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Cherkani-Hassani A, Slaoui M, Ghanname I, Mojemmi B, Eljaoudi R, Belhaj A, Kers B, Flayou M, Mouane N. Lead concentrations in breast milk of Moroccan nursing mothers and associated factors of exposure: CONTAMILK STUDY. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 85:103629. [PMID: 33684565 DOI: 10.1016/j.etap.2021.103629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
The aim of CONTAMILK study was to estimate levels of contamination of breast milk (BM) of Moroccan nursing mothers by some xenobiotics including, lead (Pb), to identify associated factors of exposure and to determine the daily intake of newborns. Lead concentrations were determined in 70 samples of colostrum by ICPMS and a structured questionnaire was filled during milk collection to report participants' data. The median lead concentration was 908 μg/L (range 1.38-515,39 μg/L) and in 79 % of samples, levels were higher than the normal range reported by the World Health Organization (WHO) in BM (2-5 μg/L). Indeed, preterm delivery, frequency of use of cosmetic powders and lipsticks were significantly associated with the level of lead in BM. The estimated daily intake was greater than the tolerable daily intake (TDI) of the European food safety authority (0.5 μg/kg/day) for 39 babies and 6 babies according to the WHO (3.6 μg/kg/day).
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Affiliation(s)
- Abha Cherkani-Hassani
- Unit of training and research in Nutrition and Food Science. Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco; Laboratory of analytical chemistry and food science, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.
| | | | - Imane Ghanname
- Team research of Pharmacoeconomics and Pharmacoepidemiology, Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, University Mohammed V, Morocco; Faculty of health sciences, International University of Casablanca, Morocco
| | - Brahim Mojemmi
- Laboratory of analytical chemistry and food science, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
| | - Rachid Eljaoudi
- Laboratory of pharmacology and toxicology, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
| | - Abdelilah Belhaj
- Laboratory of Quality Control of Waters, National Office of Electricity and Drinking Water (ONEE), Rabat, Morocco
| | - Brahim Kers
- Laboratory of Quality Control of Waters, National Office of Electricity and Drinking Water (ONEE), Rabat, Morocco
| | - Majda Flayou
- Laboratory of Quality Control of Waters, National Office of Electricity and Drinking Water (ONEE), Rabat, Morocco
| | - Nezha Mouane
- Unit of training and research in Nutrition and Food Science. Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco; Department of Pediatric, Hepatology, Gastroenterology and Nutrition PIII-Children's Hospital, Rabat, Morocco
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Vasios G, Kosmidi A, Kalantzi OI, Tsantili-Kakoulidou A, Kavantzas N, Theocharis S, Giaginis C. Simple physicochemical properties related with lipophilicity, polarity, molecular size and ionization status exert significant impact on the transfer of drugs and chemicals into human breast milk. Expert Opin Drug Metab Toxicol 2016; 12:1273-1278. [PMID: 27573378 DOI: 10.1080/17425255.2016.1230197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The transfer of xenobiotic compounds into human breast milk has raised serious concerns in the last few years. The present study is aimed to assess whether simple physicochemical properties exert significant impact on human breast milk transfer of drugs and chemicals. METHODS A large data set of 375 xenobiotic compounds with available experimental milk to plasma (M/P) ratios was systematically compiled from the literature and explored with their physicochemical properties being further analyzed with respect to their extent to transfer into breast milk. RESULTS Xenobiotic compounds with increased breast milk transfer (M/P ≥ 1) were characterized by enhanced lipophilicity and decreased molecular size (p < 0.05). Enhanced polarity and hydrogen bonding capacity were more frequently observed in xenobiotic compounds with reduced breast milk transfer (p < 0.0001). Xenobiotic compounds presenting increased positive charge at pH 7.4 were characterized by enhanced breast milk transfer (p < 0.001). Xenobiotic compounds presenting increased negative charge at pH 7.4 were characterized by decreased breast milk transfer (p < 0.001). CONCLUSIONS The present study supports evidence that simple physicochemical properties related with lipophilicity, polarity, molecular size and ionization status exert significant impact on drugs and chemicals transport into human breast milk.
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Affiliation(s)
- George Vasios
- a Department of Food Science and Nutrition, School of Environment , University of the Aegean , Lemnos , Greece
| | - Aggeliki Kosmidi
- a Department of Food Science and Nutrition, School of Environment , University of the Aegean , Lemnos , Greece
| | - Olga-Ioanna Kalantzi
- b Department of Environment, School of Environment , University of the Aegean , Lesvos , Greece
| | - Anna Tsantili-Kakoulidou
- c Department of Pharmaceutical Chemistry, School of Pharmacy , University of Athens , Athens , Greece
| | - Nikolaos Kavantzas
- d First Department of Pathology, Medical School , University of Athens , Athens , Greece
| | - Stamatios Theocharis
- d First Department of Pathology, Medical School , University of Athens , Athens , Greece
| | - Constantinos Giaginis
- a Department of Food Science and Nutrition, School of Environment , University of the Aegean , Lemnos , Greece
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Berlin CM, van den Anker JN. Safety during breastfeeding: drugs, foods, environmental chemicals, and maternal infections. Semin Fetal Neonatal Med 2013; 18:13-8. [PMID: 23131768 DOI: 10.1016/j.siny.2012.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The two ultimate goals of using maternal medications during breastfeeding are (i) to provide definitive therapy for maternal conditions for which the drugs have been prescribed, and (ii) to assure protection of the nursing infant from any adverse event related to his/her mother's treatment. Fortunately there are only a few drugs that have been identified as potentially causing harm to the infant. Analytic techniques exist to measure compounds in concentrations as small as nanograms per liter of milk. For nearly all compounds these very small amounts would not be able to exert pharmacological activity, even if absorbed by the infant via the oral route. For environmental chemicals, this ability to measure very small amounts exceeds our knowledge of any biological activity. Concern over any possible adverse event to the nursing infant should take into account the drug, its dose, the age of the infant, recognition of the interindividual variation in drug response and the role of pharmacogenetics. The latter two variables are closely linked.
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Affiliation(s)
- Cheston M Berlin
- Department of Pediatrics, Penn State Children's Hospital, Milton S. Hershey Medical Center, P.O. Box 850, MC HS83, Hershey, PA 17033, USA.
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Dórea JG, Fenton SE, LaKind JS, Berlin CM. Researching chemicals in human milk can be conducted without discouraging breastfeeding. Bosn J Basic Med Sci 2012; 12:137-8. [PMID: 22642600 DOI: 10.17305/bjbms.2012.2515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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LaKind JS, Berlin CM, Stokes JL, Naiman DQ, Paul IM, Patterson DG, Jones RS, Niehüser S, Wang RY, Needham LL, Lorber MN, Sjödin A. Lifestyle and polybrominated diphenyl ethers in human milk in the United States: A pilot study. TOXICOLOGICAL & ENVIRONMENTAL CHEMISTRY 2008; 90:1047-1054. [DOI: 10.1080/02772240801937230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
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Kim SR, Halden RU, Buckley TJ. Polycyclic aromatic hydrocarbons in human milk of nonsmoking U.S. women. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2008; 42:2663-2667. [PMID: 18505013 DOI: 10.1021/es702275x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The determination of polycyclic aromatic hydrocarbons (PAHs) in human milk is relevant in assessing the dose to mothers and infants. Since measurements for the United States are lacking, we analyzed 13 PAHs in human milk from 12 nonsmoking American mothers. Analytes were extracted from milk by using a combination of centrifugation, liquid-liquid, and solid-phase extraction techniques. Following method validation with spiked bovine milk, PAH concentrations in human milk were determined by isotope dilution gas chromatography/mass spectrometry. Phenanthrene, fluorene, fluoranthene, and pyrene were found at median concentrations of 11.8, 3.0, 1.6, and 1.1 ng/g milk fat, respectively, whereas 9 additional analytes including benzo[a]pyrene were not detected (<0.04 ng/g). Calculated average daily doses from ingestion (high: 75.8, phenanthrene; low: 6.1 ng/kg/day pyrene) were compared to doses from air pollution inhalation. Milk ingestion accounted for 47.9-81.4% of the total dose of individual PAHs to the infant. However, calculated total average daily doses of phenanthrene and pyrene from ingestion and inhalation combined (12.2 to 110.3 ng/kg-day, respectively) were 3 orders of magnitude lower than documented doses known to cause health effects. These first measurements of PAH levels in U.S. human milk are comparable to concentrations reported previously for European and Asian women.
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Affiliation(s)
- Sung R Kim
- Department of Environmental Health Sciences Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205, USA.
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McCarty LS, Borgert CJ. Review of the toxicity of chemical mixtures: Theory, policy, and regulatory practice. Regul Toxicol Pharmacol 2006; 45:119-43. [PMID: 16701933 DOI: 10.1016/j.yrtph.2006.03.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Indexed: 10/24/2022]
Abstract
An analysis of current mixture theory, policy, and practice was conducted by examining standard reference texts, regulatory guidance documents, and journal articles. Although this literature contains useful theoretical concepts, clear definitions of most terminology, and well developed protocols for study design and statistical analysis, no general theoretical basis for the mechanisms and interactions of mixture toxicity could be discerned. There is also a poor understanding of the relationship between exposure-based and internal received dose metrics. This confounds data interpretation and limits reliable determinations of the nature and extent of additivity. The absence of any generally accepted classification scheme for either modes/mechanisms of toxic action or of mechanisms of toxicity interactions is problematic as it produces a cycle in which research and policy are interdependent and mutually limiting. Current regulatory guidance depends heavily on determination of toxicological similarity concluded from the presence of a few prominent constituents, assumed from a common toxicological effect, or presumed from an alleged similar toxic mode/mechanism. Additivity, or the lack of it, is largely based on extrapolation of existing knowledge for single chemicals in this context. Thus, regulatory risk assessment protocols lack authoritative theoretical underpinnings, creating substantial uncertainty. Development of comprehensive classification schemes for modes/mechanisms of toxic action and mechanisms of interaction is needed to ensure a sound theoretical foundation for mixture-related regulatory activity and provide a firm basis for iterative hypothesis development and experimental testing.
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Affiliation(s)
- L S McCarty
- L.S. McCarty Scientific Research & Consulting, 94 Oakhaven Drive, Markham, Ont., Canada L6C 1X8.
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Berlin CM, Crase BL, Fürst P, LaKind JS, Moy G, Needham LL, Pugh LC, Tully MR. Methodologic considerations for improving and facilitating human milk research. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2005; 68:1803-23. [PMID: 16176919 DOI: 10.1080/15287390500226755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Over the past several decades, interest in using human milk as a biomonitoring matrix has increased. However, it is not always an easy matter for a new mother to provide a milk sample. In this article, guidance on facilitating collection of human milk is provided. This includes addressing the mother's ease in expressing a milk sample, and engaging with many audiences to reduce the likelihood of negatively impacting the already low breastfeeding rates in the United States. In addition, this article covers concepts regarding long-term storage and integrity of human milk samples to maximize the utility of those samples, and proposed methods for improving public access to the full spectrum of human milk biomonitoring data, with context to understand the information presented. The environmental chemicals and chemical classes for which robust analytical methods exist are enumerated, and a process for prioritizing the development of analytical methods for additional environmental chemicals is described.
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Affiliation(s)
- Cheston M Berlin
- Department of Pediatrics, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
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Wang RY, Bates MN, Goldstein DA, Haynes SG, Hench KD, Lawrence RA, Paul IM, Qian Z. Human milk research for answering questions about human health. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2005; 68:1771-801. [PMID: 16176918 DOI: 10.1080/15287390500226706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Concerns regarding human milk in our society are diverse, ranging from the presence of environmental chemicals to the health of breastfed infants and the economic value of breastfeeding to society. The panel convened for the Technical Workshop on Human Milk Surveillance and Biomonitoring for Environmental Chemicals in the United States, held at the Hershey Medical Center, Pennsylvania State College of Medicine, on 24--26 September 2004, considered how human milk research may contribute to environmental health initiatives to benefit society. The panel concluded that infant, maternal, and community health can benefit from studies using human milk biomonitoring. Unlike other biological specimens, human milk provides information regarding exposure of the mother and breastfed infant to environmental chemicals. Some of the health topics relevant to this field of research include disorders of growth and development in infants, cancer origins in women, and characterization of the trend of exposure to environmental chemicals in the community. The research focus will determine the design of the study and the need for the collection of alternative biological specimens and the long-term storage of these specimens. In order to strengthen the ability to interpret study results, it is important to identify reference ranges for the chemicals measured and to control for populations with high environmental chemical exposure, because the amount of data on environmental chemical levels in human milk that is available for comparison is extremely limited. In addition, it will be necessary to validate models used to assess infant exposure from breastfeeding because of the variable nature of current models. Information on differences between individual and population risk estimates for toxicity needs to be effectively communicated to the participant. Human milk research designed to answer questions regarding health will require additional resources to meet these objectives.
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Affiliation(s)
- Richard Y Wang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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LaKind JS, Amina Wilkins A, Berlin CM. Environmental chemicals in human milk: a review of levels, infant exposures and health, and guidance for future research. Toxicol Appl Pharmacol 2004; 198:184-208. [PMID: 15236953 DOI: 10.1016/j.taap.2003.08.021] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2003] [Accepted: 08/05/2003] [Indexed: 11/25/2022]
Abstract
The aim of this review is to introduce the reader to various science and policy aspects of the topic of environmental chemicals in human milk. Although information on environmental chemicals in human milk has been available since the 1950s, it is only relatively recently that public awareness of the issue has grown. This review on environmental chemicals in human milk provides a resource summarizing what is currently known about levels and trends of environmental chemicals in human milk, potential infant exposures, and benefits of breast-feeding relative to the risks of exposures to environmental chemicals. The term "environmental chemicals," as it pertains to human milk, refers to many classes of exogenous chemicals that may be detected in human milk. For example, pharmaceutical agents and alcohol are environmental chemicals that have been found in human milk. Other chemicals, such as heavy metals and volatile organic compounds, have also been detected in human milk. Most research on environmental chemicals in human milk has concentrated on persistent, bioaccumulative, and toxic (PBT) chemicals. In this review, a description of human milk is provided, including a brief review of endogenous substances in human milk. Determinants of levels of PBTs are discussed, as are models that have been developed to predict levels of PBTs in human milk and associated body burdens in breast-feeding infants. Methodologies for human milk sampling and analysis, and concepts for consideration in interpretation and communication of study results, as developed by the Technical Workshop on Human Milk Surveillance and Research for Environmental Chemicals in the United States are described. Studies which have compared the health risks and benefits associated with breast-feeding and formula-feeding are discussed.
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