Liver function tests in workers with occupational exposure to polychlorinated biphenyls (PCBs): comparison with yusho and yu-cheng

Associations between inhalation of typical volatile and semi-volatile organic compounds in e-waste dismantling workers with liver function damage

Studies in cell culture and animal models suggest hepatotoxicity of some volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs), however, their effects in human populations under real exposure conditions have never been clarified. In this cross-sectional study, 224 participants, 38 e-waste dismantling workers and 186 subjects residing near to the dismantling sites in southern China, were evaluated for personal inhalational exposure to 72 VOCs and 91 SVOCs according to site-specific atmospheric chemical concentrations and personal exposure time. Additionally, their serum samples were subjected to liver function tests (LFTs), including total protein (TP), albumin (ALB), globulin (GLB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and bilirubin. Linear regression analysis of the VOC/SVOC levels against the LFTs results indicated that VOC exposure was negatively associated with the TP, ALB, GLB levels (indicating liver-specific protein synthesis functions), while positively associated with AST, ALT, GGT activities (marking liver damage). Somehow, SVOC exposure appeared to be positively associated with not only AST and ALT but also TP and ALB. These findings were supported by the quantile g-computation analysis and confirmed in the Bayesian kernel machine regression model. This study indicates that simultaneous inhalation of VOCs and SVOCs may impair human liver functions.

Association of Exposure to Persistent Organic Pollutants With Mortality Risk: An Analysis of Data From the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS) Study

IMPORTANCE

It has been suggested that persistent organic pollutants (POPs) are harmful to human health.

OBJECTIVE

To investigate if POP levels in plasma are associated with future mortality.

DESIGN, SETTING, AND PARTICIPANTS

Cohort study using data from the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, collected between May 2001 and June 2004 when participants reached age 70 years. Participants were followed up for 5 years after the first examination. Mortality was tracked from age 70 to 80 years. Data analysis was conducted in January and February 2018.

EXPOSURES

Eighteen POPs identified by the Stockholm Convention, including polychlorinated biphenyls (PCBs), organochlorine pesticides, and a brominated flame retardant, were measured in plasma levels by gas chromatography-mass spectrometry.

MAIN OUTCOMES AND MEASURES

All-cause mortality.

RESULTS

The study sample initially included 992 individuals (497 [50.1%] men) aged 70 years, who were examined between 2001 and 2004. At the second examination 5 years later, 814 individuals (82.1%; 412 [50.7%] women) completed follow-up. During a follow-up period of 10.0 years, 158 deaths occurred. When updated information on POP levels at ages 70 and 75 years was associated with all-cause mortality using Cox proportional hazard analyses, a significant association was found between hexa-chloro- through octa-chloro-substituted (highly chlorinated) PCBs and all-cause mortality (except PCB 194). The most significant association was observed for PCB 206 (hazard ratio [HR] for 1-SD higher natural log-transformed circulating PCB 206 levels, 1.55; 95% CI, 1.26-1.91; P < .001). Following adjustment for hypertension, diabetes, smoking, body mass index, and cardiovascular disease at baseline, most associations were no longer statistically significant, but PCBs 206, 189, 170, and 209 were still significantly associated with all-cause mortality (PCB 206: adjusted HR, 1.47; 95% CI, 1.19-1.81; PCB 189: adjusted HR, 1.29; 95% CI, 1.08-1.55; PCB 170: adjusted HR, 1.24; 95% CI, 1.02-1.52; PCB 209: adjusted HR, 1.29; 95% CI, 1.04-1.60). In a secondary analysis, these associations were mainly because of death from cardiovascular diseases rather than noncardiovascular diseases. Three organochlorine pesticides, including dichlorodiphenyldichloroethylene, and the brominated flame retardant diphenyl ether 47 were also evaluated but did not show any significant associations with all-cause mortality.

CONCLUSIONS AND RELEVANCE

Higher levels of highly chlorinated PCBs were associated with an increased mortality risk, especially from cardiovascular diseases. These results suggest that public health actions should be undertaken to minimize exposure to highly chlorinated PCBs.

Functional and structural liver abnormalities in former PCB exposed workers - analyses from the HELPcB cohort

The effects of polychlorinated biphenyls (PCB) on liver function and structure are still under debate. Although higher transaminase activity and tumor promoting potential of PCB reported for animal and human studies was suggested, these studies were not able to provide definitive evidence on the ability of these chemicals to affect liver function and contribution to tumor development. The aim of this study was to determine the influence of PCB on liver function and morphology in a cohort of former PCB exposed workers. Over 5 years, a longitudinal analysis of the association between PCB concentration and hepatic transaminases such as alanine transaminase (ALT) aspartate amino transaminase (AST) and gamma glutamyltransferase (γGT), as well as liver size and structure was undertaken. Data demonstrated a significant inverse association between PCB concentration and γGT activity levels but there was no marked relationship with AST and ALT activities. Regarding sonographic examination, a significant association was found between liver size and PCB concentration. This association remained, even after adjusting for alcohol consumption, liver affecting drugs, timespan of internal exposure, or age. No marked correlation was noted between PCB concentration and liver structure changes. In summary, an association was observed between PCB concentration and γGT activity levels as well as liver size in humans. The long-term health consequences attributed to PCB on liver and in particular in tumorigenesis are not foreseeable in our cohort thus far, but remain a focus in further ongoing surveillance.

Persistent organic pollutants and liver dysfunction biomarkers in a population-based human sample of men and women

BACKGROUND AND OBJECTIVE

Persistent organic pollutants (POPs) are stable organic compounds generated through different industrial activities. Liver is involved in the metabolism of POPs, and hence exposure to POPs may interfere with liver function. Although a few studies have shown adverse effects of POPs on liver function, large-scale studies involving humans are lacking. We performed this large population-based cross-sectional study to assess the associations between different POPs and liver dysfunction biomarkers.

METHODS

A total of 992 individuals (all aged 70 years, 50% males) were recruited as part of Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. The total toxic equivalency (TEQ) value was calculated for seven mono-ortho and two non-ortho substituted polychlorinated biphenyls (PCBs) and octachloro-p-dibenzodioxin (OCDD) to assess their toxicological effects. The association of TEQ values, summary measures of 16 PCBs (sum of PCBs) and three organochlorine pesticides (sum of OC pesticides) with liver dysfunction biomarkers (bilirubin; alkaline phosphatase, ALP; alanine aminotransferase, ALT; and gamma-glutamyltransferase, GGT) was analyzed utilizing linear regression analysis.

RESULTS

The mono-ortho PCB TEQ values were found to be significantly positively associated with bilirubin (β=0.71, P=0.008), while sum of OC pesticide concentrations was negatively associated with ALP (β=-0.02, P=0.002) after adjusting for various potential confounders. When analyzed individually, a number of different POPs were associated with ALP, ALT and bilirubin. No such association with GGT was observed.

CONCLUSION

Various POPs including PCBs, OCDD and pesticides were associated with the liver dysfunction biomarkers bilirubin, ALT and ALP, suggesting adverse effects on liver function from these environmental pollutants.

Organohalogen contaminants and Blood plasma clinical-chemical parameters in three colonies of North Atlantic Great skua (Stercorarius skua)

The present study compares blood plasma clinical-chemical parameters (BCCPs) in birds from three geographically distinct North Atlantic Great skua (Stercorarius skua) colonies. Birds from these sites bioaccumulate different POP (persistent organic pollutant) concentrations and that enabled us to compare Great skua BCCPs in different exposure scenarios. Persistent organic pollutants (organochlorines: PCB, DDT, chlordanes, HCB, HCH, mirex and brominated flame retardants: PBDEs) and nineteen BCCPs were analysed in 114 adult Great skuas sampled during summer 2009 in North Atlantic colonies at Bjørnøya (n=42), Iceland (n=57) and Shetland (n=15). Specimens from Bjørnøya had the highest blood plasma concentrations of all contaminant groups followed by Iceland and Shetland birds, respectively (ANOVA: p<0.05). Most of the 19 BCCP parameters followed the pattern of colony differences found for contaminants, with Bjørnøya having the highest concentrations. However seven BCCPs, the three liver enzymes ALKP, ALAT and GGT as well as bile acids, cholesterol, sodium and potassium, did not differ between colonies (ANOVA: p>0.05). Therefore correlation analyses of these seven BCCPs vs. POPs were done on the combined colony data while the analyses of the remaining 12 BCCPs were carried out for each colony separately. The analyses of combined colony data showed that the blood plasma concentration of liver enzymes ALAT and GGT increased with increasing concentrations of ΣPBDE and ΣHCH, HCB and ΣCHL, respectively (all Pearson's p<0.05). In Great skuas from Shetland, the important osmotic transport protein albumin increased with increasing concentrations of ΣPCB and ΣDDT, while total blood plasma protein increased with ΣPCB, ΣDDT, ΣHCH and HCB concentrations (all Pearson's p<0.05). In both Bjørnøya and Iceland skuas, blood plasma pancreatic enzyme amylase decreased with increasing ΣHCH concentrations while the erythrocyte waste product total bilirubin in blood plasma increased with increasing ΣHCH and ΣPBDE concentrations in Iceland Great skuas (all Pearson's p<0.05). In Bjørnøya birds, blood plasma urea from protein metabolism (reflects kidney function) increased with increasing ΣPBDE concentrations (Pearson's p<0.05). Furthermore, a redundancy analysis showed that 10.6% of the variations in BCCPs could be explained by the variations in POP concentrations. Based on these results we suggest that liver and renal functions could be negatively affected by different POP compounds. It is, however, uncertain if the colony BCCP differences and their relationship to POP concentrations reflect health effects that could have an overall impact on the populations via reduced survival and reproduction parameters.

Blood plasma clinical-chemical parameters as biomarker endpoints for organohalogen contaminant exposure in Norwegian raptor nestlings

Raptors are exposed to biomagnifying and toxic organohalogenated compounds (OHCs) such as organochlorines, brominated flame retardants and perfluorinated compounds. To investigate how OHC exposure may affect biochemical pathways we collected blood plasma from Norwegian northern goshawk (n=56), golden eagle (n=12) and white-tailed eagle (n=36) nestlings during three consecutive breeding seasons. We found that blood plasma concentrations of calcium, sodium, creatinine, cholesterol, albumin, total protein, urea, inorganic phosphate, protein:creatinine, urea:creatinine and uric acid:creatinine ratios and liver enzymes ALKP and ALAT were positively correlated to PCBs, chlordanes, p,p'-DDE, HCB, PFCs and/or PBDEs. Total bilirubin and glucose were negatively correlated to PCBs while magnesium and potassium were negatively correlated to HCB and p,p'-DDE. In addition, protein:creatinine and ALAT were also negatively correlated to PCBs and PFCs, respectively. The most significant relationships were found for the highly contaminated northern goshawks and white-tailed eagles. The statistical relationships between OHCs and BCCPs indicate that biochemical pathways could be influenced while it is uncertain if such changes have any health effects. The OHC concentrations were below concentrations causing reproductive toxicity in adults of other raptor species but similar to those of concern for endocrine disruption of thyroid hormones in e.g., bald eagles.

Endocrine disrupting, haematological and biochemical effects of polybrominated diphenyl ethers in a terrestrial songbird, the European starling (Sturnus vulgaris)

We exposed female European starlings (Sturnus vulgaris) during a 6month period to environmentally relevant concentrations of a pentabromodiphenyl ether (Penta-BDE) mixture (about 1740μg/kg body weight) through subcutaneous implants, and examined endocrine disruptive, haematological and biochemical effects. To investigate endocrine disrupting effects of PBDEs, testosterone, estradiol and thyroid hormones (T(3) and T(4)) were measured in the plasma. We found no significant differences between the control and exposed groups for any of the hormones. However, 14days after implantation, T(3) concentrations tended to be lower in the exposed group compared to the control group. For albumin, our results suggest that short term exposure of PBDEs may result in a negative effect on albumin, while the opposite was observed on a longer term (6months after implantation). However, from the statistical analysis, effects on albumin disappeared when excluding females that laid eggs. These results demonstrate that observed effects during the breeding season should be interpreted carefully when the breeding status of females is unknown. There were no significant differences found between the control and exposed groups for the other biochemical parameters (total protein, uric acid, cholesterol, aspartate transaminase, total antioxidative capacity, high-density lipoproteins and creatine kinase) and haematological parameters (amount of red blood cells, haemoglobin concentration, haematocrit, mean corpuscular volume and mean corpuscular haemoglobin). All together, our results suggest that European starlings, similar to other passerine species, may be less sensitive to the effects of organohalogenated pollutants, such as PBDEs, than other bird species.

Relationships between organohalogen contaminants and blood plasma clinical-chemical parameters in chicks of three raptor species from Northern Norway

Organohalogen contaminants (OHCs) may affect various physiological parameters in birds including blood chemistry. We therefore examined blood plasma clinical-chemical parameters and OHCs in golden eagle, white-tailed eagle and goshawk chicks from Northern Norway. Correlation analyses on pooled data showed that alkaline phosphatase (ALKP), glucose and creatinine were significantly negatively correlated to various OHCs (all: p<0.05; r: -0.43 to -0.55; n=23), while alanine aminotransferase (ALAT), total protein, cholesterol, uric acid, total bilirubin, ratios protein:creatinine and uric acid:creatinine were significantly positively correlated to various OHCs (all: p<0.05; r: 0.43-0.96). Based on these relationships, we suggest that the OHC concentrations found in certain raptor chicks of Northern Scandinavia may impact blood plasma biochemistry in a way that indicates impacts on liver, kidney, bone, endocrinology and metabolism. In order to elaborate further on these relationships and mechanisms, we recommend that a larger study should take place in the near future.

Facing the challenge of data transfer from animal models to humans: the case of persistent organohalogens

A well-documented fact for a group of persistent, bioaccumulating organohalogens contaminants, namely polychlorinated biphenyls (PCBs), is that appropriate regulation was delayed, on average, up to 50 years. Some of the delay may be attributed to the fact that the science of toxicology was in its infancy when PCBs were introduced in 1920's. Nevertheless, even following the development of modern toxicology this story repeats itself 45 years later with polybrominated diphenyl ethers (PBDEs) another compound of concern for public health. The question is why? One possible explanation may be the low coherence between experimental studies of toxic effects in animal models and human studies. To explore this further, we reviewed a total of 807 PubMed abstracts and full texts reporting studies of toxic effects of PCB and PBDE in animal models. Our analysis documents that human epidemiological studies of PBDE stand to gain little from animal studies due to the following: 1) the significant delay between the commercialisation of a substance and studies with animal models; 2) experimental exposure levels in animals are several orders of magnitude higher than exposures in the general human population; 3) the limited set of evidence-based endocrine endpoints; 4) the traditional testing sequence (adult animals--neonates--foetuses) postpones investigation of the critical developmental stages; 5) limited number of animal species with human-like toxicokinetics, physiology of development and pregnancy; 6) lack of suitable experimental outcomes for the purpose of epidemiological studies. Our comparison of published PCB and PBDE studies underscore an important shortcoming: history has, unfortunately, repeated itself. Broadening the crosstalk between the various branches of toxicology should therefore accelerate accumulation of data to enable timely and appropriate regulatory action.

Effects of organohalogen pollutants on haematological and urine clinical-chemical parameters in Greenland sledge dogs (Canis familiaris)

Seven West Greenland sledge dog bitches (Canis familiaris) and their three pups were fed 50-200 g of contaminated West Greenland minke whale (Balaenoptera acutorostrata) blubber, and in a control cohort eight sister bitches and their five pups were fed a similar amount pork fat. Blood plasma and urine clinical-chemical parameters were measured and compared between the bitches and pups form the control and exposed cohorts. Based on existing reference intervals, Arctic mammals may have blood clinical-chemical endpoint levels that differ from comparable species at lower latitudes. The cortisol:creatinine ratio, protein:creatinine ratio, alkaline phosphatase, cholesterol and inorganic phosphate were significantly highest (ANCOVA: all p<0.05) in the pup generation. The cortisol:creatinine ratio, cholesterol, lactate dehydrogenase and creatinine kinase were significantly higher (ANCOVA: all p<0.05) in the control group, while glucose was significantly highest (ANCOVA: p<0.05) in the exposed group. Furthermore, the blood cholesterol levels indicate that exposure via the diet to marine mammal blubber has a preventive effect on the development of cardiovascular diseases. We therefore suggest that the consumption of contaminated Arctic marine blubber impacted liver and kidney function in adult and pup sledge dogs.

Greenland sledge dogs (Canis familiaris) develop liver lesions when exposed to a chronic and dietary low dose of an environmental organohalogen cocktail

We assessed the relationship between exposure to organohalogen polluted minke whale (Balaenoptera acutorostrata) blubber and liver morphology and function in a generational controlled study of 28 Greenland sledge dogs (Canis familiaris). The prevalence of portal fibrosis, mild bile duct hyperplasia, and vascular leukocyte infiltrations was significantly higher in the exposed group (all Chi-square: p<0.05). In case of granulomas, the frequency was significantly highest in the bitches (P generation) while the prevalence of portal fibrosis was highest in the F generation (pups) (both Chi-square: p<0.05). No significant difference between exposed and controls was found for bile acid, ALAT, and ALKP, while ASAT and LDH were significantly highest in the control group (both ANOVA: p<0.05). We therefore suggest that a daily intake of 50-200g environmentally organohalogen polluted minke whale blubber can cause liver lesions in Greenland sledge dogs. It is reasonable to infer that other apex predators such as polar bears (Ursus maritimus) and humans may suffer from similar impacts.