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

Mixtures of serum concentrations of organochlorine pesticides and breastfeeding duration

The relationship between breastfeeding duration and maternal mixtures of organochlorine pesticides (OCP) biological concentrations has not been documented. For that reason, our objective was to evaluate the association between lactation duration and mixtures of OCP serum concentrations and their principal metabolites, as well as to identify the primary contributors within these mixtures. Consequently, we conducted a secondary analysis of 878 women over 18 years old who had at least one living child and served as controls in a population-based study from 2007 to 2011 in Northern Mexico. Through direct interviews, we collected data on breastfeeding duration, sociodemographic characteristics, and medical history. We determined serum concentrations of 24 OCP, including some metabolites, using gas chromatography with an electron microcapture detector. We applied Weighted Quantile Sum (WQS) regression models with binomial family specification to assess the relationship between breastfeeding duration (both for the first child and all children) and mixtures of OCP serum concentrations and their metabolites of interest. We identified a mixture of OCP negatively associated with breastfeeding the first child (OR = 0.63, 95% CI 0.52-0.77) and all children (OR = 0.59, 95% CI 0.46-0.75). The significant OCP or metabolites in both mixtures included p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), trans-nonachlor, β-hexachlorocyclohexane (β-HCH), p,p'-dichlorodiphenyldichloroethane (p,p'-DDD), heptachlor, and hexachlorobenzene (HCB). Our results suggest serum concentrations of OCP mixtures in women who breastfed for at least 12 months are lower than those who breastfed for less than that time. Future studies are needed to evaluate the risk-benefit of multiple OCP in breast milk for maternal and child health.

Mammalian lipid droplets: structural, pathological, immunological and anti-toxicological roles

Mammalian lipid droplets (LDs) are specialized cytosolic organelles consisting of a neutral lipid core surrounded by a membrane made up of a phospholipid monolayer and a specific population of proteins that varies according to the location and function of each LD. Over the past decade, there have been significant advances in the understanding of LD biogenesis and functions. LDs are now recognized as dynamic organelles that participate in many aspects of cellular homeostasis plus other vital functions. LD biogenesis is a complex, highly-regulated process with assembly occurring on the endoplasmic reticulum although aspects of the underpinning molecular mechanisms remain elusive. For example, it is unclear how many enzymes participate in the biosynthesis of the neutral lipid components of LDs and how this process is coordinated in response to different metabolic cues to promote or suppress LD formation and turnover. In addition to enzymes involved in the biosynthesis of neutral lipids, various scaffolding proteins play roles in coordinating LD formation. Despite their lack of ultrastructural diversity, LDs in different mammalian cell types are involved in a wide range of biological functions. These include roles in membrane homeostasis, regulation of hypoxia, neoplastic inflammatory responses, cellular oxidative status, lipid peroxidation, and protection against potentially toxic intracellular fatty acids and lipophilic xenobiotics. Herein, the roles of mammalian LDs and their associated proteins are reviewed with a particular focus on their roles in pathological, immunological and anti-toxicological processes.

Correlates of plasma concentrations of brominated flame retardants in a cohort of U.S. Black women residing in the Detroit, Michigan metropolitan area

BACKGROUND

Polybrominated diphenyl ethers (PBDEs) and polybrominated biphenyls (PBBs) are brominated flame retardant chemicals detectable in the environment and U.S. population, and are associated with adverse health outcomes over the life course. Correlates of these organic pollutants are understudied among U.S. Black women.

METHODS

Using baseline data from a prospective cohort study of U.S. Black women aged 23-35 years from the Detroit area of Michigan (2010-2012), we examined correlates of PBDEs and PBB-153. Non-fasting blood samples were collected from 742 participants at enrollment, a subset of women selected for a case-cohort study of environmental chemicals. Data on socio-demographics, behaviors, diet, medical history, and early-life exposures were collected via self-administered questionnaires, telephone interviews, and in-person clinic visits. We fit linear regression models to calculate percent differences and 95% confidence intervals in lipid adjusted plasma concentrations of 11 individual PBDE congeners and PBB-153 for each baseline predictor.

RESULTS

In models adjusted for all other correlates, a 5-year increase in age was inversely associated with most PBDE congeners (% differences ranged from 6 to 15% lower), and was positively associated with PBB-153 (52% higher). A 5-kg/m2 increase in BMI was inversely associated with PBDE-153 and PBB-153 (16% lower for both), and 6% higher for PBDE-28. Compared with having never been breastfed in infancy, ≥3 months of breastfeeding in infancy was associated with 69% higher PBB-153 concentrations. Lower education, current smoking, and heavy alcohol use were associated with higher plasma concentrations of most flame retardants. Diet was not an important predictor.

CONCLUSION

Important correlates for elevated body burdens of PBB-153 were increasing age and a history of having been breastfed in infancy. Education, smoking, and heavy alcohol use were important predictors of elevated body burdens of most flame retardants. This study fills an important gap in the environmental health literature by focusing on an understudied population.

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.

Environmental Chemicals in Breast Milk and Formula: Exposure and Risk Assessment Implications

BACKGROUND

Human health risk assessment methods have advanced in recent years to more accurately estimate risks associated with exposure during childhood. However, predicting risks related to infant exposures to environmental chemicals in breast milk and formula remains challenging.

OBJECTIVES

Our goal was to compile available information on infant exposures to environmental chemicals in breast milk and formula, describe methods to characterize infant exposure and potential for health risk in the context of a risk assessment, and identify research needed to improve risk analyses based on this type of exposure and health risk information.

METHODS

We reviewed recent literature on levels of environmental chemicals in breast milk and formula, with a focus on data from the United States. We then selected three example publications that quantified infant exposure using breast milk or formula chemical concentrations and estimated breast milk or formula intake. The potential for health risk from these dietary exposures was then characterized by comparison with available health risk benchmarks. We identified areas of this approach in need of improvement to better characterize the potential for infant health risk from this critical exposure pathway.

DISCUSSION

Measurements of chemicals in breast milk and formula are integral to the evaluation of risk from early life dietary exposures to environmental chemicals. Risk assessments may also be informed by research investigating the impact of chemical exposure on developmental processes known to be active, and subject to disruption, during infancy, and by analysis of exposure-response data specific to the infant life stage. Critical data gaps exist in all of these areas.

CONCLUSIONS

Better-designed studies are needed to characterize infant exposures to environmental chemicals in breast milk and infant formula as well as to improve risk assessments of chemicals found in both foods. https://doi.org/10.1289/EHP1953.

Infant Dietary Exposures to Environmental Chemicals and Infant/Child Health: A Critical Assessment of the Literature

BACKGROUND

The benefits of breastfeeding to the infant and mother have been well documented. It is also well known that breast milk contains environmental chemicals, and numerous epidemiological studies have explored relationships between background levels of chemicals in breast milk and health outcomes in infants and children.

OBJECTIVES

In this paper, we examine epidemiological literature to address the following question: Are infant exposures to background levels of environmental chemicals in breast milk and formula associated with adverse health effects? We critically review this literature a) to explore whether exposure-outcome associations are observed across studies, and b) to assess the literature quality.

METHODS

We reviewed literature identified from electronic literature searches. We explored whether exposure-outcome associations are observed across studies by assessing the quality (using a modified version of a previously published quality assessment tool), consistency, and strengths and weaknesses in the literature. The epidemiological literature included cohorts from several countries and examined infants/children either once or multiple times over weeks to years. Health outcomes included four broad categories: growth and maturation, morbidity, biomarkers, and neurodevelopment.

RESULTS

The available literature does not provide conclusive evidence of consistent or clinically relevant health consequences to infants exposed to environmental chemicals in breast milk at background levels.

CONCLUSIONS

It is clear that more research would better inform our understanding of the potential for health impacts from infant dietary exposures to environmental chemicals. A critical data gap is a lack of research on environmental chemicals in formula and infant/child health outcomes. https://doi.org/10.1289/EHP1954.

Developmental exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin may alter LH release patterns by abolishing sex differences in GABA/glutamate cell number and modifying the transcriptome of the male anteroventral periventricular nucleus

Developmental exposure to arylhydrocarbon receptor (AhR) ligands abolishes sex differences in a wide range of neural structures and functions. A well-studied example is the anteroventral periventricular nucleus (AVPV), a structure that controls sex-specific luteinizing hormone (LH) release. In the male, testosterone (T) secreted by the developing testes defeminizes LH release mechanisms; conversely, perinatal AhR activation by 2,3,7,8,-tetrachlorodibenzo-p-dioxin (TCDD) blocks defeminization. To better understand developmental mechanisms altered by TCDD exposure, we first verified that neonatal TCDD exposure in male rats prevented the loss of AVPV GABA/glutamate neurons that are critical for female-typical LH surge release. We then used whole genome arrays and quantitative real-time polymerase chain reaction (QPCR) to compare AVPV transcriptomes of males treated neonatally with TCDD or vehicle. Our bioinformatics analyses showed that TCDD enriched gene sets important for neuron development, synaptic transmission, ion homeostasis, and cholesterol biosynthesis. In addition, upstream regulatory analysis suggests that both estrogen receptors (ER) and androgen receptors (AR) regulate genes targeted by TCDD. Of the 23 mRNAs found to be changed by TCDD at least 2-fold (p<0.05), most participate in the functions identified in our bioinformatics analyses. Several, including matrix metallopeptidase 9 and SRY-box 11 (Sox11), are known targets of E2. CUG triplet repeat, RNA binding protein 2 (cugbp2) is particularly interesting because it is sex-specific, oppositely regulated by estradiol (E2) and TCDD. Moreover, it regulates the post-transcriptional processing of molecules previously linked to sexual differentiation of the brain. These findings provide new insights into how TCDD may interfere with defeminization of LH release patterns.

Biological monitoring of Persistent Organic Pollutants in human milk in Israel

BACKGROUND

The Stockholm Convention on Persistent Organic Pollutants (POPs) aims to eliminate or restrict the production and use of POPs around the globe. The Ministry of Health, collaborating with the Ministry of Environmental Protection, measured the exposure of the population to POPs as part of the WHO-coordinated exposure study. Human milk, with a relatively high fat content is a preferred matrix for the monitoring of exposure.

METHODS

Donors of breast milk were recruited from three hospitals after signing informed consent forms. Breast milk was collected from 52 primipara women, aged 23-35, living in Israel for the last 10 years who gave birth to singleton full term healthy infants. Samples, collected at 3-17 weeks postpartum, were stored at -20 °C until sent to the WHO Reference Laboratory, State Laboratory for Chemical and Veterinary Analysis of Food (CVUA), in Frieburg, Germany for a single pooled analysis. Mothers were provided with the pooled analysis results.

RESULTS

Out of over 50 Persistent Organic Pollutants listed in the analysis, 16, including aldrin, endrin, parlar and mirex were not found at detectable levels in the Israeli pooled sample. For the indicator compounds found at detectable levels, most were lower than those reported in European countries.

DISCUSSION

Since 1982, levels of POPs contamination as measured in breast milk have declined significantly. This is likely due to restrictions on agricultural, industrial, and other uses of many POPs in Israel. Ongoing biomonitoring in Israel and inter-ministerial collaboration supports the elimination of POPs in the environment and human milk.

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.

Polychlorinated dioxins, furans (PCDD/Fs), and polychlorinated biphenyls (PCBs) and their trends in Canadian human milk from 1992 to 2005

More than 300 samples of human milk were collected from individuals residing in various regions across Canada in the years 1992 to 2005. The milks were taken from the main populated areas east to west in southern Canada as well as from the region of Nunavik in northern Quebec and analysed for polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs). The concentrations, expressed in ng kg(-1) milk lipid, show an overall decrease of virtually all compounds examined including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), World Health Organization 2005 toxic equivalents (WHO2005-TEQ) PCDD/PCDFs, WHO2005-TEQ dioxin-like PCBs (dl-PCBs), and total PCBs. Median values of 2,3,7,8-TCDD changed from about 1.5 ng kg(-1) milk lipid in 1992 to 0.8 ng kg(-1) in 2005 while the median WHO2005-TEQ PCDD/F fell from about 14-7 ng kg(-1) milk lipid in the same period. The concentrations of PCDD/Fs and PCBs in samples from Nunavik, which is in Arctic Quebec, were higher than those observed in milk from southern Quebec although this difference was not large. Over two time periods, milk samples from Hamilton, Ontario showed slightly higher levels of PCBs than Austin, Texas, USA--a North American city of similar size and development but with more than twice the PBDE exposure. When compared with earlier human milk data going back to the early 1980s, this large data set shows a steady decline of human exposure to POPs in Canada by a factor of about four times.

Temporal trends of polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in mothers' milk from Sweden, 1972-2011

Temporal trends of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in mothers' milk are still quite rare. Data are particularly scarce when it comes to concentrations from the last decade, 2000 and onwards. The aims of the present study were to assess temporal trends of PCDD, PCDF and DL-PCB in mothers' milk from Stockholm, 1972-2011 and to compare the results with previous analysis of some of the older samples. The samples were analyzed by high resolution GC/MS and results were statistically evaluated for the periods, 1972-2011 and 2002-2011. The rate of which ∑PCDDs, ∑DL-PCBs and the ∑TEQ are decreasing (on pg/g fat WHO-TEQ2005) is higher in the last decade compared to the 40year period, 1972-2011. A similar trend is indicated, but not confirmed, for ∑TEQ of PCDFs, probably due to too many PCDF congeners below LOQ in the period 2002-2011. Concentrations of ∑PCDDs, ∑PCDFs, ∑DLPCBs and ∑TEQ, all expressed as pg/g fat on TEQ-WHO2005-basis, show a statistically significant decline over time, 5.8-6.8% per year, 1972-2011. The last ten years the annual declines for ∑PCDDs, ∑DL-PCBs and ∑TEQ are 9.2-11% and for ∑PCDF, 5.4%. Congener specific trend analysis, 2002-2001, of PCDDs and DL-PCBs showed the same pattern, while the PCDF congeners showed no such general trend. The results from the re-analysis showed good agreement with slightly lower ∑TEQ1998 pg/g fat concentrations in six out of seven samples and mean difference of 13% in ∑TEQ1998. The study shows that time series can be elongated from previous studies, as long as the sample population remains the same.

Levels of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in human milk from different regions of France

We report on the pilot study carried out before the start of the Elfe project (French longitudinal study from childhood). A total of 44 samples of mature human milk were collected at home 8 weeks after delivery. A total of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), 12 dioxin-like (DL) polychlorinated biphenyls (PCBs), and 6 non dioxin-like (NDL)-PCBs were measured. For total TEQ (PCDD/Fs and DL-PCBs), the geometric mean concentration was 17.81 pg TEQ(WHO05)/g lipids. Relative PCDD, PCDF, and DL-PCB contributions to the arithmetic mean TEQ(WHO05) were 38%, 18%, and 44%, respectively. The use of TEF(WHO05) instead of TEF(WHO98) resulted in a 27% reduction of the total TEQ value. Although PCDD levels did not significantly change (less than 0.5% increase), PCDF and DL-PCB levels both decreased by 35% and 38%, respectively. Levels have been compared to data obtained during a previous non-reported national study conducted in 1998 (TEF(WHO98)) in French lactaria (n=244). The mean of PCDD/Fs has decreased about 39.4% (18.8 pg TEQ(WHO98)/g lipids in 1998 vs 11.4 pg TEQ(WHO98)/g lipids in pilot study), respectively 41.5% for PCDDs (10.6 pg TEQ(WHO98)/g lipids in 1998 vs 6.2 pg TEQ(WHO98)/g lipids in pilot study) and 36.7% for PCDFs (7.9 pg TEQ(WHO98)/g lipids in 1998 vs 5.0 pg TEQ(WHO98)/g lipids in pilot study). For the sum of the 6 NDL-PCBs, the 2007 geometric mean concentration in milk was 176.3 ng/g lipids. The arithmetic mean lipid concentration in 2007 breast milk was 26.4 g/l (range from 6.0 to 46.7 g/l). A PCDD/F and DL-PCB daily intake was estimated to be 62.3 pg TEQ(WHO05)/kg body weight per day (85.0 pg TEQ(WHO98)/kg body weight per day) for a baby of 5 kg of body weight fed daily with 700 ml of maternal milk containing 25 g/l of lipids.

Dioxins in ascites and serum of women with endometriosis: a pilot study

BACKGROUND

Animal studies and laboratory experiments have demonstrated that exposure to dioxins may be involved in the pathophysiology of endometriosis. However, recent epidemiological investigations have shown conflicting results. Although peritoneal fluid is a specific microenvironment playing a pivotal role in the development of endometriosis, to our knowledge, there is no published study evaluating the concentrations of dioxins in serum and peritoneal fluid simultaneously. The present study explores the possible correlation between the local peritoneal fluid levels of dioxins and concurrent endometriosis.

METHODS

There were 17 infertile women enrolled in the present study. After the diagnostic laparoscopic examination, the women were divided into two groups: endometriosis (n = 10) and controls (n = 7). We measured 29 dioxins simultaneously in serum and peritoneal fluid samples: 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), and 12 polychlorinated biphenyls (dioxin-like PCBs). A dioxin toxic equivalency (TEQ) system was utilized to calculate the dioxin concentration in each sample.

RESULTS

Serum concentrations of itemized components of 29 dioxins were similar in the endometriosis patients compared with the controls. Higher concentrations of PCDFs and dioxin-like PCBs were observed in peritoneal fluid than in serum, whereas the reverse was shown for PCDDs. Statistical analysis showed that higher levels of dioxin TEQ (PCDDs and PCDFs) in peritoneal fluid were significantly associated with an increased risk of endometriosis (OR: 2.5; 95% CI: 1.17-5.34; P = 0.035).

CONCLUSIONS

This is the first report suggesting that higher concentrations of dioxins (PCDDs and PCDFs) in peritoneal fluid are linked to endometriosis. More detail and epidemiological research is warranted to further explore this link.

Environmental pollutants and the thyroid

Common environmental exposures may affect thyroid function in humans. Foetuses and infants are most vulnerable to these effects because they need thyroid hormone for normal neurodevelopment. Perchlorate, thiocyanate and nitrate are all competitive inhibitors of the sodium/iodine symporter (NIS) in pharmacologic doses, but their effects on human thyroid function at environmental exposure levels remain unclear. Many compounds, including polychlorinated biphenyls (PCBs), polybrominated diphenylethers (PBDEs), bisphenol-A (BPA) and triclosan, may have direct actions on the thyroid hormone receptor, but these effects are complex and are not yet well understood. Isoflavones inhibit thyroperoxidase (TPO) activity, and, therefore, may cause goitre and hypothyroidism if ingested at high levels, particularly in iodine-deficient individuals. Organochlorine pesticides and dioxins may decrease serum T(4) half-life by activating hepatic enzymes. Additional studies are needed to further elucidate the risk posed by these and other potentially thyroid-disrupting compounds.

Do human milk concentrations of persistent organic chemicals really decline during lactation? Chemical concentrations during lactation and milk/serum partitioning

BACKGROUND

Conventional wisdom regarding exposures to persistent organic chemicals via breast-feeding assumes that concentrations decline over the course of lactation and that the mother's body burden reflects her cumulative lifetime exposure. Two important implications stemming from these lines of thought are, first, that assessments of early childhood exposures should incorporate decreasing breast milk concentrations over lactation; and, second, that there is little a breast-feeding mother can do to reduce her infant's exposures via breast-feeding because of the cumulative nature of these chemicals.

OBJECTIVES

We examined rates of elimination and milk/serum partition coefficients for several groups of persistent organic chemicals.

METHODS

We collected simultaneous milk and blood samples of 10 women at two times postpartum and additional milk samples without matching blood samples.

RESULTS

Contrary to earlier research, we found that lipid-adjusted concentrations of polybrominated diphenyl ethers, polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins and furans, and organochlorine pesticides in serum and milk do not consistently decrease during lactation and can increase for some women. Published research has also suggested an approximate 1:1 milk/serum relationship (lipid adjusted) on a population basis for 2,3,7,8-tetrachlorodibenzo-p-dioxin; however, our results suggest a more complex relationship for persistent, lipophilic chemicals with the milk/serum relationship dependent on chemical class.

CONCLUSIONS

Decreases in concentration of lipophilic chemicals on a lipid-adjusted basis during lactation should no longer be assumed. Thus, the concept of pumping and discarding early milk as means of reducing infant exposure is not supported. The hypothesis that persistent lipophilic chemicals, on a lipid-adjusted basis, have consistent concentrations across matrices is likely too simplistic.

Perspective on serum dioxin levels in the United States: an evaluation of the NHANES data

The Centers for Disease Control and Prevention released its third set of nationally representative data on serum levels of polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-ortho and coplanar polychlorinated biphenyls (PCBs) in the United States collected during the 2003-2004 sampling period as part of the National Health and Nutrition Examination Survey (NHANES). We utilize the serum PCDD/F data from the three NHANES sampling periods spanning 1999-2004 to assess whether there are discernable temporal trends in the United States, either for the overall population or by age. We also compare population serum data to biomonitoring equivalents (BEs) derived for PCDDs/Fs/PCBs; BEs are estimates of the concentration of PCDD/Fs/PCBs corresponding to existing exposure guidance values estimated by various governmental agencies. The serum PCDD/F data from 1999 to 2004 provide evidence that levels in the US population are declining, mirroring international trends, although the lower levels are principally observable in the 2003-2004 time period. Examining the trend by population age, from the 1999 to 2004, PCDD/F serum levels decreased by 56% for the 12-to 19-year-old group and by 38% for the 20-to 39-year olds. A slight nonsignificant decrease was observed for 40-to 59-year olds and a slight significant increase was found for 60+ year olds. Interpretation of the data across time is complicated by certain aspects of the data unique to the various sampling time periods; thus, caution should be exercised when evaluating trend information. The population mean PCDD/F/PCB TEQ is approximately equal to the BE based on the Agency for Toxic Substances and Disease Registry's Minimum Risk Level and is approximately 2-4 times lower than the remaining BEs, placing the population mean at the border between medium and low priority levels. However, certain segments of the population have levels at the medium/high priority level (e.g., the 95th percentiles for ages 60 years and older).

Concentrations of PCDD/Fs, PCBs and PBDEs in breast milk of women from Catalonia, Spain: a follow-up study

The concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) were determined in breast milk from women living in the vicinity of a new hazardous waste incinerator (HWI) in Catalonia, Spain. The results were compared with the levels obtained in two previous surveys carried out in 1998 (baseline study) and 2002. The current concentrations of PCDD/Fs in breast milk ranged from 45 to 143 pg/g fat (2.8 to 11.2 pg WHO-TEQ/g fat), while total PCBs ranged from 114 to 617 pg/g fat (2.8 to 17.6 pg WHO-TEQ/g fat). PBDE concentrations (sum 15 congeners) ranged from 0.57 ng/g fat to 5.9 ng/g fat, with a mean value of 2.5 ng/g fat. A general decrease of the concentrations for PCDD/Fs and both planar and total PCBs was observed. Regarding to PBDE concentrations in breast milk, similar levels between the 2002 and the present study were noted. The levels of PCDD/Fs and PCBs in milk of women living in urban areas were higher than those corresponding to the industrial zones (38% and 40%, respectively). However, the current PBDE levels were slightly lower (13%) in the urban than in the industrial zone. For PCDD/Fs and PCBs, the current decreases are in accordance with the reduction in the dietary intake of these pollutants found in recent studies carried out in the same area of study.

The heart of the matter on breastmilk and environmental chemicals: essential points for healthcare providers and new parents

Abstract The increasing number of environmental chemicals measured in breastmilk is a consequence of improved analytical capabilities and the increased interest in biomonitoring. It has been generally concluded that the benefits to the infant from breastfeeding outweigh potential risks associated with environmental chemical exposures associated with breastfeeding. However, there have been reports of subtle effects on infants associated with chemicals in breastmilk. Associations between concentrations of chemicals in breastmilk and a biochemical or other change in infants may signal the need for further study or regulatory action, whereas on an individual level, these changes may not be considered adverse. For healthcare providers, this distinction is critical, as many in the field are being asked for nuanced information on risks and benefits associated with breastfeeding, and this information is not readily available. Recognizing the challenge faced by healthcare providers, we have explored and developed a case study on dioxins in breastmilk. The essential conclusion for healthcare providers and new parents is that in studies of breastfed versus formula-fed infants across time, including times when levels of environmental chemicals such as dioxins were higher, beneficial effects associated with breastfeeding have been found. The current evidence does not support altering the World Health Organization recommendations promoting and supporting breastfeeding.

Human breast biomonitoring and environmental chemicals: use of breast tissues and fluids in breast cancer etiologic research

Extensive research indicates that the etiology of breast cancer is complex and multifactorial and may include environmental risk factors. Breast cancer etiology and exposure to xenobiotic compounds, diet, electromagnetic fields, and lifestyle have been the subject of numerous scientific inquiries, but research has yielded inconsistent results. Biomonitoring has been used to explore associations between breast cancer and levels of environmental chemicals in the breast. Research using breast tissues and fluids to cast light on the etiology of breast cancer is, for the most part, predicated on the assumption that the tissue or fluid samples either contain measurable traces of the environmental agent(s) associated with the cancer or that they retain biological changes that are biomarkers of such exposure or precursors of carcinogenic effect. In this paper, we review breast cancer etiology research utilizing breast biomonitoring. We first provide a brief synopsis of the current state of understanding of associations between exposure to environmental chemicals and breast cancer etiology. We then describe the published breast cancer research on tissues and fluids, which have been used for biomonitoring, specifically human milk and its components, malignant and benign breast tissue, nipple aspirate fluid (NAF) and breast cyst fluid. We conclude with a discussion on recommendations for biomonitoring of breast tissues and fluids in future breast cancer etiology research. Both human milk and NAF fluids, and the cells contained therein, hold promise for future biomonitoring research into breast cancer etiology, but must be conducted with carefully delineated hypotheses and a scientifically supportable epidemiological approach.