Polychlorinated dibenzo-p-dioxins, furans, and biphenyls (PCDDs/PCDFs and PCBs) in breast milk and early childhood growth and IGF1

Polychlorinated biphenyls (PCBs) in the colostrum samples from the Yangtze River Region: Exposure profile and risk assessment

Polychlorinated biphenyls (PCBs) may transfer into the neonates through the placental transfer and via breastfeeding after the delivery, thus might be harmful to the infant. Sixty colostrum samples in the Yangtze River Region were collected to investigate the concentration, distribution pattern, and enantiomer characteristic of the PCB exposure. Among all samples, over 90% of pollutants were tetra-to hepta-chlorinated PCBs. The sum concentration of the PCB was 512 (IQR: 322-856) ng g^-1 lipid weight. Enantiomer fraction (EF) of PCB 95 and PCB 149 was found lower than the racemic value, while EFs of PCB 45 and PCB 136 were found higher and near-racemic state, respectively. The concentration pattern and enantiomeric properties of the PCBs indicated that the mothers from Mianyang had a recent exposure to PCBs. Among all samples, similar exposure and metabolic pathways of the PCB congeners were observed. PCB exposure showed no significant correlation with the birth outcome of the infants, but 43.3% of the infants have potential health risks via breastfeeding.

Trends in concentrations of selected dioxins and furans across various stages of kidney function for US adults

Exposure to dioxins and furans has the potential to affect kidney function and could be associated with chronic kidney disease. Data for US adults aged ≥ 20 years from the National Health and Nutrition Examination Survey for 1999-2004 (N = 4433) were analyzed to study trends in adjusted concentrations (AGM) of 1,2,3,7,8-pentachlorodibenzo-p-dioxin, 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin, 1,2,3,4,6,7,8-heptachlororodibenzo-p-dioxin, 1,2,3,4,6,7,8,9-octachlorodibenzo-p-dioxin, 2,3,4,7,8-pentachlorodibenzofuran, 1,2,3,4,7,8-hexachlorodibenzofuran, 1,2,3,6,7,8-hexachlorodibenzofuran, and 1,2,3,4,6,7,8-heptachlorodibenzofuran across the stages of kidney function (KF). Stages of KF were defined based on estimated glomerular filtration rate or eGFR expressed in mL/min/1.73 m2. For KF-1, eGFR was > 90, between 60 and 90 for KF-2, between 45 and 60 for KF-3A, and between 15 and 45 for KF-3B/4. AGMs for 1,2,3,7,8-pentachlorodibenzo-p-dioxin and 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin increased consistently across the full spectrum of kidney function. For example, AGMs for the total population for 1,2,3,7,8-pentachlorodibenzo-p-dioxin were 2.5, 4.5, 9.3, and 14.9 fg/g lipid for KF-1, KF-2, KF-3A, and KF-3B/4, respectively. For other six dioxins/furans, AGMs increased over KF-1 through KF-3A but then decreased for KF-3B/4, for example, 1,2,3,4,6,7,8-heptachlorodibenzofuran for males, and AGMs for KF-1, KF-2, KF-3A, and KF-3B/4 were 7.9, 8.4, 10.7, and 7.5 fg/g lipid, respectively. For 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin and 1,2,3,6,7,8-hexachlorodibenzofuran, smokers were found to have lower AGMs than nonsmokers. For example, for 1,2,3,4,6,7,8-heptaachlorodibenzo-p-dioxin, smoker-nonsmoker AGMs were 22.2 vs. 39.4 fg/g lipid at KF-1, 29.5 vs. 51.4 fg/g lipid at KF-2, 61.6 vs. 72.8 fg/g lipid at KF-3A, and 34.9 vs. 66.4 fg/g lipid at KF-3B/4. The reverse more often than not, was, however, observed for other six dioxins/furans. Smoker-nonsmoker AGMs for 1,2,3,7,8-pentachlorodibenzo-p-dioxin were 2.4 vs. 2.6 fg/g lipid at KF-1, 5.1 vs. 4.0 fg/g lipid at KF-2, 12.7 vs. 6.7 fg/g lipid at KF-3A, and 18.6 vs. 11.9 fg/g lipid at KF-3B/4. In conclusion, lipid-adjusted serum concentrations of dioxins and furans continue increasing as kidney function keeps deteriorating until KF-3A. However, these increases in serum concentrations until KF-3A may be followed by substantial decreases for selected dioxins/furans during KF-3B/4.

The insulin-like growth factor system: A target for endocrine disruptors?

The insulin-like growth factor (IGF) system is a critical regulator of growth, especially during fetal development, while also playing a central role in metabolic homeostasis. Endocrine disruptors (EDs) are ubiquitous compounds able to interfere with hormone action and impact human health. For example, exposure to EDs is associated with decreased birthweight and increased incidence of metabolic disorders. Therefore, the IGF system is a potential target for endocrine disruption. This review summarises the state of the science regarding effects of exposure to major classes of endocrine disruptors (dioxins and dioxin-like compounds, polycyclic aromatic hydrocarbons, polybrominated diphenyl ethers, phthalates, perfluoroalkyl substances and bisphenol A) on the IGF system. Evidence from both experimental models (in vitro and in vivo) and epidemiological studies is presented. In addition, possible molecular mechanisms of action and effects on methylation are discussed. There is a large body of evidence supporting the link between dioxins and dioxin-like compounds and IGF disruption, but mixed findings have been reported in human studies. On the other hand, although only a few animal studies have investigated the effects of phthalates on the IGF system, their negative association with IGF levels and methylation status has been more consistently reported in humans. For polybrominated diphenyl ethers, perfluoroalkyl substances and bisphenol A the evidence is still limited. Despite a lack of studies for some ED classes linking ED exposure to changes in IGF levels, and the need for further research to improve reproducibility and determine the degree of risk posed by EDs to the IGF system, this is clearly an area of concern.

Levels and profiles of persistent organic pollutants in breast milk in China and their potential health risks to breastfed infants: A review

Although some persistent organic pollutants (POPs) were prohibited or limited in use several decades ago, they are still frequently detected in the human body. The purpose of this study was to understand the levels and profiles of POPs in breast milk in China and assess their potential health risks among breastfed infants under six months of age. A literature review focused on China was performed for studies published from 2001 to 2020. The POP levels in breast milk along with other important variables were extracted, and then the average individual POP levels in breast milk were estimated. This review summarises the distribution of traditional and new POPs, including polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), legacy brominated flame retardants (BFRs), perfluorinated compounds (PFCs), and chlorinated paraffins (CPs) and reported notably high levels of short-chain chlorinated paraffins and 1,1-dichloro-2,2-bis (p-chlorophenyl) ethylene (p,p'-DDE) in breast milk. Although the levels of traditional POPs generally declined over time, especially p,p'-DDE and beta-hexachlorocyclohexane (β-HCH), women living in coastal areas, urban areas, and southern China still have a high body burden of certain POPs. In the present study, the estimated daily intake (EDI) of POPs through breastfeeding was used to evaluate the health risk for infants by comparing with acceptable levels. The findings suggested that infants born in coastal areas most likely suffered potential health risk from exposure to DDT, and the health risk of hexachlorobenzene (HCB) in infants in most nationwide regions remains a concern. More importantly, the EDI of PCBs for infants exceeds the safe limit on a national scale. Continuous surveillance of PCBs in breast milk is critical to evaluate the potential health effects on humans.

Halogenated organic compounds in the eggs of aquatic birds from the Gulf of Gdansk and Wloclawek Dam (Poland)

Diet is the major route of exposure to environmental contaminants in biota and, after penetration into an organism, xenobiotics continue to accumulate in the body. In birds the egg-laying process acts as a transfer mechanism for the accumulated pollutants and results in the burdening of the next generation at an early stage of development. This transfer has a strong influence on developmental disorders and even breeding success. With this in mind polybrominated diphenyl ethers (PBDE), polychlorinated dibenzo-p-dioxins and polychlorinated dibenzo furans (PCDD/Fs), as well as polychlorinated biphenyls (PCBs), were analyzed in the eggs of aquatic birds from different habitats and with different diet preferences. The highest concentration of PBDE was noted in gull eggs (198.31 ng g^-1 dw.) and the lowest in tern eggs (sandwich tern: 76.96 ng g^-1 dw.; common tern: 113.73 ng g^-1 dw). Deca-BDE was detected only in herring gull eggs from the Wloclawek reservoir. PCDDF/s were found in the eggs of terns from the southern coast of the Baltic Sea and gulls from an inland reservoir (dam) on the River Vistula close to the town of Wloclawek. The highest toxicity (birds Toxic Equivalent Factor) was found in the eggs of terns (sandwich tern - 93.97 pg g^-1 dw., common tern - 68.35 pg g^-1 dw.), and this was found to be several times higher than in herring gull eggs (18.80 pg g^-1 dw.). Non-dioxin like PCBs were ten times higher than other analyzed PCB congeners, but the congener pattern was similar to other studies.

Associations of peri-pubertal serum dioxins and polychlorinated biphenyls with growth and body composition among Russian boys in a longitudinal cohort

BACKGROUND

Childhood exposure to organochlorines has been associated with alterations in somatic growth. We evaluated the associations of peri-pubertal serum levels of dioxin-like compounds (DLCs) and nondioxin-like polychlorinated biphenyls (NDL-PCBs), with adolescent growth, body composition, and near adult height (NAH) in a longitudinal cohort study of Russian boys.

METHODS

473 8-9 year-old boys had serum DLCs and associated toxic equivalents (TEQs) and NDL-PCBs concentrations measured. Physical examinations were performed at enrollment between 2003 and 2005, and annually over 11 years to 2016; annual bio-electric impedance analysis (BIA) of body composition began in 2006. We used mixed effects models to evaluate associations of quartiles of serum chemical concentrations with longitudinal measurements through age 19 of body mass index (BMI-Z) and height (HT-Z) z-scores, annual height velocity (HV), and BIA-derived height-adjusted fat (FMi) and fat-free mass (FFMi) indexes. Potential modification by age of the associations of chemical exposures with growth was evaluated. NAH (defined as HV < 1 cm/year) and age at NAH attainment were estimated using parametric survival models accounting for right censoring.

RESULTS

The medians of serum ∑TEQs, ∑DLCs, and ∑NDL-PCBs were 21.1 pg TEQ/g lipid, 362 pg/g lipid, and 250 ng/g lipid, respectively. In multivariable models, higher serum concentrations of peri-pubertal ∑TEQs, ∑DLCs, and ∑NDL-PCBs were associated with significantly lower BMI-Z, FMi, and FFMi over 11 years of follow-up. The differences in FFMi for boys with higher versus lower ΣTEQs and ΣNDL-PCBs increased with age. In multivariable models, higher ∑NDL-PCBs were associated with lower HT-Z, with attenuation of the association with age (interaction p < 0.001). The highest versus the lowest quartiles of ∑NDL-PCBs were not associated with differences in NAH, but were associated with an average of 6 months later attainment of NAH.

CONCLUSIONS

Our findings suggest that dioxin and NDL-PCB exposures during childhood are associated with alterations in body composition and subsequent somatic growth.

Effects of perinatal dioxin exposure on development of children: a 3-year follow-up study of China cohort

The purpose of this study was to investigate the longitudinal effects of perinatal exposure to dioxin on physical growth in a 3-year follow-up study. In 2015, 27 mother-infant pairs living in an electronic waste (e-waste) dismantling region and 35 pairs living in a control region were enrolled in the present study. Breast milk samples were collected at 4 weeks after birth. Physical growth, including weight, height, and head and chest circumferences, was measured at 6 months and 3 years of age. Dioxin levels in the breast milk were measured by gas chromatography/high-resolution mass spectrometry. Levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin and toxic equivalency values in maternal breast milk of polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and PCDDs/PCDFs were significantly higher in women residing in the e-waste dismantling region. In 3-year-old boys, inverse associations were found between height and PCDDs-TEQ. In girls, positive associations were found between height and 2,3,7,8-TetraCDD, PCDDs-TEQ, and PCDDs/PCDFs-TEQ, and for weight and PCDDs-TEQ and PCDDs/PCDFs-TEQ at 3 years of age. In this study, sex-specific differences were observed in children, in whom dioxin exposure decreased growth in boys but increased growth in girls during the first 3 years of life.

In utero dioxin exposure and cardiometabolic risk in the Seveso Second Generation Study

Background/Objectives:

In utero exposure to endocrine-disrupting compounds such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) may alter risk of obesity and related metabolic disease later in life. We examined the relationship of prenatal exposure to TCDD with obesity and metabolic syndrome (MetS) in children born to a unique cohort of TCDD-exposed women resulting from a 1976 explosion in Seveso, Italy.

Subjects/Methods:

In 2014, nearly 40 years after the explosion, we enrolled 611 post-explosion offspring, 2 to 39 years of age, in the Seveso Second Generation study. In utero TCDD exposure was defined primarily as TCDD concentration measured in maternal serum collected soon after the explosion and alternately as TCDD estimated at pregnancy. We measured height, weight, waist circumference, body fat, blood pressure, and fasting blood levels of lipids and glucose, which were combined to assess body mass index (BMI) and MetS.

Results:

Children (314 female, 297 male) averaged 23.6 (±6.0) years of age. Among the 431 children ≥18 years, a 10-fold increase in initial maternal TCDD concentration was inversely associated with BMI in daughters (adj-β=−0.99 kg/m²; 95% CI −1.86, −0.12), but not sons (adj-β=0.41 kg/m²; 95% CI −0.35, 1.18) (p-int=0.02). A similar relationship was found in the younger children (2-17 years); a 10-fold increase in initial maternal TCDD was inversely associated with BMI z-score (adj-β = −0.59 kg/m²; 95% CI −1.12, −0.06) among daughters, but not sons (adj-β = 0.04 kg/m²; 95% CI −0.34, 0.41) (p-int=0.03). In contrast, in sons only, initial maternal TCDD was associated with increased risk for MetS (adj-RR = 2.09, 95% CI 1.09, 4.02). Results for TCDD estimated at pregnancy were comparable.

Conclusions:

These results suggest prenatal TCDD exposure alters cardiometabolic endpoints in a sex-specific manner. In daughters, in utero TCDD is inversely associated with adiposity measures. In sons, in utero TCDD is associated with increased risk for MetS.

Early-life exposure to endocrine disrupting chemicals associates with childhood obesity

Increasing prevalence of childhood obesity poses threats to the global health burden. Because this rising prevalence cannot be fully explained by traditional risk factors such as unhealthy diet and physical inactivity, early-life exposure to endocrine disrupting chemicals (EDCs) is recognized as emerging novel risk factors for childhood obesity. EDCs can disrupt the hormone-mediated metabolic pathways, affect children's growth and mediate the development of childhood obesity. Many organic pollutants are recently classified to be EDCs. In this review, we summarized the epidemiological and laboratory evidence related to EDCs and childhood obesity, and discussed the possible mechanisms underpinning childhood obesity and early-life exposure to non-persistent organic pollutants (phthalates, bisphenol A, triclosan) and persistent organic pollutants (dichlorodiphenyltrichloroethane, polychlorinated biphenyls, polybrominated diphenyl ethers, per- and polyfluoroalkyl substances). Understanding the relationship between EDCs and childhood obesity helps to raise public awareness and formulate public health policy to protect the youth from exposure to the harmful effects of EDCs.

Cancer Stem Cells: Emergent Nature of Tumor Emergency

A functional analysis of 167 genes overexpressed in Krebs-2 tumor initiating cells was performed. In the first part of the study, the genes were analyzed for their belonging to one or more of the three groups, which represent the three major phenotypic manifestation of malignancy of cancer cells, namely (1) proliferative self-sufficiency, (2) invasive growth and metastasis, and (3) multiple drug resistance. 96 genes out of 167 were identified as possible contributors to at least one of these fundamental properties. It was also found that substantial part of these genes are also known as genes responsible for formation and/or maintenance of the stemness of normal pluri-/multipotent stem cells. These results suggest that the malignancy is simply the ability to maintain the stem cell specific genes expression profile, and, as a consequence, the stemness itself regardless of the controlling effect of stem niches. In the second part of the study, three stress factors combined into the single concept of "generalized cellular stress," which are assumed to activate the expression of these genes, were defined. In addition, possible mechanisms for such activation were identified. The data obtained suggest the existence of a mechanism for the de novo formation of a pluripotent/stem phenotype in the subpopulation of "committed" tumor cells.

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.

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.

Prenatal exposure to polychlorinated biphenyls and fetal growth in British girls

Polychlorinated biphenyls (PCBs) are synthetic chemicals that bioaccumulate in the food chain. PCBs were used primarily for industrial applications due to their insulating and fire retardant properties, but were banned in the 1970s in the United States and in the 1980s in the United Kingdom, as adverse health effects following exposure were identified. Previous studies of populations with high PCB exposure have reported inverse associations with birth weight and gestational length. Birth weight is a powerful predictor of infant survival, and low birth weight can predispose infants to chronic conditions in adult life such as diabetes and cardiovascular diseases. Using data from the Avon Longitudinal Study of Parents and Children, we investigated the association between prenatal exposure to PCBs and fetal growth in a sample of 448 mother-daughter dyads. Concentrations of three common PCB analytes, PCB-118, PCB-153 and PCB-187, were measured in maternal serum collected during pregnancy, and fetal growth was measured by birth weight and birth length. Multivariable linear regression was used to examine the associations between PCB analytes and measures of fetal growth, after adjusting for parity, maternal age, pre-pregnancy BMI, educational status, tobacco use and gestational age of infant at sample collection. Birth length, ponderal index and gestational age were not associated with any of the PCB analytes. Mothers' educational status modified associations for PCB analytes with birthweight. We observed significant inverse associations with birth weight only among daughters of mothers with less education. Daughter's birth weight was -138.4 g lower (95% CI: -218.0, -58.9) for each 10 ng/g lipid increase in maternal serum PCB-118. Similarly, every 10 ng/g lipid increase in maternal serum PCB-153 was associated with a -41.9 g (95% CI: -71.6, -12.2) lower birth weight. Every 10 ng/g lipids increase in maternal serum PCB-187, was associated with a -170.4 g (95% CI: -306.1, -34.7) lower birth weight, among girls with mothers in the lowest education group. Our findings suggest that prenatal exposure to PCBs is inversely associated with daughters' birth weight and that mothers' education, which is a possible marker for socioeconomic status, significantly modified the association between maternal PCB concentrations and birth weight in female newborns.

Estimating national dioxins and furans emissions, major sources, intake doses, and temporal trends in Iran from 1990-2010

BACKGROUND

Polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDFs) are highly toxic persistent organic pollutants (POPs), which can cause various health outcomes, such as cancer. As a part of the National and Sub-national Burden of Disease Study (NASBOD), we aimed to estimate dioxins and furans national emissions, identify their main sources, estimate daily intake doses, and assess their trend from 1990-2010 in Iran.

METHODS

The Toolkit for Identification and Quantification of Releases of Dioxins, Furans and Other Unintentional POPs, which is developed by the United Nations Environment Programme (UNEP 2013), was used to estimate the emissions of PCDD/PCDFs from several sources into the air, water, land, residue, and other products. The daily intake doses were estimated using a linear regression of estimated emissions by UNEP Toolkit and average intake doses in other countries. Finally, the trend of PCDD/PCDFs emissions and daily intake doses were explored from 1990-2010.

RESULTS

The total emissions were estimated as 960 g Toxic Equivalents (g TEQ) for 1990 and 1957 g TEQ for 2010 (18.2 and 26.8 g TEQ per million capita, respectively). The estimations suggest that albeit contribution of open burning to PCDD/PCDFs emissions has been declining from 1990 to 2010, it remained the major source of emissions in Iran contributing to about 45.8% out of total emissions in 1990 to 35.7% in 2010. We further found that PCDD/PCDFs are mostly emitted into the ambient air, followed by residue, land, products, and water. The daily intake doses were estimated to be 3.1 and 5.4 pg TEQ/kg bw/day for 1990 and 2010, respectively. We estimated an increasing trend for PCDD/PCDFs emissions and intake doses in Iran from 1990-2010.

CONCLUSIONS

The high levels of emissions, intake doses, and their increasing trend in Iran may pose a substantial health risk to the Iranian population. Further studies with more rigorous methods are recommended but this should not circumvent taking appropriate policy actions against these pollutants. Currently, Iran has no standard for dioxins and furans. Adaptation of the World Health Organization recommended guidelines might be an appropriate starting point to control dioxins and furans emissions.

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.

The association of peripubertal serum concentrations of organochlorine chemicals and blood lead with growth and pubertal development in a longitudinal cohort of boys: a review of published results from the Russian Children's Study

Organochlorine chemicals and lead are environmental exposures that have endocrine disrupting properties (EDCs) which interfere with many aspects of hormone action. Childhood and adolescence are windows of susceptibility for adverse health effects of EDCs. Our ongoing study, the Russian Children's Study (RCS), is one of the few longitudinal studies investigating the impact of EDCs on growth and puberty in boys. It is conducted in the historically contaminated city of Chapaevsk, in the Samara region. The study focuses on evaluating the associations of persistent organochlorine chemicals and lead with growth and pubertal timing. At enrollment in 2003-2005, we collected blood from 516 boys at ages 8-9 years to measure dioxins, furans, polychlorinated biphenyls (PCBs), chlorinated pesticides and lead. At enrollment and at annual visits through the ages of 18-19 years, a physician performed physical examinations that included pubertal staging and testicular volume measurements. We review the history of Chapaevsk as a research site and summarize published RCS data on the association of peripubertal serum concentrations of organochlorines and blood lead levels with growth, pubertal onset and sexual maturity. Overall, we found that persistent organochlorines and lead negatively affected growth during puberty. Our results also suggest that total toxic equivalents (TEQs), dioxin-like compounds, organochlorine pesticides and lead may delay, while nondioxin-like-PCBs may advance, the timing of male puberty. These findings promoted remediation programs in Chapaevsk, with improvement in health indicators, resulting in Chapaevsk being designated a member of the World Health Organization (WHO) network "Healthy Cities" in 2015.

Perinatal exposure to dioxins and dioxin-like compounds and infant growth and body mass index at seven years: A pooled analysis of three European birth cohorts

BACKGROUND

Dioxins and dioxin-like compounds are endocrine disrupting chemicals (EDCs). Experimental studies suggest perinatal exposure to EDCs results in later obesity. However, the few epidemiological investigations on dioxins are inconclusive. We investigated perinatal exposure to dioxins and dioxin-like compounds, infant growth and body mass index (BMI) in childhood.

METHODS

We pooled data from 3 European birth cohorts (Belgian, Norwegian, Slovak) with exposure assessment in cord blood or breast milk. Two cohorts had dioxin-like toxicity assessed using dioxin-responsive chemical-activated luciferase expression (DR-CALUX) bioassay and one cohort had measured concentrations of dioxins, furans and dioxin-like polychlorinated biphenols with CALUX relative potency values applied. Growth was cohort- and sex-specific change in weight-for-age z-score between birth and 24months (N=367). BMI was calculated at around 7years (median 7.17, interquartile range [IQR] 7.00-7.37years, N=251), and overweight defined according to international standards for children equivalent to adult BMI >25kg/m(2) (Cole and Lobstein, 2012). We fitted multivariate models using generalized estimating equations, and tested effect modification by sex, breastfeeding and cohort. Results per 10pgCALUXTEQ/g lipid increase in exposure.

RESULTS

Dioxin exposure was highest in the Belgian and lowest in the Norwegian cohort; median (IQR) of the pooled sample 13 (12.0) pgCALUXTEQ/g lipid. Perinatal exposure to dioxins and dioxin-like compounds appeared associated with increased growth between 0 and 24months (adjusted estimate for change in z-score: β=0.07, 95% CI: -0.01, 0.14). At 7years, dioxins exposure was associated with a statistically significant increase in BMI in girls (adjusted estimate for BMI units β=0.49, 95% CI: 0.07, 0.91) but not in boys (β=-0.03, 95% CI: -0.55, 0.49) (p-interaction=0.044). Furthermore, girls had a 54% (-6%, 151%) increased risk of overweight at 7years (p-interaction=0.023).

CONCLUSION

Perinatal exposure to dioxin and dioxin-like compounds was associated with increased early infant growth, and increased BMI in school age girls. Studies in larger sample sizes are required to confirm these sex-specific effects.

Developmental Exposure to Environmental Chemicals and Metabolic Changes in Children

The incidence of childhood obesity, type 2 diabetes, and other forms of metabolic disease have been rising over the past several decades. Although diet and physical activity play important roles in these trends, other environmental factors also may contribute to this significant public health issue. In this article, we discuss the possibility that widespread exposure to endocrine-disrupting chemicals (EDCs) may contribute to the development of metabolic diseases in children. We summarize the epidemiological evidence on exposure to environmental chemicals during early development and metabolic outcomes in infants and children. Prenatal exposure to EDCs, particularly the persistent organic pollutant DDT and its metabolite DDE, may influence growth patterns during infancy and childhood. The altered growth patterns associated with EDCs vary according to exposure level, sex, exposure timing, pubertal status, and age at which growth is measured. Early exposure to air pollutants also is linked to impaired metabolism in infants and children. As a result of these and other studies, professional health provider societies have called for a reduction in environmental chemical exposures. We summarize the resources available to health care providers to counsel patients on how to reduce chemical exposures. We conclude with a discussion of environmental policies that address chemical exposures and ultimately aim to improve public health.

Effects of Perinatal Dioxin Exposure on Development of Children during the First 3 Years of Life

OBJECTIVE

To investigate the longitudinal effects of perinatal exposure to dioxin on neurodevelopment and physical growth of a birth cohort during the first 3 years of life.

STUDY DESIGN

A total of 217 mother-infant pairs living in a dioxin-contaminated area in Vietnam were followed up. Perinatal dioxin exposure of infants was estimated by the measurement of dioxin levels in breast milk of nursing mothers. Neurodevelopment of infants and children, including cognitive, language, and motor development, was determined at 4 months, 1 year, and 3 years of age. Physical growth, including weight, height, and head and abdominal circumferences, was measured at birth, 1 and 4 months, and 1 and 3 years of age. Multivariate mixed models were applied for analyzing repeated measures.

RESULTS

In boys, composite motor and gross motor scores were decreased with increasing exposure of 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TetraCDD). The high toxic equivalent of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDDs/PCDFs-TEQ) group showed a significant decrease in expressive communication score. In girls, there was no decreased score in any neurodevelopment aspects in high-exposure groups. All body size measures in boys were decreased in the high-exposure groups of 2,3,7,8-TetraCDD and PCDDs/PCDFs-TEQ. In girls, high 2,3,7,8-TetraCDD and PCDDs/PCDFs-TEQ exposure was associated with increased head and abdominal circumferences.

CONCLUSIONS

Perinatal dioxin exposure affects physical growth and neurodevelopment of infants and children in the first 3 years of life in a sex-specific manner.

Environmental pollutants and child health-A review of recent concerns

In recent years, many new studies have evaluated associations between environmental pollutants and child health. This review aims to provide a broad summary of this literature, comparing the state of epidemiological evidence for the effects of a wide range of environmental contaminants (air pollutants, heavy metals, organochlorine compounds, perfluoroalkyl substances, polybrominated diphenyl ethers, pesticides, phthalates and bisphenol A) on child health outcomes. The review addresses effects on foetal growth and prematurity, neurodevelopment, respiratory and immune health, and childhood growth and obesity. Findings of recent prospective studies and meta-analyses have corroborated previous good evidence, often at lower exposure levels, for effects on foetal growth of air pollution and polychlorinated biphenyls (PCBs), for neurotoxic effects of lead, methylmercury, PCBs and organophosphate pesticides, and for respiratory health effects of air pollution. Moderate evidence has emerged for a potential role of environmental pollutants in attention deficit hyperactivity disorder and autism (lead, PCBs, air pollution), respiratory and immune health (dichlorodiphenyldichloroethylene - DDE - and PCBs), and obesity (DDE). In addition, there is now moderate evidence that certain chemicals of relatively recent concern may be associated with adverse child health outcomes, specifically perfluorooctanoate and foetal growth, and polybrominated diphenyl ethers and neurodevelopment. For other chemicals of recent concern, such as phthalates and bisphenol A, the literature is characterised by large inconsistencies preventing strong conclusions. In conclusion, since most of the recent literature evaluates common exposures in the general population, and not particularly high exposure situations, this accumulating body of evidence suggests that the unborn and young child require more protection than is currently provided. Large, coordinated research efforts are needed to improve understanding of long-term effects of complex chemical mixtures.

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.

Dioxins and Nonortho PCBs in Breast Milk of Vietnamese Mothers Living in the Largest Hot Spot of Dioxin Contamination

Bien Hoa Air Base is the largest dioxin contamination hot spot in Vietnam. In 2012, we recruited 216 mothers who were living in 10 communities around Bien Hoa Air Base and had delivered newborns at a prefecture hospital, and we investigated recent exposure levels of dioxins and nonortho PCBs in their breast milk. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (2,3,7,8-tetraCDD) was present at 2.6 pg/g lipid in primiparae and 2.2 pg/g lipid in multiparae. Among multiparae and total subjects, significant high prevalence of 2,3,7,8-tetraCDD≥5 pg/g lipid and 2,3,7,8-tetraCDD contribution≥40% were observed in mothers living in the five communities closest to Bien Hoa Air Base. The TEQ for nonortho PCBs was 1.6 pg-TEQ/g lipid for primiparae, and this was even lower than that in the unsprayed area. The length of residency was a strong factor to increase dioxins, including 2,3,7,8-tetraCDD. Residency in the five communities with the highest exposure was a specific risk factor for increased 2,3,7,8-tetraCDD in breast milk. Food intake might contribute partly to the increased levels of dioxin congeners other than 2,3,7,8-tetraCDD in breast milk. These results suggest that Bien Hoa Air Base has led to elevated 2,3,7,8-tetraCDD levels in breast milk of mothers in nearby areas even in the recent years.

Association of placenta organotin concentrations with growth and ponderal index in 110 newborn boys from Finland during the first 18 months of life: a cohort study

BACKGROUND

Humans are exposed to tributyltin (TBT), previously used as an antifouling paint in ships, mainly through fish consumption. As TBT is a known obesogen, we studied the association of placenta TBT and other organotin compounds (OTCs) with ponderal index (PI) and growth during the first 18 months of life in boys.

METHODS

In a prospective Finnish study, 110 placenta samples were collected from mothers of boys born in 1997-1999 with (n = 55) and without (n = 55) cryptorchidism. To account for the original study design, linear regression, weighted for sampling fractions of boys with (121/55) and without (5677/55) cryptorchidism from the total cohort, was used to study the association between placenta OTCs and children's weight, length, growth rates and PI up to 18 months of age.

RESULTS

Placenta TBT concentrations were above the limit of quantification (LOQ) in 99% of the samples. However, monobutyltin (MBT), dibutyltin (DBT) and triphenyltin (TPhT) concentrations were below LOQ in 90%, 35% and 57% of samples, respectively. Placenta TBT was positively associated (p = 0.024) with weight gain during the first three months of life, but no other significant associations were observed for weight or length gain. Also, no significant associations between placenta OTC concentrations and child length, weight or PI at any time point were found.

CONCLUSIONS

We observed a trend towards higher weight gain from birth to 3 months of age with increasing placenta TBT concentration. These results should be interpreted with caution because obesogenic effects in animal experiments were seen after in-utero TBT exposures to doses that were orders of magnitude higher. Also the number of study subjects included in this study was limited.