causal scenarios. The odds of K-ras mutated EPC was associated with some TSL-corrected OCs, including p,p'-DDT (p-value: 0.008) and polychlorinated biphenyl 138 (p-trend: 0.024). When OCs were not corrected by TSL, the OR of a K-ras mutation was significant for p,p'-DDT (p-trend: 0.035). Additionally adjusting for cholestatic syndrome increased the ORs of TSL-corrected OCs. When models were adjusted by the interval from first symptom to blood extraction (ISE), the ORs increased for both TSL-corrected and uncorrected OCs. Models with TSL-corrected OCs and adjusted for cholestatic syndrome or ISE yielded the highest ORs. We show that DAGs clarify the covariates necessary to minimize bias, and demonstrate scenarios under which adjustment for TSL-corrected OCs and failure to adjust for symptoms or ISE may induce bias. Models with TSL-uncorrected OCs may be biased too, and adjusting by symptoms or ISE may not control such biases. Our findings may have implications as well for studying environmental causes of other clinically aggressive diseases.

The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization

BACKGROUND

Non-communicable diseases (NCDs) are increasing worldwide. We hypothesize that environmental factors (including social adversity, diet, lack of physical activity and pollution) can become "embedded" in the biology of humans. We also hypothesize that the "embedding" partly occurs because of epigenetic changes, i.e., durable changes in gene expression patterns. Our concern is that once such factors have a foundation in human biology, they can affect human health (including NCDs) over a long period of time and across generations.

OBJECTIVES

To analyze how worldwide changes in movements of goods, persons and lifestyles (globalization) may affect the "epigenetic landscape" of populations and through this have an impact on NCDs. We provide examples of such changes and effects by discussing the potential epigenetic impact of socio-economic status, migration, and diet, as well as the impact of environmental factors influencing trends in age at puberty.

DISCUSSION

The study of durable changes in epigenetic patterns has the potential to influence policy and practice; for example, by enabling stratification of populations into those who could particularly benefit from early interventions to prevent NCDs, or by demonstrating mechanisms through which environmental factors influence disease risk, thus providing compelling evidence for policy makers, companies and the civil society at large. The current debate on the '25 × 25 strategy', a goal of 25% reduction in relative mortality from NCDs by 2025, makes the proposed approach even more timely.

CONCLUSIONS

Epigenetic modifications related to globalization may crucially contribute to explain current and future patterns of NCDs, and thus deserve attention from environmental researchers, public health experts, policy makers, and concerned citizens.