Individual breast milk consumption and exposure to PCBs and PCDD/Fs in Hungarian infants: a time-course analysis of the first three months of lactation

Persistent organic pollutants in Croatian breast milk: An overview of pollutant levels and infant health risk assessment from 1976 to the present

This review article summarizes our research of persistent organic pollutants (POPs) in human milk from Croatian mothers over the last few decades. Our studies make up the bulk of all POPs research in human milk in Croatia and show a state-of-the art in the research area. The first investigations were made in 1970's. Aim of our review article is to document the comprehensive results over several decades as the best tool to: 1.) contribute to understanding of POPs and their potential health risks, 2.) evaluate effectiveness of legislative bans and restrictions on human exposure to POPs in Croatia, and 3.) to suggest further actions. In our review we discuss: 1.) Human milk between 2011 and 2014 - evaluation of interrelations of organochlorine pesticides (OCP) and polychlorinated biphenyls (PCB) in human milk and their association with the mother's age and parity using artificial intelligence methods; and our yet unpublished research data on health risks for infants assessed through daily PCB and OCP intake. 2.) Time trends of PCB and OCP in human milk between 1976 and 2014. 3.) polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofuran (PCDD/F) in human milk in 2000., and yet unpublished data on PCDD/F and polybrominated diphenyl ethers (PBDE) in 2014.

Polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in human milk from national human breast milk monitoring in 2016-2019 in China

Human breast milk monitoring programs were recommended to be carried out to assess human body burden to persistent organic pollutants and their temporal trends. Thus, we conducted a national survey during the period of 2016-2019 to determine PCDD/Fs and dl-PCBs in human breast milk from China. The total TEQ amounts in the upper bound (UB) was in the range of 1.97 to 15.1 pg TEQ g^-1 fat with a geometric mean (GM) of 4.50 pg TEQ g^-1 fat. 2,3,4,7,8-PeCDF, 1,2,3,7,8-PeCDD, and PCB-126 were more predominant contributors with the percentage contribution of 34.2 %, 17.9 %, and 17.4 %, respectively. By comparison with our previous monitoring results, the total TEQ in breast milk sample of the present study is statistically lower than that in 2011 with a reduction of 16.9 % in the average (p < 0.05), and comparable to that in 2007. The estimated GM of dietary intake of total TEQ for the breastfed was 25.4 pg TEQ kg^-1 body weight day^-1 that was higher than that of the adult. It is therefore worthy to make more efforts to reduce amounts of PCDD/Fs and dl-PCBs in breast milk and to continue monitoring to further observe if the amount of these chemicals continue to decrease.

Characterization of different contaminants and current knowledge for defining chemical mixtures in human milk: A review

Hundreds of xenobiotics, with very diverse origins, have been detected in human milk, including contaminants of emerging concern, personal care products and other current-use substances reflecting lifestyle. The routes of exposure to these chemicals include dermal absorption, ingestion and inhalation. Specific families of chemicals are dominant among human milk monitoring studies (e.g., organochlorine pesticides, bisphenol A, dioxins), even though other understudied families may be equally toxicologically relevant (e.g., food-processing chemicals, current-use plasticizers and flame retardants, mycotoxins). Importantly, the lack of reliable human milk monitoring data for some individual chemicals and, especially, for complex mixtures, is a major factor hindering risk assessment. Non-targeted screening can be used as an effective tool to identify unknown contaminants of concern in human milk. This approach, in combination with novel methods to conduct risk assessments on the chemical mixtures detected in human milk, will assist in elucidating exposures that may have adverse effects on the development of breastfeeding infants.

Breastfed infants' exposure to polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins and dibenzofurans, and per- and polyfluoroalkyl substances: A cross-sectional study of a municipal waste incinerator in China

A municipal waste incinerator (MWI) in Zhejiang, China, operating since 2008 was completely reconstructed from 2016 to 2019. In 2013, we conducted a cross-sectional study of breastfeeding mothers living near the MWI. We evaluated the concentrations of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the mothers' breast milk and their infants' estimated daily intake (EDI). To investigate the temporal variations of these pollutants, we conducted a cross-sectional study of 29 mothers in 2019. We assessed the levels of 18 PCB congeners, 17 PCDD/F congeners, and 21 per- and polyfluoroalkyl substance (PFAS) congeners in breast milk and estimated the EDI. The mean total concentrations of PCDD/Fs (ΣPCDD/Fs) and PCBs (ΣPCBs) were 81.2 and 4.90 ng/g lipid, respectively, while the toxic equivalent quantity (TEQ) levels of ΣPCDD/Fs and dioxin-like PCBs (ΣDL-PCBs) were 2.7 and 1.4 pg WHO-TEQ/g lipid, respectively. Compared to our 2013 measurements, the mass concentrations of ΣPCDD/Fs and ΣPCBs decreased by 13% and 35%, respectively (3.361 vs. 2.915 pg/g wet weight [ww] and 269.1 vs. 175.0 pg/g ww, respectively). The TEQ-ΣPCDD/F levels decreased by 67% (0.241 vs. 0.080 pg/g ww), but the TEQ-ΣDL-PCB levels increased by 11% (0.046 vs. 0.051 pg WHO-TEQ/g ww). The median concentration of PFASs was 0.250 ng/mL, ranging from 0.151 to 0.833 ng/mL. The infants' mean EDI of total PCDD/Fs and DL-PCBs was 17.7 pg TEQ/kg body weight [bw], representing a 20% decline compared to 2013. The average EDI levels of PFOS, PFOA, and PFNA were 5.8, 17.9, and 1.7 ng/kg bw, respectively. A comprehensive comparison of the results with studies from around the world showed that the potential health risks posed by legacy PCDD/F and PCB pollutants were not as grave for mothers and infants living near this MWI, but the emerging PFAS pollutants represented a new cause for concern. MAIN FINDINGS: The potential health risks posed by legacy PCDD/F and PCB pollutants were not particularly serious for mothers and infants living near the MWI, but the emerging PFAS pollutants raised new concerns.

Dioxin Congener Patterns in Breast Milk Samples from Areas Sprayed with Herbicide during the Vietnam War 40 Years after the War Ended

Large amounts of herbicides containing polychlorinated dibenzo-p-dioxins and dibenzo-furans (PCDD/Fs) were sprayed in South Vietnam during the Vietnam War. Levels of PCDD/Fs in the environment of South Vietnam remained high even 40 years later. A total of 861 breast milk samples (597 from three areas sprayed with herbicides, Quang Tri, Da Nang, and Bien Hoa, and 264 from three unsprayed areas in North Vietnam) were collected between 2007 and 2015 and the PCDD/F concentrations in the samples were determined. Levels of TEQ-PCDD/Fs and 17 PCDD/F congeners were higher in the sprayed area samples than the unsprayed area samples. We found particular PCDD/F congener patterns for different areas. High tetrachlorodibenzo-p-dioxin (TCDD) concentrations were found in Bien Hoa, high TCDD and 1,2,3,6,7,8-hexadibenzo-p-dioxin concentrations were found in Da Nang, and high 1,2,3,4,6,7,8-heptadibenzo-p-dioxin concentrations were found in Quan Tri. High 1,2,3,4,7,8-hexadibenzofuran and 1,2,3,4,6,7,8-heptadibenzofuran concentrations were also found in Da Nang and Quang Tri. However, breast feeding may have caused associations between the TCDD and polychlorinated dibenzofuran congener concentrations. Advanced statistical analysis will need to be performed in future to assess the characteristic PCDD/F congener profiles in breast milk samples from areas of Vietnam previously sprayed with herbicides.

Accumulation characteristics of polychlorinated dibenzo-p-dioxins and dibenzofurans and polychlorinated biphenyls in human breast milk from a seaside city of North China

Breast milk samples were collected from 51 mothers in a seaside city Dalian, where the residents usually have higher dietary exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs) due to the larger consumption of seafood. The lipid-basis concentrations of ∑Cl_2-8DD/Fs, ∑Cl_2-10Bs, and total toxicity equivalent (WHO-TEQ) were measured to be in the ranges of 35.7-2727.8 pg/g, 4.91-52.64 ng/g, and 2.27-36.30 pg/g, respectively. The average proportion of ∑Cl_2-3DD/Fs was higher than that of ∑Cl_4-7DD/Fs in the collected human breast milk samples, suggesting that the health risk of Cl_2-3DD/Fs should be especially concerned. The concentration data of PCDD/Fs and PCBs in human breast milk essentially followed a positive skew probability distribution. Women in high-level exposure scenarios exhibited a higher potential to accumulate homologues Cl₄DFs, Cl₇DFs, Cl₈DF, and Cl₆Bs in breast milk. Three PCDD/F congeners (1,2,3,6,7,8-Cl₆DF, 1,2,3,4,7,8-Cl₆DF, and 1,2,3,4,6,7,8-Cl₇DD) and three PCB congeners (PCB 126, PCB 138, and PCB 169) were identified as good indicators for the accumulation of PCDD/Fs and PCBs in human breast milk, respectively. The food-to-milk accumulation factors (FMAF) were calculated to evaluate the accumulation potentials of different PCDD/F and PCB congeners in human breast milk via dietary exposure. The calculated FMAF value presented a non-monotonic variation with the logarithm of n-octanol-water partition coefficient (log K_OW) with a peak at a log K_OW value of about 7.3 and a valley at a log K_OW value of about 8. The mean value of the estimated daily intake (EDI) of total WHO-TEQ for breast-fed infants in Dalian, predicted by Monte Carlo simulation, was 10 folds higher than the upper range of the tolerable daily intake (TDI) value (4 pg WHO-TEQ/kg bw/d), suggesting continued and enhanced efforts should be made to reduce the exposure risk of infants to PCDD/Fs and PCBs.

Exposure and risk assessment of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) for primiparous mothers and breastfed infants in Penang, Malaysia

An average 50 ml breast milk samples were collected from 21 lactating primiparous mothers (range 25 to 45 years, mean 33 years), 4-8 weeks after delivery in Penang Island, Malaysia. The geometric mean concentration of the most toxic congeners, 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) was 0.14 pg WHO₂₀₀₅-TEQ g^-1 zlipid. The most abundant congeners of PCDD/Fs were octachlorodibenzo-p-dioxin (OCDD) (5.9-75.4%), followed by 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (1,2,3,4,6,7,8-HpCDD) (1.1-30.7%). The geometric mean level of total dioxins and dl-PCBs was 2.2 pg WHO₂₀₀₅-TEQ g^-1 lipid, significantly lower than those in developed countries or highly contaminated areas. The total dioxins and dl-PCBs in pg WHO₂₀₀₅-TEQ levels in breast milk were significantly correlated with years of residence at potential contaminated site. The average daily intake of 11.8 pg WHO₂₀₀₅-TEQ kg^-1 body weight was estimated for a breastfed infant at 6 months of age. This demonstrates the exposure risk to infants, especially from Penang region, to these pollutants from human milk intake are potentially high during the lactation period.

Multiple persistent organic pollutants in mothers' breastmilk: Implications for infant dietary exposure and maternal thyroid hormone homeostasis in Uganda, East Africa

Persistent organic pollutants (POPs) are ubiquitous contaminants with adverse health effects in the ecosystem. One of such effects is endocrine disruption in humans and wildlife even at background exposure concentrations. This study assessed maternal breastmilk concentrations of POPs; brominated flame retardants (BFRs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs), and the potential health risks posed to the nursing infants. We also evaluated the association of these POPs with total 3,3',5-triiodo-L-thyronine (T₃), L-thyroxine (T₄), and 3,3',5'-triiodo-L-thyronine (rT₃) levels measured in human breast milk. Thirty breastmilk samples were collected from Kampala, Uganda between August and December 2018. Hexabromobenzene was not detected while the maximum level of 2,2',4,4',5,5'-hexabrombiphenyl was 64.7 pg/g lw. The median levels of total indicator PCBs, PBDEs, dioxin-like PCBs, and PCDD/Fs in the samples were 159 pg/g lw, 511 pg/g lw, 1.16 pg TEQ/g lw, and 0.4 pg TEQ/g lw, respectively. These levels were lower than those reported in other countries. Owing to their bio accumulative nature, PCBs -81, -169, and ∑PCDD/Fs increased with increase in maternal age. Estimated dietary intakes for dioxin-like PCBs and PCDD/Fs were lower than those reported elsewhere but were higher than the WHO tolerable daily intakes suggesting potential health risks to nursing infants. In adjusted single pollutant models, PCB-126, PCB-169, and ∑PCB_TEQ were negatively associated with T₃, while 1,2,3,4,5,7,8-HpCDF was positively associated with rT₃. Although these associations did not persist in multipollutant models, our findings suggest potential thyroid hormone disruption by POPs in mothers. This may reduce the levels of thyroid hormones transferred from the mother to the neonates and, hence, adversely influence infant growth. A temporal study with a bigger sample size is required to corroborate these findings.

Levels of Polychlorinated Dibenzo-p-Dioxins/Furans (PCDD/Fs) and Dioxin-Like Polychlorinated Biphenyls (DL-PCBs) in Human Breast Milk in Chile: A Pilot Study

Persistent organic pollutants (POPs) are organic compounds that resist biochemical degradation, moving long distances across the atmosphere before deposition occurs. Our goal was to provide up-to-date data on the levels of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in breast milk from Chilean women and to estimate the exposure of infants due to breast milk consumption. In Chile, we conducted a cross-sectional study based on methodologies proposed by the WHO, with a sample of 30 women recruited from three defined areas: 10 from the Arica Region (urban; Arica and Parinacota Region), 10 from Coltauco (rural; O'Higgins Region), and 10 from Molina (40% rural; Maule Region). High-resolution gas chromatography coupled with high-resolution mass spectrometry (HRGC/HRMS) was performed on pooled samples from each area. We calculated equivalent toxic concentrations (WHO-TEQ) based on the current WHO Toxic Equivalency Factors (TEF). The minimum and maximum values of ∑ PCDDs/Fs + DL-PCBs-TEQ were 4.317 pg TEQ/g fat in Coltauco and 6.31 pg TEQ/g fat in Arica. Molina had a total TEQ of 5.50 pg TEQ/g fat. The contribution of PCDD/Fs was approximately five-fold higher than that of DL-PCBs. The Estimated Daily Intake (EDI) of ∑ PCDDs/Fs + DL-PCBs based on the three pooled samples ranged between 6.71 and 26.28 pg TEQ/kg body weight (bw)/day, with a mean intake of 16.11 (±6.71) pg TEQ/kg bw/day in breastfed children from 0 to 24 months old. These levels were lower than those reported in international studies. Despite the fact that the observed levels were low compared to those in most industrialized countries, the detection of a variety of POPs in breast milk from Chilean women indicates the need for follow-up studies to determine whether such exposures during childhood could represent a health risk in adulthood.

Biomonitoring of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) in human milk: Exposure and risk assessment for lactating mothers and breastfed children from Spain

The main objective of the present research was to evaluate the levels of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (dl-PCBs) in the human milk of Spanish lactating women who participated in the BETTERMILK project so that exposure and risk could be assessed for these mothers and their breastfed children. The total ∑PCDD/Fs + dl-PCBs TEQ₂₀₀₅ concentrations in the upper-bound (UB) ranged from 1.29 to 13.48 pgTEQ₂₀₀₅ g^-1 lipid. The estimated geometric mean level for the sum of PCDD/F and dl-PCBs was 4.10 and 4.42 pgTEQ₂₀₀₅ g^-1 lipid, lower-bound (LB) and UB respectively and were below the reference level reported by EFSA, which is associated with adverse effects in boys of 9 years and related to lactating mothers' exposure values of the tolerable weekly intake (TWI) of around 2 pgTEQ₂₀₀₅ kg^-1 bw per week. Nevertheless, it was exceeded when the 95th percentile (8.31 pgTEQ₂₀₀₅ g^-1 lipid, as UB) was considered. Results from a multiple regression analysis showed that age has a significant impact on milk ∑PCDD/Fs + dl-PCBs levels, with higher concentrations observed in the milk from older mothers.

Persistent Organic Pollutants in Food: Contamination Sources, Health Effects and Detection Methods

Persistent organic pollutants (POPs) present in foods have been a major concern for food safety due to their persistence and toxic effects. To ensure food safety and protect human health from POPs, it is critical to achieve a better understanding of POP pathways into food and develop strategies to reduce human exposure. POPs could present in food in the raw stages, transferred from the environment or artificially introduced during food preparation steps. Exposure to these pollutants may cause various health problems such as endocrine disruption, cardiovascular diseases, cancers, diabetes, birth defects, and dysfunctional immune and reproductive systems. This review describes potential sources of POP food contamination, analytical approaches to measure POP levels in food and efforts to control food contamination with POPs.

QuEChERS extraction coupled to GC-MS for a fast determination of polychlorinated biphenyls in breast milk from Polish women

Polychlorinated biphenyls (PCBs) in breast milk has been determined. Therefore, it was necessary to develop and adapt an analytical method to analyze PCB compounds. The whole procedure was applied to 31 breast milk samples, which were collected from Polish mothers. The QuEChERS method was optimized as a fast and cheap sample preparation method. The procedure allowed us to obtain recovery values between 96.46% and 119.98% with acceptable relative standard deviations (3.36-12.71%). Gas chromatography with mass spectrometry (GC-MS) was used for final determination. The method was validated using parameters such as linearity, limit of detection and quantification, intra-day precision, and reproducibility. The mean concentration of ∑iPCBs in this study was 30.94 ng/g of lipid. Assigned daily intake of PCBs was lower than the tolerable daily intake, which shows that the analyzed milk is safe to the infants. However, the monitoring of PCBs in milk is still important, and the QuEChERS method with GC-MS can be an effective tool for tracking organic impurities in breast milk.

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.

Introducing of modeling techniques in the research of POPs in breast milk - A pilot study

This study used advanced statistical and machine learning methods to investigate organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in breast milk, assuming that in a complex biological mixture, the pollutants emitted from the same source or with similar properties are statistically interrelated and possibly exhibit non-linear dynamics. The elaborated analyses such as Unmix source apportionment characterized individual source groups, while guided regularized random forest indicated the pollutant dependence on the ortho-chlorine atom attached to the congener's phenyl ring and mother's age. Mutual associations among PCBs were further discussed, but the results implied they were mostly not related to child delivery. PCB congeners -153, -180, -170, -118, -156, -105, and -138 appeared to be compounds of the outmost importance for mutual prediction with reference to their interrelations regarding chemical structure and metabolic processes in the mother's body. Finally, machine learning methods, which provided prediction relative errors lower than 30% and correlation coefficients higher than 0.90, suggested a possible strong non-linear relationship among the pollutants and consequently, the complexity of their pathways in the breast milk.

Concentrations of dioxins and furans in breast milk of women living near a hazardous waste incinerator in Catalonia, Spain

Since 1999, a hazardous waste incinerator (HWI) is operating in Constantí (Tarragona County, Catalonia, Spain). In 1996-1998, when the facility was being built, we started a monitoring program aimed at evaluating the impact of the emissions of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) by the HWI on the environment and the human health. This study aimed at determining the current concentrations of PCDD/Fs in breast milk samples of women living nearby the HWI and at comparing these levels and profiles with those obtained in the baseline (1996-1998) and previous surveys (2002, 2007 and 2012). Furthermore, the association between the dietary intake of PCDD/Fs and the congener profiles in breast milk was also explored. Twenty milk samples were collected from women living in Tarragona downtown and near the industrial area where the HWI is placed. The content of PCDD/Fs was analyzed by following a procedure derived from the US EPA methods 1613 and 8290A. The mean concentration of PCDD/Fs was 2.26 pg WHO-TEQ/g fat. No significant differences were found between women living in industrial and urban areas (1.67 pg vs. 2.48 pg WHO-TEQ/g fat). Interestingly, a notable significant reduction (81%) was observed with respect to the concentrations found in the baseline study. The profiles of PCDD/Fs in breast milk were similar independently on the area and period of collection, being mainly influenced by the intake of fish, meat, oils and fats. The decreasing trend of PCDD/Fs in human milk agrees with the reduction observed in the dietary intake of these pollutants. It was also concluded that the current levels of PCDD/Fs in human milk levels are not influenced by the HWI stack emissions.

The impact of environmental pollution on the quality of mother's milk

Breastfeeding is a gold standard of neonate nutrition because human milk contains a lot of essential compounds crucial for proper development of a child. However, milk is also a biofluid which can contain environmental pollution, which can have effects on immune system and consequently on the various body organs. Polychlorinated biphenyls are organic pollutants which have been detected in human milk. They have lipophilic properties, so they can penetrate to fatty milk and ultimately to neonate digestive track. Another problem of interest is the presence in milk of heavy metals-arsenic, lead, cadmium, and mercury-as these compounds can lead to disorders in production of cytokines, which are important immunomodulators. The toxicants cause stimulation or suppression of this compounds. This can lead to health problems in children as allergy, disorders in the endocrine system, end even neurodevelopment delay and disorder. Consequently, correlations between pollutants and bioactive components in milk should be investigated. This article provides an overview of environmental pollutants found in human milk as well as of the consequences of cytokine disorder correlated with presence of heavy metals. Graphical abstract.

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.

Risk for animal and human health related to the presence of dioxins and dioxin-like PCBs in feed and food

The European Commission asked EFSA for a scientific opinion on the risks for animal and human health related to the presence of dioxins (PCDD/Fs) and DL-PCBs in feed and food. The data from experimental animal and epidemiological studies were reviewed and it was decided to base the human risk assessment on effects observed in humans and to use animal data as supportive evidence. The critical effect was on semen quality, following pre- and postnatal exposure. The critical study showed a NOAEL of 7.0 pg WHO2005-TEQ/g fat in blood sampled at age 9 years based on PCDD/F-TEQs. No association was observed when including DL-PCB-TEQs. Using toxicokinetic modelling and taking into account the exposure from breastfeeding and a twofold higher intake during childhood, it was estimated that daily exposure in adolescents and adults should be below 0.25 pg TEQ/kg bw/day. The CONTAM Panel established a TWI of 2 pg TEQ/kg bw/week. With occurrence and consumption data from European countries, the mean and P95 intake of total TEQ by Adolescents, Adults, Elderly and Very Elderly varied between, respectively, 2.1 to 10.5, and 5.3 to 30.4 pg TEQ/kg bw/week, implying a considerable exceedance of the TWI. Toddlers and Other Children showed a higher exposure than older age groups, but this was accounted for when deriving the TWI. Exposure to PCDD/F-TEQ only was on average 2.4- and 2.7-fold lower for mean and P95 exposure than for total TEQ. PCDD/Fs and DL-PCBs are transferred to milk and eggs, and accumulate in fatty tissues and liver. Transfer rates and bioconcentration factors were identified for various species. The CONTAM Panel was not able to identify reference values in most farm and companion animals with the exception of NOAELs for mink, chicken and some fish species. The estimated exposure from feed for these species does not imply a risk.

Elucidating Adverse Nutritional Implications of Exposure to Endocrine-Disrupting Chemicals and Mycotoxins through Stable Isotope Techniques

Multiple drivers of the double burden of malnutrition (DBM) include a rapid shift from predominantly plant-based diets to energy-dense foods based on meats, milk, animal fats and vegetable oils. The shift to overweight and obesity is driven by increased exposure to mass media, urbanization, technological advances in food processing, rising income and increased population density associated with increased access to cheap foods. At the same time, undernutrition persists mainly due to food insecurity and lack of access to safe water, sanitation and adequate health care. All known nutrition interventions result in only one third reduction in stunting. Little consideration has been given to hazardous exposure to endocrine disrupting chemicals (EDCs) and microbial toxins as major components of the malnutrition-causal framework. These hazards include microbial toxins, for example, mycotoxins, and environmental pollutants such as persistent organic pollutants (POPs), some of which are known to disrupt the endocrine system. These hazards sit at the cross road of undernutrition and overweight and obesity since the exposure cuts across the critical window of opportunity (the first 1000 days). In this review, we update on the role of food and environmental contaminants, especially EDCs and aflatoxins, in child growth and on the implications for metabolic dysfunction and disease risk in later life, and discuss potential applications of nuclear and isotopic techniques to elucidate the underlying biological mechanisms, outcome indicators, as well as occurrence levels.

An 18-Year Follow-up Survey of Dioxin Levels in Human Milk in Japan

Background

Globally, few published studies have tracked the temporal trend of dioxin levels in the human body since 2000. This study describes the annual trend of dioxin levels in human breast milk in Japanese mothers from 1998 through 2015.

Methods

An observational study was conducted from 1998 through 2015. Participants were 1,194 healthy mothers following their first delivery who were recruited annually in Japan. Breast milk samples obtained from participants were analyzed using gas chromatography and mass spectrometry for dioxins, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs).

Results

Mean age was 29.5 years, and 53% of participants were 20–25 years old. A declining trend in total dioxin levels was found, from a peak of 20.8 pg toxic equivalence (TEQ)/g fat in 1998 to 7.2 pg TEQ/g fat in 2014. Data from the last 5 years of the study indicated a plateau at minimal levels. In contrast, an increasing trend was found in the mean age of participants during the last 5 years. Although significantly higher dioxin levels were observed in samples from older participants, an upward trend in dioxin levels was not observed, indicating that dietary and environmental exposure to dioxins had greatly diminished in recent years.

Conclusions

Dioxin levels in human breast milk may be approaching a minimum in recent years in Japan. The findings may contribute to global reference levels for environmental pollution of dioxins, which remains a problem for many developing countries.

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.

Using stable isotope techniques in nutrition assessments and tracking of global targets post-2015

Stable isotopes are non-radioactive, safe and are applied for various purposes in human health assessment in trace amounts that minimally disturb normal physiology. The International Atomic Energy Agency supports the use of stable isotope techniques to design and evaluate interventions addressing malnutrition in all its forms with focus on infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases; healthy ageing and gut function. These techniques can be used to objectively measure: (1) amount of human milk consumed and whether an infant is exclusively breastfed; (2) body composition in the context of re-feeding programmes for moderate and severe acute malnutrition and as an indicator of the risk for obesity; (3) bioavailability and bioconversion of pro-vitamin A and vitamin A body stores following vitamin A intervention programmes; (4) absorption and retention of iron, zinc and protein; (5) total energy expenditure for validation of physical activity measurement and dietary assessment tools and (6) diagnosis of Helicobacter pylori. Stable isotope techniques will be invaluable in the tracking of global targets on exclusive breast-feeding childhood obesity and anaemia among women. Efforts are underway to make nuclear techniques more affordable, field-friendly and less invasive, and to develop less sophisticated but precise equipment. Advocacy for the wide adoption of the techniques is needed.

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.

Organochlorine pesticides and PCBs (including dl-PCBs) in human milk samples collected from multiparae from Croatia and comparison with primiparae

This study investigated the levels of 20 congeners of polychlorinated biphenyls (PCBs), including toxic dioxin-like PCBs and 7 organochlorine pesticides (OCPs) in 33 human milk samples collected in 2011 from multiparae living in Zadar, Croatia. Concentrations of ∑PCBs, ∑DDTs, ∑HCHs and HCB in samples ranged from 11.7 to 146.3, 8.7 to 89.2, 0.9 to 28.4, and <LOD to 8.0ngg(-1) milk fat, respectively. PCB congeners -153, -138, -180 and -170 dominated in the PCB profiles, while p,ṕ-DDE was the most abundant OCP. PCB-126 was the most abundant non-ortho PCB, while among mono-ortho PCBs, the congeners -118, -105 and -156 equally contributed to the mono-ortho PCB fraction. TEQs for dl-PCBs ranged between 0 and 13.3pgg(-1) milk fat. The calculated estimated daily intakes for all compound groups were below the tolerable daily intake indicating no risk for breastfed infants. A comparison of our results with our previous study on primiparae revealed that the concentrations of the main contaminant groups are lower in the milk of multiparae, with the exception of toxic mono-ortho PCBs whose concentrations and TEQ remained similar among the groups, and HCB whose concentrations were found to be higher in multiparae. Concentrations of PCBs and OCPs found in the samples from this study did not exceed those from other parts of the world. This study revealed that there are differences in contaminant concentrations depending on the mothers' parity and that this fact should be taken into account when risk assessment studies are conducted.

Cumulative Chemical Exposures During Pregnancy and Early Development

Industrial and consumer product chemicals are widely used, leading to ubiquitous human exposure to the most common classes. Because these chemicals may affect developmental milestones, exposures in pregnant women and developing fetuses are of particular interest. In this review, we discuss the prevalence of chemical exposures in pregnant women, the chemical class-specific relationships between maternal and fetal exposures, and the major sources of exposures for six chemical classes of concern: phthalates, phenols, perfluorinated compounds (PFCs), flame retardants, polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCs). Additionally, we describe the current efforts to characterize cumulative exposures to synthetic chemicals during pregnancy. We conclude by highlighting gaps in the literature and discussing possible applications of the findings to reduce the prevalence of cumulative exposures during pregnancy.

Associations between plasma concentrations of PCB 28 and possible indoor exposure sources in Danish school children and mothers

BACKGROUND

Polychlorinated biphenyls (PCBs) are ubiquitously present in the environment and are suspected of carcinogenic, neurotoxic and immunotoxic effects. Significantly higher plasma concentrations of the congener PCB 28 occur in children compared to adults. Exposure in schools may contribute to this difference.

OBJECTIVE

To determine whether increased blood plasma concentrations of PCB 28 in Danish school children and mothers are associated with living in homes or attending schools constructed in the PCB period (1959-1977).

METHODS

PCB 28 was analyzed in plasma samples from 116 children aged 6-11years and 143 mothers living in an urban and a rural area in Denmark and participating in the European pilot project DEMOCOPHES (Demonstration of a study to COordinate and Perform Human Biomonitoring on a European Scale). In Denmark, PCBs were used in construction in the period 1950-1977, and year of construction or renovation of the homes and schools was used as a proxy for indoor PCB exposure. Linear regression models were used to assess the association between potential PCB exposure from building materials and lipid adjusted concentrations of PCB 28 in plasma, with and without adjustment for potential confounders.

RESULTS

Among the 116 children and 143 mothers, we were able to specify home construction period in all but 4 children and 5 mothers leaving 111 children and 138 mothers for our analyses. The median lipid adjusted plasma PCB 28 concentration was 3 (range: 1-28) ng/g lipid in the children and 2 (range: 1-8) ng/g lipid in the mothers. Children living in homes built in the PCB period had significantly higher lipid adjusted plasma PCB 28 concentrations compared to children living in homes built before or after the PCB period. Following adjustment for covariates, PCB 28 concentrations in children were 40 (95% CI: 13; 68) percent higher than concentrations of children living in homes constructed at other times. Furthermore, children attending schools built or substantially refurbished in the PCB period also had significantly higher (46%, 95% CI: 22; 70) PCB 28 concentrations compared to children attending schools constructed before or after the PCB period, while their mothers had similar concentrations. Adjustment for the most prevalent congener, PCB 153, did not change this effect of home or school construction. When both home and school construction year were included in the models, the increase in lipid adjusted plasma PCB 28 for children living in or attending schools from the PCB period was no longer statistically significant. The individual effect of home and school construction periods could not be evaluated further with the available data.

CONCLUSION

Our results suggest that PCB exposure in the indoor environment in schools and homes constructed during the PCB period may contribute significantly to children's plasma PCB 28 concentration. Efforts to minimize PCB exposure in indoor environments should be considered.

Perinatal dioxin exposure and the neurodevelopment of Vietnamese toddlers at 1 year of age

Dioxin concentrations remain elevated in both the environment and in humans residing near former US Air Force bases in South Vietnam. This may potentially have adverse health effects, particularly on infant neurodevelopment. We followed 214 infants whose mothers resided in a dioxin-contaminated area in Da Nang, Vietnam, from birth until 1 year of age. Perinatal exposure to dioxins was estimated from toxic equivalent (TEQ) levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDDs/Fs-TEQ), and 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TetraCDD) concentrations in breast milk. In infants, daily dioxin intake (DDI) was used as an index of postnatal exposure through breastfeeding. Neurodevelopment of toddlers was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). No significant differences in neurodevelopmental scores were exhibited for cognitive, language or motor functions between four exposure groups of PCDDs/Fs-TEQ or 2,3,7,8-TetraCDD. However, social-emotional scores were decreased in the high PCDDs/Fs-TEQ group and the high 2,3,7,8-TetraCDD group compared with those with mild exposure, after adjusting for confounding factors. Cognitive scores in the mild, moderate, and high DDI groups were significantly higher than those in low DDI group, but there were no differences in cognitive scores among the three higher DDI groups. These results suggest that perinatal exposure to dioxins may affect social-emotional development of 1-year-old toddlers, without diminishing global neurodevelopmental function.

Levels of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in breast milk in Shanghai, China: A temporal upward trend

Human milk samples were collected from 150 mothers in 2011 and 2012 in Shanghai, China and analyzed for 17 polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and 12 dioxin-like polychlorinated biphenyls (DL-PCBs). The up-bound Toxic Equivalent Quantity (TEQ) ranged from 0.27 to 16.8 pg TEQ/g lipid (mean 5.4 pg TEQ/g lipid) for ∑PCDD/Fs and from 0.75 to 10.2 pg TEQ/g lipid (mean 2.9 pg TEQ/g lipid) for ∑DL-PCBs. TEQs in our study were lower than those in most countries worldwide, and displayed a notable uptrend, in contrast with those in China's national survey in 2007. TEQs in mother milks from urban areas were higher than those from rural areas, and an orderly distribution was found in four geographical regions: Eastern China>Central China≈Southwestern China>Northwestern China. Levels of analytes in Shanghai native mothers' milk ranked the first among those from all provinces and cities investigated. Migrant mothers to Shanghai from other inland provinces could potentially represent the population for exposure and risk assessment in their birth and grown-up places. Both the distribution and the uptrend were associated with release of these pollutants due to rapid industrialization and urbanization in China. Fine correlations were observed between TEQs and age of mothers, and weak correlations between TEQs and consumption of meat & meat products. Participants, who preferred both fresh water and marine fish to freshwater fish only, were prone to be exposed to higher level of PCBs. The estimated daily intake (EDI) doses for breastfed neonates entirely exceeded the tolerable intake dose by WHO.

Perinatal dioxin exposure and psychosocial and behavioral development in school-aged children

OBJECTIVE

The aim of this study was to elucidate the association between psychosocial and behavioral problems in children at school age and dioxin level in breast milk or estimated dioxin exposure (EDE) through breastfeeding in the general Japanese population.

METHODS

Dioxin level of breast milk at 1month of age and breastfeeding ratio through the first year of life were used to calculate the EDE of infants born in 1998-2005 in Japan. The Japanese Social Difficulties Questionnaire (SDQ) for the assessment of children's behavior was sent by mail to mothers whose breast milk underwent the dioxin survey, at the time when their infants were aged 6-13 years.

RESULTS

The study subjects were 175 pairs of mothers and their first infants (79 boys, 96 girls). The mean total dioxin levels of breast milk were 18.3 and 19.8 (pgTEQ/g fat) and EDEs were 16.4 and 19.6 (ngTEQ/kg/year) in boys and girls, respectively. In linear multiple regression analyses after adjusting for age at SDQ, maternal age, birth weight and maternal smoking habit, dioxin level in breast milk was not significantly related to the total difficulties score (TDS) of SDQ in boys, B=2.29 (95% CI -7.60-12.18), or in girls, B=-1.04 (95% CI -9.24-7.15). EDE correlated to the TDS in neither boys, B=-0.99 (95% CI -4.14-2.15), nor girls, B=1.08 (95% CI -2.69-4.85).

CONCLUSION

No evidence was found of a correlation between perinatal dioxin exposure and behavioral and psychosocial problems of children measured by SDQ. These results support the benefits of recommending breastfeeding.

Persistent organic pollutants in matched breast milk and infant faeces samples

Assessing blood concentration of persistent organic pollutants (POPs) in infants is difficult due to the ethical and practical difficulties in obtaining sufficient quantities of blood. To determine whether measuring POPs in faeces might reflect blood concentration during infancy, we measured the concentrations of a range of POPs (i.e. polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and organochlorine pesticides (OCPs)) in a pilot study using matched breast milk and infant faecal samples obtained from ten mother–child pairs. All infants were breast fed, with 8 of them also receiving solid food at the time of faecal sampling. In this small dataset faecal concentrations (range 0.01–41 ng g(−1) lipid) are strongly associated with milk concentrations (range 0.02–230 ng g(−1) lipid). Associations with other factors generally could not be detected in this dataset, with the exception of a small effect of age or growth. Different sources (external or internal) of exposure appeared to directly influence faecal concentrations of different chemicals based on different inter-individual variability in the faeces-to-milk concentration ratio Rfm. Overall, the matrix of faeces as an external measure of internal exposure in infants looks promising for some chemicals and is worth assessing further in larger datasets.

Lactational exposure to low levels of the six indicator non-dioxin-like polychlorinated biphenyls induces DNA damage and repression of neuronal activity, in juvenile male mice

Previously, we evaluated the effects of lactational exposure to a representative mixture of the six indicator non-dioxin-like polychlorinated biphenyls (∑6 NDL-PCBs) at low levels on the neurobiological changes and developmental/behavioral performances in mice. In this study, we analyzed the global gene expression profile in cerebellar neurons isolated from male mice presenting the most significant induction of anxiety-like behavior in our previous study (10 ng/kg ∑6 NDL-PCBs). Our results revealed changes in the expression of 16658 genes in the neurons of the exposed mice. Among these, 693 upregulated [fold change (FC)>2; p<0.05] and 665 downregulated (FC<2; p<0.05) genes were statistically linked to gene ontology terms (GO). Overexpressed genes belonged to GO terms involved with the cell cycle, DNA replication, cell cycle checkpoint, response to DNA damage stimulus, regulation of RNA biosynthetic processes, and microtubule cytoskeleton organization. Downregulated genes belonged to terms involved with the transmission of nerve impulses, projection neurons, synapse hands, cell junctions, and regulation of RNA biosynthetic processes. Using qPCR, we quantified gene expression related to DNA damage and validated the transcriptomic study, as a significant overexpression of Atm-Atr Bard1, Brca2, Fancd2, Figf, Mycn, p53 and Rad51 was observed between groups (p<0.001). Finally, using immunoblots we determined the expression level of six selected proteins. We found that changes in the protein expression of Atm Brca1, p53, Kcnma1, Npy4r and Scn1a was significant between exposed and control groups (p<0.05), indicating that the expression pattern of these proteins agreed with the expression pattern of their genes by qPCR, further validating our transcriptomic findings. In conclusion, our study showed that early life exposure of male mice to a low level of ∑6 NDL-PCBs induced p53-dependent responses to cellular stress and a decrease in the expression of proteins involved in the generation, conduction, and transmission of electrical signals in neurons.

Maldives: an archipelago that burns. A first survey of PCDD/Fs and DL-PCBs from human activities

Due to its geographical peculiarities, the Republic of Maldives represents a case study of great interest for the investigation of persistent organic pollutants, from both a socio-economic and an ecological perspective. Thus, we conducted a first survey to assess the current status of polychlorinated dibenzo-p-dioxin (PCDD), polychlorinated dibenzofuran (PCDF) and dioxin-like polychlorinated biphenyl (DL-PCB) concentrations in Maldivian soils. The range for PCDD/F and DL-PCB soil concentrations was 0.01-49.3 pg WHO2005-TEQ g(-1) and 0.01-3.69 pg WHO2005-TEQ g(-1) dw respectively. PCDD/F concentrations exceeding several international soil guidelines were found in samples from locations in the proximity of local waste combustion sources. DL-PCB concentrations were lower than PCDD/Fs and comparable to those in previous reports from background areas and in areas with developing industrial and agricultural activities. PCDD/F and DL-PCB levels (expressed as WHO2005-TEQ) in soils were strongly correlated (r=0.89), which suggests that, in most of the sites, they are originated from the same emission sources. Results indicate that PCDD/F soil concentrations (expressed as WHO2005-TEQ) tend to decrease with the distance from the local pollution sources. Principal component analysis (PCA) showed that PCDD/Fs in the most polluted locations are mainly generated by waste combustion. These findings highlight the need for immediate changes in waste management policies in the Archipelago, in order to reduce the release of Persistent Organic Pollutants (POPs) in the fragile local environment.

Current concepts in neuroendocrine disruption

In the last few years, it has become clear that a wide variety of environmental contaminants have specific effects on neuroendocrine systems in fish, amphibians, birds and mammals. While it is beyond the scope of this review to provide a comprehensive examination of all of these neuroendocrine disruptors, we will focus on select representative examples. Organochlorine pesticides bioaccumulate in neuroendocrine areas of the brain that directly regulate GnRH neurons, thereby altering the expression of genes downstream of GnRH signaling. Organochlorine pesticides can also agonize or antagonize hormone receptors, adversely affecting crosstalk between neurotransmitter systems. The impacts of polychlorinated biphenyls are varied and in many cases subtle. This is particularly true for neuroedocrine and behavioral effects of exposure. These effects impact sexual differentiation of the hypothalamic-pituitary-gonadal axis, and other neuroendocrine systems regulating the thyroid, metabolic, and stress axes and their physiological responses. Weakly estrogenic and anti-androgenic pollutants such as bisphenol A, phthalates, phytochemicals, and the fungicide vinclozolin can lead to severe and widespread neuroendocrine disruptions in discrete brain regions, including the hippocampus, amygdala, and hypothalamus, resulting in behavioral changes in a wide range of species. Behavioral features that have been shown to be affected by one or more these chemicals include cognitive deficits, heightened anxiety or anxiety-like, sociosexual, locomotor, and appetitive behaviors. Neuroactive pharmaceuticals are now widely detected in aquatic environments and water supplies through the release of wastewater treatment plant effluents. The antidepressant fluoxetine is one such pharmaceutical neuroendocrine disruptor. Fluoxetine is a selective serotonin reuptake inhibitor that can affect multiple neuroendocrine pathways and behavioral circuits, including disruptive effects on reproduction and feeding in fish. There is growing evidence for the association between environmental contaminant exposures and diseases with strong neuroendocrine components, for example decreased fecundity, neurodegeneration, and cardiac disease. It is critical to consider the timing of exposures of neuroendocrine disruptors because embryonic stages of central nervous system development are exquisitely sensitive to adverse effects. There is also evidence for epigenetic and transgenerational neuroendocrine disrupting effects of some pollutants. We must now consider the impacts of neuroendocrine disruptors on reproduction, development, growth and behaviors, and the population consequences for evolutionary change in an increasingly contaminated world. This review examines the evidence to date that various so-called neuroendocrine disruptors can induce such effects often at environmentally-relevant concentrations.

Breastfeeding and risk of atopic dermatitis up to the age 42 months: a birth cohort study in Japan

PURPOSE

The purpose of this study was to investigate the association between breastfeeding and atopic dermatitis (AD) up to the age 42 months.

METHODS

Data from a nationally representative population-based birth cohort study in Japan were used (N = 38,757). Feeding pattern and breastfeeding duration were investigated via questionnaires when infants were aged 6 months. Physician-diagnosed AD during the previous 1 year was ascertained via questionnaires when the children were aged 18, 30, and 42 months. The associations between feeding patterns or breastfeeding duration and physician-diagnosed AD from the age 6 to 42 months, categorized by AD status (no history of AD, episodic AD, and persistent AD), were analyzed using ordered logistic regression adjusted for covariates.

RESULTS

Breastfeeding was positively associated with AD, with dose-response association (P for trend < .001). Exclusively breastfed infants were 1.26 times more likely to have AD (95% confidence interval, 1.12-1.41) than infants fed formula alone. Furthermore, children with a longer breastfeeding duration were also significantly more likely to have AD (P for trend < .001).

CONCLUSIONS

Breastfeeding is associated with an increased risk of AD up to the age 42 months. Further study is needed to elucidate the mechanism underlying the association between breastfeeding and AD.